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Goswamy R, Ajufo H, Maiti A, Brown R, Juneja H, Apostolidou E. Refractory Hydroa Vacciniforme-like Lymphoma: Biological Insights from Morphoproteomic Analysis. Int J Hematol Oncol Stem Cell Res 2022; 16:177-183. [PMID: 36694700 PMCID: PMC9831872] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/26/2021] [Indexed: 01/26/2023] Open
Abstract
T-cell/natural killer cell lymphoproliferative disorders are rare, associated with poor overall survival, and have limited treatment options. We report a case of a patient who developed hydroa vacciniforme-like lymphoma (HVLL, an EBV-peripheral T-cell lymphoma), refractory to multiple lines of systemic therapy including methotrexate, mycophenolate mofetil, dapsone, thalidomide, prednisone, and romidepsin. We conducted morphoproteomic analysis of the patient's tumor which provided important biological insights. Histopathology showed primarily lymphohistiocytic infiltrates strongly positive EBV expression with a Ki-67 of >50% in the pretreatment biopsy and approximately 90% in the post-treatment biopsy, strong expression of Enhancer of Zester Homolog 2 (EZH2), a constitutively active mTOR pathway, 50% cytoplasmic BCL-2 expression; largely negative PD-1 positive CD8 T-cells. Based on this morphoproteomic analysis and published literature, we postulated that novel agents, including venetoclax, tazemetostat, and other agents may provide a targeted approach for treating HVLL. This case illustrates the use of morphoproteomic analysis to better understand the biology of tumors.
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Affiliation(s)
- Rohit Goswamy
- Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United States
| | - Helen Ajufo
- Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United States
| | - Abhishek Maiti
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Robert Brown
- Department of Pathology and Laboratory Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United States
| | - Harinder Juneja
- Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United States
| | - Effrosyni Apostolidou
- Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United States
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Brown RE, Senniappan S, Hussain K, McGuire MF. Morphoproteomics and biomedical analytics coincide with clinical outcomes in supporting a constant but variable role for the mTOR pathway in the biology of congenital hyperinsulinism of infancy. Orphanet J Rare Dis 2017; 12:181. [PMID: 29246172 PMCID: PMC5732475 DOI: 10.1186/s13023-017-0735-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/21/2017] [Accepted: 12/06/2017] [Indexed: 11/10/2022] Open
Abstract
We first introduced the concept of the mTOR pathway’s involvement in congenital hyperinsulinism of infancy (CHI), based largely on morphoproteomic observations and clinical outcomes using sirolimus (rapamycin) as a therapeutic agent in infants refractory to octreotide and diazoxide treatment. Subsequent publications have verified the efficacy of such treatment in some cases but limited and variable in others. We present further evidence of a constant but variable role for the mTOR pathway in the biology of CHI and provide a strategy that allows for the short-term testing of sirolimus in individual CHI patients.
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Affiliation(s)
- Robert E Brown
- Department of Pathology and Laboratory Medicine, UT Health McGovern Medical School, Houston, TX, USA.
| | - Senthil Senniappan
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, L12 2AP, UK
| | - Khalid Hussain
- Department of Paediatric Medicine Division of Endocrinology, Sidra Medical & Research Center OPC, C6-337, PO Box 26999, Doha, Qatar
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Brown RE, Naqvi S, McGuire MF, Buryanek J, Karni RJ. Morphoproteomics, E6/E7 in-situ hybridization, and biomedical analytics define the etiopathogenesis of HPV-associated oropharyngeal carcinoma and provide targeted therapeutic options. J Otolaryngol Head Neck Surg 2017; 46:52. [PMID: 28818106 PMCID: PMC5561614 DOI: 10.1186/s40463-017-0230-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 08/10/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) has been identified as an etiopathogenetic factor in oropharyngeal squamous cell carcinoma. The HPV E6 and E7 oncogenes are instrumental in promoting proliferation and blocking differentiation leading to tumorigenesis. Although surgical intervention can remove such tumors, the potential for an etiologic field effect with recurrent disease is real. A downstream effector of E7 oncoprotein, enhancer of zeste homolog 2 (EZH2), is known to promote proliferation and to pose a block in differentiation and in turn, could lead to HPV-induced malignant transformation. However, the EZH2 pathway is amenable to low toxicity therapies designed to promote differentiation to a more benign state and prevent recurrent disease by inhibiting the incorporation of HPV into the genome. This is the first study using clinical specimens to demonstrate EZH2 protein expression in oropharyngeal carcinoma (OPC). METHODS The study included eight patients with oropharyngeal carcinoma, confirmed p16INK4a- positive by immunohistochemistry (IHC). The tissue expression of E6/E7 messenger RNA (mRNA) was measured by RNAscope® in-situ hybridization technology. Expression of EZH2, Ki-67, and mitotic indices were assessed by morphoproteomic analysis. Biomedical analytics expanded the results with data from Ingenuity Pathway Analysis (IPA) and KEGG databases to construct a molecular network pathway for further insights. RESULTS Expression of E6 and E7 oncogenes in p16INK4a- positive oropharyngeal carcinoma was confirmed. EZH2 and its correlates, including elevated proliferation index (Ki-67) and mitotic progression were also present. Biomedical analytics validated the relationship between HPV- E6 and E7 and the expression of the EZH2 pathway. CONCLUSION There is morphoproteomic and mRNA evidence of the association of p16INK4a-HPV infection with the E6 and E7 oncogenes and the expression of EZH2, Ki-67 and mitotic progression in oropharyngeal carcinoma. The molecular network biology was confirmed by biomedical analytics as consistent with published literature. This is significant because the biology lends itself to targeted therapeutic options using metformin, curcumin, celecoxib and sulforaphane as therapeutic strategies to prevent progression or recurrence of disease.
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Affiliation(s)
- Robert E. Brown
- Department of Pathology and Laboratory Medicine, at UT Health McGovern Medical School, Houston, TX USA
| | - Syed Naqvi
- Department of Otorhinolaryngology, Head and Neck Surgery at UT Health McGovern Medical School, Houston, TX USA
| | - Mary F. McGuire
- Department of Pathology and Laboratory Medicine, at UT Health McGovern Medical School, Houston, TX USA
| | - Jamie Buryanek
- Department of Pathology and Laboratory Medicine, at UT Health McGovern Medical School, Houston, TX USA
| | - Ron J. Karni
- Department of Otorhinolaryngology, Head and Neck Surgery at UT Health McGovern Medical School, Houston, TX USA
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Kojima YA, Assylbekova B, Zhao B, Nugent E, Brown RE. Morphoproteomics Identifies the EZH2 and SIRT1 Pathways as Potential Blocks to Differentiation in Yolk Sac Tumor of the Ovary and Provides Therapeutic Options: a Case Study. Ann Clin Lab Sci 2017; 47:88-91. [PMID: 28249923] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Yolk sac tumor of the ovary is a rare but highly malignant and aggressive germ cell tumor. The objective of this case study of an ovarian yolk sac tumor was to identify putative pathways that are known to pose a block in differentiation, both in early embryogenesis and in tumorigenesis, that might be amenable to low toxicity therapies designed to promote differentiation to a more benign state and prevent recurrent disease in such tumors. The enhancer of Zeste homolog 2 (EZH2), a histone methyl transferase, and silent mating type information regulation 2 homolog 1 (SIRT1), a NAD+ histone deacetylase, are two such pathways.
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Affiliation(s)
- Yumi A Kojima
- Department of Pathology and Laboratory Medicine, UT Health-McGovern Medical School, Houston, TX, USA
| | - Binara Assylbekova
- Department of Pathology and Laboratory Medicine, UT Health-McGovern Medical School, Houston, TX, USA
| | - Bihong Zhao
- Department of Pathology and Laboratory Medicine, UT Health-McGovern Medical School, Houston, TX, USA
| | - Elizabeth Nugent
- Department of Obstetrics and Gynecology UT Health-McGovern Medical School, Houston, TX, USA
| | - Robert E Brown
- Department of Pathology and Laboratory Medicine, UT Health-McGovern Medical School, Houston, TX, USA
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Maiti A, Brown RE, Corn PG, Murthy R, Ganeshan DM, Tsimberidou AM, Subbiah V. Antitumor Response to Combined Antiangiogenic and Cytotoxic Chemotherapy in Recurrent Metastatic Chromophobe Renal Cell Carcinoma: Response Signatures and Proteomic Correlates. Clin Genitourin Cancer 2015; 14:e187-93. [PMID: 26684814 DOI: 10.1016/j.clgc.2015.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/03/2015] [Indexed: 01/04/2023]
Affiliation(s)
- Abhishek Maiti
- Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, TX
| | - Robert E Brown
- Department of Pathology and Laboratory Medicine, University of Texas Health Sciences Center at Houston, Houston, TX
| | - Paul G Corn
- Division of Cancer Medicine, Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ravi Murthy
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Apostolia M Tsimberidou
- Division of Cancer Medicine, Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Vivek Subbiah
- Division of Cancer Medicine, Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Quesada AE, Rios A, Brown RE, Nguyen ND. Expression of constitutively activated NF-κB/mTORC pathway proteins and response to CHOP with bortezomib in a patient with angioimmunoblastic peripheral T-cell lymphoma. Clin Lymphoma Myeloma Leuk 2014; 14 Suppl:S87-9. [PMID: 25486962 DOI: 10.1016/j.clml.2014.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 06/04/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Andrés E Quesada
- Department of Pathology and Laboratory Medicine, The University of Texas at Houston, Houston, TX.
| | - Adan Rios
- Department of Internal Medicine, Division of Oncology, The University of Texas at Houston, Houston, TX
| | - Robert E Brown
- Department of Pathology and Laboratory Medicine, The University of Texas at Houston, Houston, TX
| | - Nghia D Nguyen
- Department of Pathology and Laboratory Medicine, The University of Texas at Houston, Houston, TX
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Shin D, Arthur G, Popescu M, Korkin D, Shyu CR. Uncovering influence links in molecular knowledge networks to streamline personalized medicine. J Biomed Inform 2014; 52:394-405. [PMID: 25150201 DOI: 10.1016/j.jbi.2014.08.003] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 08/04/2014] [Accepted: 08/08/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We developed Resource Description Framework (RDF)-induced InfluGrams (RIIG) - an informatics formalism to uncover complex relationships among biomarker proteins and biological pathways using the biomedical knowledge bases. We demonstrate an application of RIIG in morphoproteomics, a theranostic technique aimed at comprehensive analysis of protein circuitries to design effective therapeutic strategies in personalized medicine setting. METHODS RIIG uses an RDF "mashup" knowledge base that integrates publicly available pathway and protein data with ontologies. To mine for RDF-induced Influence Links, RIIG introduces notions of RDF relevancy and RDF collider, which mimic conditional independence and "explaining away" mechanism in probabilistic systems. Using these notions and constraint-based structure learning algorithms, the formalism generates the morphoproteomic diagrams, which we call InfluGrams, for further analysis by experts. RESULTS RIIG was able to recover up to 90% of predefined influence links in a simulated environment using synthetic data and outperformed a naïve Monte Carlo sampling of random links. In clinical cases of Acute Lymphoblastic Leukemia (ALL) and Mesenchymal Chondrosarcoma, a significant level of concordance between the RIIG-generated and expert-built morphoproteomic diagrams was observed. In a clinical case of Squamous Cell Carcinoma, RIIG allowed selection of alternative therapeutic targets, the validity of which was supported by a systematic literature review. We have also illustrated an ability of RIIG to discover novel influence links in the general case of the ALL. CONCLUSIONS Applications of the RIIG formalism demonstrated its potential to uncover patient-specific complex relationships among biological entities to find effective drug targets in a personalized medicine setting. We conclude that RIIG provides an effective means not only to streamline morphoproteomic studies, but also to bridge curated biomedical knowledge and causal reasoning with the clinical data in general.
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Affiliation(s)
- Dmitriy Shin
- University of Missouri, School of Medicine, Department of Pathology and Anatomical Sciences, Columbia, MO 65212, United States; University of Missouri, Graduate School, MU Informatics Institute, Columbia, MO 65211, United States.
| | - Gerald Arthur
- University of Missouri, School of Medicine, Department of Pathology and Anatomical Sciences, Columbia, MO 65212, United States; University of Missouri, Graduate School, MU Informatics Institute, Columbia, MO 65211, United States
| | - Mihail Popescu
- University of Missouri, School of Medicine, Department of Health Management and Informatics, Columbia, MO 65212, United States; University of Missouri, Graduate School, MU Informatics Institute, Columbia, MO 65211, United States; University of Missouri, College of Engineering, Department of Computer Science, Columbia, MO 65211, United States
| | - Dmitry Korkin
- Worcester Polytechnic Institute, Department of Computer Science, Department of Biology and Biotechnology, Department of Applied Math, Worcester, MA 01609, United States
| | - Chi-Ren Shyu
- University of Missouri, Graduate School, MU Informatics Institute, Columbia, MO 65211, United States; University of Missouri, College of Engineering, Department of Electrical and Computer Engineering, Columbia, MO 65211, United States
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Quesada A, Quesada J, Khalil K, Ferguson EC, Brown RE. Morphoproteomic study of primary pleural angiosarcoma of lymphangioendothelial lineage: a case report. Ann Clin Lab Sci 2013; 43:317-322. [PMID: 23884228] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
An unusual case of bilateral primary pleural angiosarcoma with an immunophenotype of lymphangioendothelial lineage is described. Pleural angiosarcoma is a highly malignant neoplasm for which there is currently no standard of care. A comprehensive immunophenotypic characterization established a lymphangioendothelial lineage. A morphoproteomic analysis was also performed to identify the proteins and corresponding molecular pathways activated in the patient's tumor. The information derived from the morphoproteomic studies provides insight into the biology of the tumor and may be useful in formulating therapeutic alternatives.
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Affiliation(s)
- Andres Quesada
- Department of Pathology, Internal Medicine, University of Texas Medical School at Houston, TX, USA
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Alexandrescu S, Tatevian N, Czerniak BA, Covinsky MH, Burns NK, Brown RE. Morphoproteomics provides support for TGF-β pathway signaling in the osteoclastogenesis and immune dysregulation of osteolytic Langerhans cell histiocytosis. Int J Clin Exp Pathol 2012; 5:503-511. [PMID: 22949932 PMCID: PMC3430113] [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] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 06/25/2012] [Indexed: 06/01/2023]
Abstract
Langerhans cell histiocytosis (LCH) has a challenging and still unclear pathogenesis. A body of literature points to impaired maturation of the lesional dendritic cells, and to immune dysregulation in the form of increased FoxP3 cells. Various cytokine abnormalities such as expression of transforming growth factor (TGF)-β have been reported, as well as abnormalities in lipid content in LCH cells. Morphoproteomic techniques were applied to identify the signal transduction pathways that could influence histogenesis and immune regulation in osteolytic LCH. Five pediatric cases of osteolytic LCH were examined, using antibodies against CD1a, S100, CD68, CD8, FoxP3, phosphorylated (p)-STAT3 (Tyr705), protein kinase C (PKC)-α, phospholipase (PL)D1, fatty acid synthase (FASN), and zinc finger protein, Gli2. Positive and negative controls were performed. A FoxP3(+)/CD8(+) cell ratio was calculated by counting the FoxP3+ and CD8+ cells in 10 high power fields for each case. There is induction of sonic hedgehog (SHH) mediators consistent with TGF-β signaling pathway through Smad3-dependent activation of Gli2, findings supported by the plasmalemmal and cytoplasmic expression of PKC-α and PLD1, and nuclear expression of Gli2, in lesional cells. The FoxP3+/CD8+ cell ratio is increased, ranging from 1.7-7.94. There is moderate cytoplasmic expression of FASN in most of the Langerhans cells, a finding that supports previously published phospholipid abnormalities in LCH and is consistent with PKC-α/PLD1/TGF-β signaling. With our study, we strongly suggest that the TGF-β cell signaling pathway is a major player in the pathogenesis of LCH, leading to non-canonical induction of nuclear Gli2 expression, thereby contributing to osteoclastogenesis in LCH histiocytes. It could also cause a state of immune frustration in LCH, by inducing the transformation of CD4(+)CD25(-) cells into CD4(+)/FoxP3(+) cells. This coincides with the clinical evidence of a response to thalidomide in patients with osteolytic LCH, given its reported ability to reduce TGF-beta 1 and FoxP3 cells. Such TGF-β signaling in osteoclastogenesis and immune dysregulation, and the presence of FASN in the majority of cells, have additional therapeutic implications for osteolytic LCH.
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Affiliation(s)
- Sanda Alexandrescu
- Department of Pathology, University of Texas at Houston–Health Science CenterHouston, TX, USA
| | - Nina Tatevian
- Department of Pathology, University of Texas at Houston–Health Science CenterHouston, TX, USA
| | | | - Michael H Covinsky
- Department of Pathology, University of Texas at Houston–Health Science CenterHouston, TX, USA
| | - Nadja K Burns
- Department of Pathology, University of Texas at Houston–Health Science CenterHouston, TX, USA
| | - Robert E Brown
- Department of Pathology, University of Texas at Houston–Health Science CenterHouston, TX, USA
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Dhingra S, Rodriguez ME, Shen Q, Duan X, Stanton ML, Chen L, Zhang R, Brown RE. Constitutive activation with overexpression of the mTORC2-phospholipase D1 pathway in uterine leiomyosarcoma and STUMP: morphoproteomic analysis with therapeutic implications. Int J Clin Exp Pathol 2010; 4:134-146. [PMID: 21326806 PMCID: PMC3037199] [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] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 01/26/2010] [Indexed: 05/30/2023]
Abstract
The mammalian target of rapamycin (mTOR) is centrally involved in growth, survival and metabolism. In cancer, mTOR is frequently hyperactivated and is a clinically validated target for therapy and drug development. Biologically, mTOR acts as the catalytic subunit of two functionally distinct complexes, called mTOR complex 1 (mTORC1) which is predominantly cytoplasmic in subcellular localization and mTOR complex 2 (mTORC2) which is both cytoplasmic and nuclear. mTORC1 is sensitive to the selective inhibitor rapamycin. By contrast, mTORC2 is relatively resistant to rapamycin. Moreover, its putative downstream effector, Akt phosphorylated on serine 473 represents a signal transduction pathway for tumor survival. Phospholipase D (PLD) and its product, phosphatidic acid (PA) have been implicated as an activator of mTOR signaling, including the direct phosphorylative activation of p70S6K atthreonine 389. The latter promotes cell cycle progression. In this study, we investigated the activation status and subcellular localization of mTOR and the relative expression of PLD1, as well as their downstream effectors in a spectrum of uterine smooth muscle tumors using normal myometria as controls. The results show significant activation with overexpression of phosphorylated mTORC2 complex in uterine leiomyosarcoma (ULMS) and smooth muscle tumors of uncertain malignant potential (STUMP) as evidenced by nuclear localization of p-mTOR (Ser 2448) in ULMS>STUMP>uterine leiomyoma and normal myometria (p<0.05) and with overexpression of PLD1(p<0.05). Cor-relatively, there are overexpressions of nuclear p-Akt (Ser 473) and nuclear p-p70S6K (Thr 389) in ULMS and STUMP (p<0.05). The activation with overexpression of components of the mTORC2-PLD1 pathway in ULMS and to a lesser degree in STUMP provides insight into their tumorigenic mechanisms. Thus the development of therapies designed to target mTORC2 and PLD1 activity may be beneficial in treating ULMS.
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Affiliation(s)
- Sadhna Dhingra
- Department of Pathology and Laboratory Medicine, UT Health- Medical School at Houston, 6431 Fannin St, Houston, TX 77030, USA
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