Ex Vivo Modeling of Human Neuroendocrine Tumors in Tissue Surrogates

Few models exist for studying neuroendocrine tumors (NETs), and there are mounting concerns that the currently available array of cell lines is not representative of NET biology. The lack of stable patient-derived NET xenograft models further limits the scientific community's ability to make conclusions about NETs and their response to therapy in patients. To address these limitations, we propose the use of an ex vivo 3D flow-perfusion bioreactor system for culturing and studying patient-derived NET surrogates. Herein, we demonstrate the utility of the bioreactor system for culturing NET surrogates and provide methods for evaluating the efficacy of therapeutic agents on human NET cell line xenograft constructs and patient-derived NET surrogates. We also demonstrate that patient-derived NET tissues can be propagated using the bioreactor system and investigate the near-infrared (NIR) dye IR-783 for its use in monitoring their status within the bioreactor. The results indicate that the bioreactor system and similar 3D culture models may be valuable tools for culturing patient-derived NETs and monitoring their response to therapy ex vivo.

High Fructose Corn Syrup-Moderate Fat Diet Potentiates Anxio-Depressive Behavior and Alters Ventral Striatal Neuronal Signaling

The neurobiological mechanisms that mediate psychiatric comorbidities associated with metabolic disorders such as obesity, metabolic syndrome and diabetes remain obscure. High fructose corn syrup (HFCS) is widely used in beverages and is often included in food products with moderate or high fat content that have been linked to many serious health issues including diabetes and obesity. However, the impact of such foods on the brain has not been fully characterized. Here, we evaluated the effects of long-term consumption of a HFCS-Moderate Fat diet (HFCS-MFD) on behavior, neuronal signal transduction, gut microbiota, and serum metabolomic profile in mice to better understand how its consumption and resulting obesity and metabolic alterations relate to behavioral dysfunction. Mice fed HFCS-MFD for 16 weeks displayed enhanced anxiogenesis, increased behavioral despair, and impaired social interactions. Furthermore, the HFCS-MFD induced gut microbiota dysbiosis and lowered serum levels of serotonin and its tryptophan-based precursors. Importantly, the HFCS-MFD altered neuronal signaling in the ventral striatum including reduced inhibitory phosphorylation of glycogen synthase kinase 3β (GSK3β), increased expression of ΔFosB, increased Cdk5-dependent phosphorylation of DARPP-32, and reduced PKA-dependent phosphorylation of the GluR1 subunit of the AMPA receptor. These findings suggest that HFCS-MFD-induced changes in the gut microbiota and neuroactive metabolites may contribute to maladaptive alterations in ventral striatal function that underlie neurobehavioral impairment. While future studies are essential to further evaluate the interplay between these factors in obesity and metabolic syndrome-associated behavioral comorbidities, these data underscore the important role of peripheral-CNS interactions in diet-induced behavioral and brain function. This study also highlights the clinical need to address neurobehavioral comorbidities associated with obesity and metabolic syndrome.

Non-toxic fragment of botulinum neurotoxin type A and monomethyl auristatin E conjugate for targeted therapy for neuroendocrine tumors

Surgical resection is the only cure for neuroendocrine tumors (NETs). However, widespread metastases have already occured by the time of initial diagnosis in many cases making complete surgical removal impossible. We developed a recombinant heavy-chain receptor binding domain (rHCR) of botulinum neurotoxin type A that can specifically target synaptic vesicle 2 (SV2), a surface receptor abundantly expressed in multiple neuroendocrine tumors. Expression of neuroendocrine differentiation markers chromogranin A (CgA) and achaete-scute complex 1 (ASCL1) were signficantly reduced when treated with rHCR. rHCR conjugated to the antimitotic agent monomethyl auristatin E (MMAE) significantly suppressed proliferation of pancreatic carcinoid (BON) and medullary thyroid cancer cells (MZ) at concentrations of 500 and 300 nM respectively, while no growth suppression was observed in pulmonary fibroblasts and cortical neuron control cell lines. In vivo, rHCR-MMAE significantly reduced tumor volume in mouse xenografts with no observed adverse effects. These data suggest recombinant HCR (rHCR) of BoNT/A preferentially targets neuroendocrine cancer without the neurotoxicity of the full BoNT/A and that SV2 is a specific and promising target for delivering drugs to neuroendocrine tumors.

Targeting pheochromocytoma/paraganglioma with polyamine inhibitors

BACKGROUND

Pheochromocytomas (PCCs) and paragangliomas (PGLs) are neuroendocrine tumors that are mostly benign. Metastatic disease does occur in about 10% of cases of PCC and up to 25% of PGL, and for these patients no effective therapies are available. Patients with mutations in the succinate dehydrogenase subunit B (SDHB) gene tend to have metastatic disease. We hypothesized that a down-regulation in the active succinate dehydrogenase B subunit should result in notable changes in cellular metabolic profile and could present a vulnerability point for successful pharmacological targeting.

METHODS

Metabolomic analysis was performed on human hPheo1 cells and shRNA SDHB knockdown hPheo1 (hPheo1 SDHB KD) cells. Additional analysis of 115 human fresh frozen samples was conducted. In vitro studies using N¹,N¹¹-diethylnorspermine (DENSPM) and N¹,N¹²- diethylspermine (DESPM) treatments were carried out. DENSPM efficacy was assessed in human cell line derived mouse xenografts.

RESULTS

Components of the polyamine pathway were elevated in hPheo1 SDHB KD cells compared to wild-type cells. A similar observation was noted in SDHx PCC/PGLs tissues compared to their non-mutated counterparts. Specifically, spermidine, and spermine were significantly elevated in SDHx-mutated PCC/PGLs, with a similar trend in hPheo1 SDHB KD cells. Polyamine pathway inhibitors DENSPM and DESPM effectively inhibited growth of hPheo1 cells in vitro as well in mouse xenografts.

CONCLUSIONS

This study demonstrates overactive polyamine pathway in PCC/PGL with SDHB mutations. Treatment with polyamine pathway inhibitors significantly inhibited hPheo1 cell growth and led to growth suppression in xenograft mice treated with DENSPM. These studies strongly implicate the polyamine pathway in PCC/PGL pathophysiology and provide new foundation for exploring the role for polyamine analogue inhibitors in treating metastatic PCC/PGL. PRéCIS: Cell line metabolomics on hPheo1 cells and PCC/PGL tumor tissue indicate that the polyamine pathway is activated. Polyamine inhibitors in vitro and in vivo demonstrate that polyamine inhibitors are promising for malignant PCC/PGL treatment. However, further research is warranted.

MON-199 Targeting Pheochromocytoma/Paraganglioma with Polyamine Inhibitors

Background: Pheochromocytomas (PCCs) and paragangliomas (PGLs) are neuroendocrine tumors that are mostly benign. Metastatic disease occurs in about 10% of cases, and for these patients no effective therapies are available. Patients with mutations in the succinate dehydrogenase subunit B (SDHB) gene tend to have metastatic disease with very little treatment options. To find a new treatment strategy, we utilized a metabolomics approach to identify unique metabolic pathways. A metabolomic analysis was performed on human hPheo1 cells and shRNA SDHB knockdown hPheo1 (hPheo1 SDHB KD) cells. Additional analysis of 50 human fresh frozen PCC/PGL samples was conducted. Since the polyamine pathway surfaced in the metabolomics analysis, we hypothesized that treatment with polyamine inhibitors would be an effective option for aggressive PCC/PGL tumors. In vitro studies using N1,N11-diethylnorspermine (DENSPM) and N1,N12- diethylspermine (DESPM) treatments were carried out. DENSPM efficacy was assessed in xenograft models. Results: Components of the polyamine pathway were elevated in hPheo1 SDHB KD cells compared to wild-type cells. A similar observation was noted in SDHx PCC/PGLs tumor tissues compared to their SDHB wild-type counterparts. Specifically, spermidine, and spermine were significantly elevated in SDHx-mutated PCC/PGLs, with a similar trend in hPheo1 SDHB KD cells. Polyamine pathway inhibitors DENSPM and DESPM effectively inhibited growth of hPheo1 cells in vitro as well in mouse xenografts. Conclusions: This study demonstrates overactive polyamine pathway in PCC/PGL with SDHB mutations. Treatment with polyamine inhibitors significantly inhibited hPheo1 cell growth and led to growth inhibition in xenograft mouse models treated with DENSPM. These studies strongly implicate the polyamine pathway in PCC/PGL pathophysiology and provide new foundation for exploring the role for polyamine analogue inhibitors in treating metastatic PCC/PGL.

Abstract A33: Biomarkers of Cdk5 driven neuroendocrine tumors

Background: Neuroendocrine (NE) cancers originate from secretory cells of the body's various endocrine structures. Surgical resection is the primary treatment for these tumors. However, the majority of NE cancers are metastatic at the time of detection and no effective adjuvant therapies exist for primary NE tumors or their metastases. Patients often develop two or more NE cancers, a syndrome termed multiple endocrine neoplasia (MEN). DNA sequencing has lead to breakthroughs in the identification of genes mutated in four types of familial MEN syndromes: Menin, RET, and CDNK1B. Unfortunately, a large percentage of NE cancers are sporadic, resulting from somatic mutations, and a high percentage of these do not harbor menin, RET, or CDNK1B mutations. Our lab has determined that Cdk5 promotes growth in multiple types of NE cancer. Phosphoproteomic studies revealed a selective set of proteins potentially phosphorylated downstream of Cdk5 activation. We hypothesize that these phosphoproteins will serve as biomarkers to identify tumors that will be responsive to anti-Cdk5 therapies.

Methods: Phosphorylation state-specific antibodies were generated to novel phosphoprotein sites by inoculation of New Zealand White rabbits with phosphopeptides specific to each site. Antibodies were isolated from rabbit sera by affinity purification using phosphopeptide columns. Human NE cell lines were treated with Cdk5 inhibitors and monitored for effects on phosphoprotein levels. Phosphoprotein levels were examined in growing and arrested medullary thyroid carcinoma tumors isolated from an inducible/arrestable (NSE-tTA; tetO-p25GFP) mouse model and in normal lung versus small cell lung cancer tumors isolated from a triple conditional knockout (p130 f/f; p53 f/f; Rb f/f) mouse model. Phosphoprotein levels were examined in control tissue and human medullary thyroid carcinoma, gastrointestinal NETs, and pancreatic NETs.

Results: Phosphorylation state-specific antibodies were successfully generated to 10 novel phosphoproteins. Cdk5 inhibition decreases phosphorylation levels of 5 of these 10 proteins in several types of NE cell lines. Levels of 4 of these phosphoproteins are elevated in human NE tumors.

Conclusion: Four novel phosphoproteins downstream of Cdk5 comprise a set of biomarkers for Cdk5-dependent human NE tumors. The combination of these biomarkers with pathway specific therapies currently under development will constitute a coupled diagnostic-therapeutic regimen for personalized treatment of NE cancer patients.

Citation Format: Angela M. Carter, Rahul Telange, Sarah Oltmann, Fiemu Nwariaku, Bruce Robinson, Elizabeth Grubbs, James Bibb. Biomarkers of Cdk5 driven neuroendocrine tumors. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Cancer Cell Cycle - Tumor Progression and Therapeutic Response; Feb 28-Mar 2, 2016; Orlando, FL. Philadelphia (PA): AACR; Mol Cancer Res 2016;14(11_Suppl):Abstract nr A33.

Abstract 4741: Targeting tumor growth in a medullary thyroid carcinoma mouse model using a combinatorial treatment with a tyrosine kinase inhibitor and histone deacetylase inhibitor

Neuroendocrine tumors are rare forms of cancers arising from hormone-producing cells that are scattered throughout the body. Medullary thyroid carcinoma (MTC) originates from the thyroid gland parafollicular cells. Treatment options for progressive, metastatic MTC patients are limited to the recently FDA-approved tyrosine kinase inhibitors (TKIs), Vandetanib and Cabozantinib, which target multiple receptor tyrosine kinases, including VEGFR2. However, the efficacy of TKIs is limited and development of TKI resistance is common.

Here we examined, the effect of a combinatorial drug therapy using the TKI, Nintedanib, and the histone deacetylase (HDAC) inhibitor, Romidepsin, on MTC growth in the NSE/p25-gfp bi-transgenic mouse line, an inducible MTC mouse model (see Pozo et al. 2013). The TKI- and HDAC inhibitors were administered intraperitoneally for 3 weeks and tumor growth progression was monitored using a T2 weighted magnetic resonance imaging on a 7 Tesla system. Tumor tissues were analyzed for oncogenic signaling pathways by immunoblotting and immunohistochemistry.

We find that co-administration of Nintedanib and Romidepsin stops tumor growth and increases the number of necrotic foci within the tumor tissue. Interestingly, Nintedanib treatment alone reduced tumor vascularization as shown by decreased density of the vascular marker, CD31, but did not stop parafollicular cell proliferation. Taken together, these results suggest that a combinatorial drug therapy with a TKI- and an HDAC inhibitor may be a more efficient strategy to target MTC progression and overcome recurrence.

Citation Format: Karine Pozo, Stefan Zahler, Chunfeng Tan, Keisuke Ishimatsu, Masaya Takahashi, James Bibb. Targeting tumor growth in a medullary thyroid carcinoma mouse model using a combinatorial treatment with a tyrosine kinase inhibitor and histone deacetylase inhibitor. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4741.

Abstract 3567: Identification of potential biomarkers and novel therapeutic candidates for neuroendocrine cancer

Neuroendocrine (NE) cancers originate from secretory cells of the body's various endocrine structures. Surgical resection is the primary treatment for these tumors. However, the majority of NE cancers are metastatic at the time of detection and no effective adjuvant therapies exist for primary NE tumors or their metastases. Patients often develop two or more NE cancers, a syndrome termed multiple endocrine neoplasia (MEN). DNA sequencing has lead to breakthroughs in the identification of the causes of familial forms of the four types of MEN syndromes. Mutations in a protein of unknown function, menin, are associated with MEN1. Mutations in the receptor tyrosine kinase RET are linked to MEN2 and MEN3. The cyclin-dependent kinase inhibitor, CDNK1B, is mutated in MEN4. Unfortunately, a large percentage of NE cancers are sporadic, resulting from somatic mutations, and a high percentage of these do not harbor menin, RET, or CDNK1B mutations. Due to the lack of development of successful adjuvant therapies there has been little improvement in survival rates of NE cancer patients in the past several decades. Thus, there is a great need for the elucidation of signaling molecules that promote NE tumorigenesis in order to guide the development of novel and effective treatments for this family of cancers.

Our laboratory has found that cyclin-dependent kinase 5 (Cdk5) is an important tumorigenic signaling molecule in sporadic medullary thyroid carcinoma (MTC), a type of NE cancer that originates from calcitonin-producing C cells in the thyroid. New data supports a role for Cdk5 in multiple types of NE cancer and provides a new prospective from which to explore their causes. Cdk5 is expressed in many NE cancers and inhibition of Cdk5 activity blocks growth of NE cancer cell lines. Phosphoproteomic analysis of growing versus arrested MTC tumors, induced by expression of the Cdk5 activator p25 in our transgenic mouse model of MTC, revealed elevation of over 200 phosphorylation sites. We have used short interfering peptides (SIPs) to selectively target a set of these phosphorylation sites and found that 15 of these SIPs blocked growth of NE cancer cell lines. Phosphorylation state specific antibodies were generated to several of these sites and phosphorylation levels were confirmed to be decreased in arrested MTC tumors. In conclusion, 1) multiple types of NE cancer cells are dependent on Cdk5 activity for growth, 2) phosphorylation of multiple signaling proteins is elevated downstream of Cdk5, and 3) select inhibition of these pathways blocks growth of NE cancer cells.

Future studies will focus on analysis of these phosphoproteins in human NE tumors to validate of them as biomarkers for targeted cancer therapies as well as exploration of these phosphoproteins as direct targets for developing new therapeutics that are effective against NE cancers.

Citation Format: Angela Carter, Karine Pozo, Chun-Feng Tan, Fiemu Nwariaku, James Bibb. Identification of potential biomarkers and novel therapeutic candidates for neuroendocrine cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3567. doi:10.1158/1538-7445.AM2015-3567

Abstract 163: Inhibition of p38a Regulates SERCA2a Function

Rationale: p38 MAPK is a negative regulator of cardiac contractile function, but the underlying molecular mechanism is not well understood.

Objective: To determine the molecular mechanism mediating the positive inotropic effect of p38 inhibition.

Methods and Results: The effect of p38 inhibition on calcium regulatory proteins and calcium cycling was investigated in isolated neonatal and adult rodent cardiomyocytes using chemical inhibitors, recombinant adenoviruses and RNAi. Chemical inhibition of p38 enhanced phospholamban (PLB) phosphorylation at serine 16 residue. This was recapitulated with dominant negative p38α adenovirus and by p38α RNAi, but not with dominant negative p38β adenovirus. Chemical inhibition of p38 and dominant negative p38α resulted in significant decrease in Ca 2+ -transient decay time in adult rat cardiomyocytes. Inhibition of p38α, but not p38β, induced an increase in phosphorylation of protein phosphatase inhibitor-1 at the protein kinase A site threonine 35. Analysis of underlying mechanisms revealed that p38 inhibition increased phosphorylation of G protein-coupled receptor kinase 2 (GRK2), but not GRK3 or GRK5. p38 inhibition- induced PLB phosphorylation was abolished in cardiomyocytes overexpressing wild type GRK2. In contrast, increased PLB phosphorylation upon p38 inhibition was not reduced in cardiomyocytes overexpressing GRK2 harboring a non-phosphorylatable mutation in serine 670 residue. Finally, p38 inhibition-induced shortening of Ca 2+ -transient decay time was absent in cardiomyocytes overexpressing wild type GRK2.

Conclusions: Inhibition of p38α regulates protein phosphatase inhibitor-1 resulting in increased PLB phosphorylation and enhanced SERCA2a function.

Requirement for DARPP-32 in progesterone-facilitated sexual receptivity in female rats and mice

DARPP-32, a dopamine- and adenosine 3',5'-monophosphate (cAMP)-regulated phosphoprotein (32 kilodaltons in size), is an obligate intermediate in progesterone (P)-facilitated sexual receptivity in female rats and mice. The facilitative effect of P on sexual receptivity in female rats was blocked by antisense oligonucleotides to DARPP-32. Homozygous mice carrying a null mutation for the DARPP-32 gene exhibited minimal levels of P-facilitated sexual receptivity when compared to their wild-type littermates. P significantly increased hypothalamic cAMP levels and cAMP-dependent protein kinase activity. These increases were not inhibited by a D1 subclass dopamine receptor antagonist. P also enhanced phosphorylation of DARPP-32 on threonine 34 in the hypothalamus of mice. DARPP-32 activation is thus an obligatory step in progestin receptor regulation of sexual receptivity in rats and mice.