Doxorubicin-induced upregulation of follistatin-like 3 (FSTL3): a new therapeutic target

Introduction

Doxorubicin (DOX) is among the most used anticancer drugs with associated cardiotoxicity. Follistatin-like 3 (FSTL3), a secreted member of the follistatins family that can selectively bind to members of the TGF-β superfamily, is involved in regulation of cardiac hypertrophy and heart failure. FSTL3 is also upregulated in breast and colorectal cancer tumours, is also an unfavourable prognostic indicator for various cancers.

Purpose

We aim to determine the dual role of FSTL3 in prevention of DOX-induced cardiotoxicity and synergistic anti-cancer effects.

Methods

Human cardiomyocytes (HCMs) were treated with DOX at 1uM (EC50) for 72 hours. Cell viability was assessed via CellTiter-Glo®. Secreted FSTL3 levels, as measured by ELISA (R&D systems). FSTL3 and TGF-β mRNA levels were measured by qPCR. Co-treatment of DOX with human anti-FSTL3 antibodies (Aviva Systems Biology) at 10ug/mL were introduced for 72hrs treatment.

Results

Secreted FSTL3 levels were significantly increased in DOX-treated HCMs at 72hrs compared to control (n=5, p<0.001). Consistently, FSTL3 and TGF-β mRNA levels, in collected HCMs were significantly increased in DOX-treated cells. Co-treatment of DOX with human anti-FSTL3 antibodies at 10ug/mL significantly improved HCM viability compared to IgG control group. Conversely, anti-FSTL3 antibodies provided synergistic anti-cancer effects with DOX: MCF-7 breast cancer cells were significantly reduced when co-treated with DOX and anti-FSTL3 antibody vs. IgG controls.

Conclusion

We show, for the first time, that: 1) FSTL3 is secreted directly from HCMs; 2) FSTL3 levels (both circulating and mRNA) is markedly elevated with DOX treatment; 3) neutralisation of FSTL3 in DOX-treated HCMs, restored HCM viability; and 4) exhibit synergistic anti-cancer effects with DOX. Taken together, FSTL3 is a potential target for dual anti-cancer and cardioprotective effects.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Heart Foundation of Australia Future Leader FellowshipsNSW Ministry of Health EMC FellowshipNSW Ministry of Health Translational Research Grant

Follistatin-like 3 (FSTL3) levels are increased in acute heart failure patients

Introduction

Follistatin-like 3 (FSTL3) is a secreted protein that has been suggested to play an important role in modulating cardiac remodeling and hypertrophy. In this study, we aim to determine whether: 1) FSTL3 is incrementally elevated in patients with HF vs those with other cardiovascular disease (CVD); and 2) increased FSTL3 is associated with 2 or more hospital admissions due to major adverse CV events (MACE) within 1 year.

Methods and results

We measured circulating levels of FSTL3 using commercially available ELISA (R&D systems) in a total of n=696 patients. FSTL3 levels were compared between: 1) healthy-aging volunteers with no prior major CVD (n=267, age 67±6 years) and 2) patients admitted to cardiology unit for various CVD (n=429, age 66±14 years); among those (n=178, age 68±13 years) had HF. Patients with HF had 2-fold higher FSTL3 levels vs healthy age-matched controls vs those with other CVD (p<0.001). Occurrences of MACE were recorded up to 1 year for patients admitted to cardiology unit. On univariate analyses, patient with 2 or more MACE within 1 year (n=91, 27%) had significant elevated FSTL3 levels (P=0.003), is associated with older age (P<0.005). On multivariate analysis, high FSTL3 levels (P=0.034) is an independent predictor of 2 or more MACE admissions within 1 year after adjusting for age, clinical comorbidities and medications.

Conclusions

FSTL3 is incrementally increased in patients with HF and is associated with poorer prognosis. Elevated FSTL3 levels is associated with increased risks of cardiac hospital readmissions for patients with multiple CV morbidities.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NSW Ministry of Health EMC Fellowship (Australia)

Efficacy and safety of mij821 in patients with treatment-resistant depression: Results from a randomized, placebo-controlled, proof-of-concept study

Introduction

MIJ821 is a novel N-methyl-D-aspartate (NMDA) receptor antagonist, with a potentially low rate of the psychotomimetic side effects that limit the therapeutic utility of ketamine in treatment-refractory depression (TRD).

Objectives

To assess efficacy and safety of MIJ821.

Methods

Adults with TRD (>2 prior treatment failures; Montgomery-Asberg Depression Rating Scale [MADRS], >24) were eligible and were randomized (n=70) to low versus high doses of MIJ821, with two dosing regimens of weekly or biweekly, versus ketamine versus placebo. The primary outcome was change in MADRS total score at 24 hours and final follow up was at 6 weeks.

Results

At 24 hours, adjusted mean differences (ΔAM) versus placebo were –8.25 (p=0.001), –5.71 (p=0.019) and –5.67 (p=0.046) and at 48 h were –7.06 (p=0.013), –7.37 (p=0.013), –11.02 (p=0.019) in the pooled MIJ821 low dose, high dose, and ketamine groups, respectively. At 6 weeks, ΔAM (80% CI) versus placebo on MADRS were –6.46 (–11.8, –1.15); p=0.059 for low dose MIJ821, –5.42 (–10.8, –0.02); p=0.099) for high dose MIJ821, and –5.24 (–10.4, –0.06); p=0.097 for ketamine. Further details on dosing, efficacy, and safety outcomes will be provided.

Conclusions

In this proof-of-concept study, MIJ821 was effective and tolerable in TRD. This study was funded by Novartis. Clinical trial.gov: NCT03756129

Conflict of interest

Employee of Novartis.

Thermophotovoltaic (TPV) properties of hornet cuticle as dependent on relative humidity

This paper deals with the thermophotovoltaic (TPV) properties of the cuticle of the Oriental hornet as assessed over time under different regimens of relative humidity (RH). The tests were run at two levels of RH, namely, 30% vs. 90%. Each experiment entailed measuring the cuticular voltage and current in the dark as compared to under illumination (white light = 700 Lux), and at a temperature range of 20-30 degrees C. It was found that increase in the RH level boosts the current values by 2-3 orders of magnitude; contrariwise, the voltage values rise by about three times with drop in the RH. At high RH, the changes in current become rhythmical and each cycle of warming-cooling assumes a distinctly cyclic pattern. Under illumination, the current decreases, the polarity reverses and the resistance increases. The obtained results are describable by a model of electric conductance upon a surface, in this case the hornet cuticle; the findings are also discussed and compared with similar phenomena recorded from other substances possessing the properties of organic semiconductors.

Navigation and thermophotovoltaic activity by hornets at different light conditions: the influence of UVB blockers

The aim of the present investigation was two-fold: a) to observe the homing of the Oriental hornet, Vespa orientalis (Hymenoptera, Vespinae) from different distances; and b) to study the photothermoelectric activity of hornet cuticle obtained from the subjects of goal (a) and kept frozen for a number of days prior to its testing. In both the above mentioned phases of the investigation, an attempt was made to assess how the covering of the hornets' cuticle with Ultra Violet B (UVB) blockers affects their activity as compared to the control. Flying hornets were observed to return to the nest from distances of up to 7 km, once they had learned the way back. However, covering of the cuticle with UVB blockers increases the percentage of 'non-returners' to nearly 100%. Covering the cuticle completely or partly with a number of UVB blockers (except for Sisley) proves lethal for the hornets within 24 hours. A statistical model on homing is proposed of the effect of range, of covering with UVB blockers and covering ocelli with Tippex. In the wing of the hornet there is increase in the electric current with rise in the temperature and decrease in the current upon drop of the temperature, but light has no effect on this alar (wing) current. Contrariwise, the body cuticle of the hornet responds to both temperature and illumination in terms of its electric current. Coating of the cuticle with UVB blockers causes in the wing (under all conditions of illumination) and in the cuticle (only in the dark) a moderation in the amplitude of the photothermoelectric current.