Progesterone induces meiosis through two obligate co-receptors with PLA2 activity

The steroid hormone progesterone (P4) regulates multiple aspects of reproductive and metabolic physiology. Classical P4 signaling operates through nuclear receptors that regulate transcription. In addition, P4 signals through membrane P4 receptors (mPRs) in a rapid nongenomic modality. Despite the established physiological importance of P4 nongenomic signaling, its detailed signal transduction remains elusive. Here, using Xenopus oocyte maturation as a well-established physiological readout of nongenomic P4 signaling, we identify the lipid hydrolase ABHD2 (α/β hydrolase domain-containing protein 2) as an essential mPRβ co-receptor to trigger meiosis. We show using functional assays coupled to unbiased and targeted cell-based lipidomics that ABHD2 possesses a phospholipase A2 (PLA2) activity that requires both P4 and mPRβ. This PLA2 activity bifurcates P4 signaling by inducing mPRβ clathrin-dependent endocytosis and producing lipid messengers that are G-protein coupled receptors agonists. Therefore, P4 drives meiosis by inducing the ABHD2 PLA2 activity that requires both mPRβ and ABHD2 as obligate co-receptors.

Lipid Signaling During Gamete Maturation

Cell lipids are differentially distributed in distinct organelles and within the leaflets of the bilayer. They can further form laterally defined sub-domains within membranes with important signaling functions. This molecular and spatial complexity offers optimal platforms for signaling with the associated challenge of dissecting these pathways especially that lipid metabolism tends to be highly interconnected. Lipid signaling has historically been implicated in gamete function, however the detailed signaling pathways involved remain obscure. In this review we focus on oocyte and sperm maturation in an effort to consolidate current knowledge of the role of lipid signaling and set the stage for future directions.

The carboxy terminal coiled-coil modulates Orai1 internalization during meiosis

Regulation of Ca²⁺ signaling is critical for the progression of cell division, especially during meiosis to prepare the egg for fertilization. The primary Ca²⁺ influx pathway in oocytes is Store-Operated Ca²⁺ Entry (SOCE). SOCE is tightly regulated during meiosis, including internalization of the SOCE channel, Orai1. Orai1 is a four-pass membrane protein with cytosolic N- and C-termini. Orai1 internalization requires a caveolin binding motif (CBM) in the N-terminus as well as the C-terminal cytosolic domain. However, the molecular determinant for Orai1 endocytosis in the C-terminus are not known. Here we show that the Orai1 C-terminus modulates Orai1 endocytosis during meiosis through a structural motif that is based on the strength of the C-terminal intersubunit coiled coil (CC) domains. Deletion mutants show that a minimal C-terminal sequence after transmembrane domain 4 (residues 260–275) supports Orai1 internalization. We refer to this region as the C-terminus Internalization Handle (CIH). Access to CIH however is dependent on the strength of the intersubunit CC. Mutants that increase the stability of the coiled coil prevent internalization independent of specific mutation. We further used human and Xenopus Orai isoforms with different propensity to form C-terminal CC and show a strong correlation between the strength of the CC and Orai internalization. Furthermore, Orai1 internalization does not depend on clathrin, flotillin or PIP2. Collectively these results argue that Orai1 internalization requires both the N-terminal CBM and C-terminal CIH where access to CIH is controlled by the strength of intersubunit C-terminal CC.

Membrane progesterone receptor induces meiosis in Xenopus oocytes through endocytosis into signaling endosomes and interaction with APPL1 and Akt2

The steroid hormone progesterone (P4) mediates many physiological processes through either nuclear receptors that modulate gene expression or membrane P4 receptors (mPRs) that mediate nongenomic signaling. mPR signaling remains poorly understood. Here we show that the topology of mPRβ is similar to adiponectin receptors and opposite to that of G-protein-coupled receptors (GPCRs). Using Xenopus oocyte meiosis as a well-established physiological readout of nongenomic P4 signaling, we demonstrate that mPRβ signaling requires the adaptor protein APPL1 and the kinase Akt2. We further show that P4 induces clathrin-dependent endocytosis of mPRβ into signaling endosome, where mPR interacts transiently with APPL1 and Akt2 to induce meiosis. Our findings outline the early steps involved in mPR signaling and expand the spectrum of mPR signaling through the multitude of pathways involving APPL1.

The steroid hormone progesterone mediates many physiological processes through either nuclear receptors that modulate gene expression, or membrane progesterone receptors (mPRs) that mediate non-genomic signaling. This study shows that non-genomic mPRβ signaling progresses through clathrin-dependent endocytosis into signaling endosomes where it interacts with and activates APPL1 and Akt2 to induce oocyte meiosis.

miRNA-dependent regulation of STIM1 expression in breast cancer

Store-operated Ca²⁺ entry (SOCE) has been shown to be important for breast cancer metastasis in xenograft mouse models. The ER Ca²⁺ sensor STIM1 and Orai plasma membrane Ca²⁺ channels molecularly mediate SOCE. Here we investigate the role of the microRNA machinery in regulating STIM1 expression. We show that STIM1 expression is regulated post-transcriptionally by the miRNA machinery and identify miR-223 and miR-150 as regulators of STIM1 expression in the luminal non-aggressive MCF7 breast cancer cell line. In contrast, STIM1 expression in the more aggressive basal triple-negative MDA-MB-231 cell line is not significantly modulated by a single miRNA species but is rather upregulated due to inhibition of the miRNA machinery through downregulation of Ago2. Consistently, overexpression of Ago2 results in decreased STIM1 protein levels in MDA-MB-231 cells. Clinically, STIM1 and Ago2 expression levels do not correlate with breast cancer progression, however in the basal subtype high STIM1 expression is associated with poorer survival. Our findings show that STIM1 expression is differentially regulated by the miRNA machinery in different cell types and argue for a role for this regulation in breast cancer.

Classification of pregnancy and labor contractions using a graph theory based analysis

In this paper, we propose a new framework to characterize the electrohysterographic (EHG) signals recorded during pregnancy and labor. The approach is based on the analysis of the propagation of the uterine electrical activity. The processing pipeline includes i) the estimation of the statistical dependencies between the different recorded EHG signals, ii) the characterization of the obtained connectivity matrices using network measures and iii) the use of these measures in clinical application: the classification between pregnancy and labor. Due to its robustness to volume conductor, we used the imaginary part of coherence in order to produce the connectivity matrix which is then transformed into a graph. We evaluate the performance of several graph measures. We also compare the results with the parameter mostly used in the literature: the peak frequency combined with the propagation velocity (PV +PF). Our results show that the use of the network measures is a promising tool to classify labor and pregnancy contractions with a small superiority of the graph strength over PV+PF.

VLDL receptor regulates membrane progesterone receptor trafficking and non-genomic signaling

Progesterone mediates its physiological functions through activation of both transcription-coupled nuclear receptors and 7-transmembrane progesterone receptors (mPRs) that transduce progesterone's rapid non-genomic actions by coupling to various signaling modules. However, the immediate mechanisms of action downstream of mPRs remain in question. Herein we use an untargeted quantitative proteomics approach to identify mPR interactors to better define progesterone non-genomic signaling. Surprisingly, we identify the VLDL Receptor (VLDLR) as an mPR partner required for its plasma membrane localization. Knocking down VLDLR abolishes non-genomic progesterone signaling, a phenotype that is rescued by overexpressing VLDLR. Mechanistically, we show that the VLDLR is required for mPR trafficking from the ER to the Golgi. Taken together, our data define a novel function for the VLDLR as a trafficking chaperone required for the mPR subcellular localization and as such non-genomic progesterone-dependent signaling.

A node-wise analysis of the uterine muscle networks for pregnancy monitoring

The recent past years have seen a noticeable increase of interest in the correlation analysis of electrohysterographic (EHG) signals in the perspective of improving the pregnancy monitoring. Here we propose a new approach based on the functional connectivity between multichannel (4×4 matrix) EHG signals recorded from the women's abdomen. The proposed pipeline includes i) the computation of the statistical couplings between the multichannel EHG signals, ii) the characterization of the connectivity matrices, computed by using the imaginary part of the coherence, based on the graph-theory analysis and iii) the use of these measures for pregnancy monitoring. The method was evaluated on a dataset of EHGs, in order to track the correlation between EHGs collected by each electrode of the matrix (called `node-wise' analysis) and follow their evolution along weeks before labor. Results showed that the strength of each node significantly increases from pregnancy to labor. Electrodes located on the median vertical axis of the uterus seemed to be the more discriminant. We speculate that the network-based analysis can be a very promising tool to improve pregnancy monitoring.

AKT1 has dual actions on the glucocorticoid receptor by cooperating with 14-3-3

Glucocorticoids are important therapeutic compounds for acute lymphoblastic leukemia (ALL). AKT1 or the protein kinase B is frequently activated in ALL, and contributes to the development of glucocorticoid resistance. We examined impact of AKT1 on glucocorticoid receptor (GR)-induced transcriptional activity in cooperation with phospho-serine/threonine-binding protein 14-3-3. AKT1 has two distinct actions on GR transcriptional activity, one through segregation of GR in the cytoplasm by phosphorylating GR at Ser-134 and subsequent association of 14-3-3, and the other through direct modulation of GR transcriptional activity in the nucleus. For the latter, AKT1 and 14-3-3 are attracted to DNA-bound GR, accompanied by AKT1-dependent p300 phosphorylation, H3S10 phosphorylation and H3K14 acetylation at the DNA site. These two actions of AKT1 regulate distinct sets of glucocorticoid-responsive genes. Our results suggest that specific inhibition of the AKT1/14-3-3 activity on the cytoplasmic retention of GR may be a promising target for treating glucocorticoid resistance observed in ALL.

Release from Xenopus oocyte prophase I meiotic arrest is independent of a decrease in cAMP levels or PKA activity

Vertebrate oocytes arrest at prophase of meiosis I as a result of high levels of cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) activity. In Xenopus, progesterone is believed to release meiotic arrest by inhibiting adenylate cyclase, lowering cAMP levels and repressing PKA. However, the exact timing and extent of the cAMP decrease is unclear, with conflicting reports in the literature. Using various in vivo reporters for cAMP and PKA at the single-cell level in real time, we fail to detect any significant changes in cAMP or PKA in response to progesterone. More interestingly, there was no correlation between the levels of PKA inhibition and the release of meiotic arrest. Furthermore, we devised conditions whereby meiotic arrest could be released in the presence of sustained high levels of cAMP. Consistently, lowering endogenous cAMP levels by >65% for prolonged time periods failed to induce spontaneous maturation. These results argue that the release of oocyte meiotic arrest in Xenopus is independent of a reduction in either cAMP levels or PKA activity, but rather proceeds through a parallel cAMP/PKA-independent pathway.

Detecting labor using graph theory on connectivity matrices of uterine EMG

Premature labor is one of the most serious health problems in the developed world. One of the main reasons for this is that no good way exists to distinguish true labor from normal pregnancy contractions. The aim of this paper is to investigate if the application of graph theory techniques to multi-electrode uterine EMG signals can improve the discrimination between pregnancy contractions and labor. To test our methods we first applied them to synthetic graphs where we detected some differences in the parameters results and changes in the graph model from pregnancy-like graphs to labor-like graphs. Then, we applied the same methods to real signals. We obtained the best differentiation between pregnancy and labor through the same parameters. Major improvements in differentiating between pregnancy and labor were obtained using a low pass windowing preprocessing step. Results show that real graphs generally became more organized when moving from pregnancy, where the graph showed random characteristics, to labor where the graph became a more small-world like graph.

Role for endocytosis of a constitutively active GPCR (GPR185) in releasing vertebrate oocyte meiotic arrest

Vertebrate oocytes are naturally arrested at prophase of meiosis I for sustained periods of time before resuming meiosis in a process called oocyte maturation that prepares the egg for fertilization. Members of the constitutively active GPR3/6/12 family of G-protein coupled receptors represent important mediators of meiotic arrest. In the frog oocyte the GPR3/12 homolog GPRx (renamed GPR185) has been shown to sustain meiotic arrest by increasing intracellular cAMP levels through GαSβγ. Here we show that GPRx is enriched at the cell membrane (~80%), recycles through an endosomal compartment at steady state, and loses its ability to signal once trapped intracellularly. Progesterone-mediated oocyte maturation is associated with significant internalization of both endogenous and overexpressed GPRx. Furthermore, a GPRx mutant that does not internalize in response to progesterone is significantly more efficient than wild-type GPRx at blocking oocyte maturation. Collectively our results argue that internalization of the constitutively active GPRx is important to release oocyte meiotic arrest.

Asymmetric photonic resonances in GaN slab waveguide for mid infrared selective filters

We demonstrate a spectrally selective reflector that exploits asymmetric photonic resonances of a 1D photonic crystal. The proposed spectrally selective reflector has a very simple structure - essentially just a single high-index slab of GaN, properly perforated, and supported by a transparent sapphire substrate. With the proper 1D array design, nearly 100% reflection is achieved with a narrow spectral width between 10 cm⁻¹ - 18 cm⁻¹, while the background reflection remains low across the entire mid-IR range. The reflection peak can be tuned over a large wavelength span based on physical parameters. Resonant transmission dips in the experimentally measured spectra corroborate the device theory and simulation, exhibiting the narrowband low-background mid-IR reflection as predicted.

African American renal transplant recipients (RTR) require higher tacrolimus doses to achieve target levels compared to white RTR: does clotrimazole help?

The number of African Americans (AAs) on the kidney waiting list is increasing in the United States. Several studies showed that AAs are at higher risk for rejection and graft loss. Because of genetic polymorphisms, AAs may metabolize calcineurin inhibitors faster than Caucasian (C) individuals. The goal of this study is to evaluate the tacrolimus (TAC) dose required to reach therapeutic levels and to assess the impact of clotrimazole on TAC metabolism in AAs compared to C patients. One hundred forty-two AA renal transplant recipients (RTRs) were compared to 309 C RTRs. Demographics were similar in both groups. Induction therapy and maintenance immunosuppression were similar in both groups and included TAC, mycophenolate acid (MPA), and steroids. The goal in all RTRs was to maintain a 12-hour trough level of 10 to 15 ng/mL in the first 3 months, 8 to 10 ng/mL for the first year, and 5 to 8 ng/mL thereafter. To achieve these levels, AA RTRs require a significantly higher dosage of TAC compared to C patients (5.9 ± 2.9 vs 3.6 ± 2 mg/d, respectively, P < .0001). By multivariate analysis, TAC dose requirements were not affected by age, gender, MPA or prednisone dose, diabetes, and renal function. Adding clotrimazole (CTM) to the RTR regimen significantly reduced the TAC dose requirements in all RTRs. When CTM was used, the TAC dose requirement was not statistically significantly different between AA and C patients (2.6 ± 1.2 mg/d vs 1.8 ± 1.5 mg/d, P = .07). We conclude that AAs required a higher TAC dose to reach the desired trough level in RTRs compared to C RTRs. The use of CTM eliminates the need for higher doses of TAC in AA RTRs. Thus, CTM may aid AA RTRs in achieving therapeutic TAC levels while reducing drug costs.

Salmonella-mediated tumor regression involves targeting of tumor myeloid suppressor cells causing a shift to M1-like phenotype and reduction in suppressive capacity

The effectiveness of attenuated Salmonella in inhibiting tumor growth has been demonstrated in many therapeutic models, but the precise mechanisms remain incompletely understood. In this study, we show that the anti-tumor capacity of Salmonella depends on a functional MyD88-TLR pathway and is independent of adaptive immune responses. Since myeloid suppressor cells play a critical role in tumor growth, we investigated the consequences of Salmonella treatment on myeloid cell recruitment, phenotypic characteristics, and functional activation in spleen and tumor tissue of B16.F1 melanoma-bearing mice. Salmonella treatment led to increased accumulation of splenic and intratumoral CD11b(+)Gr-1(+) myeloid cells, exhibiting significantly increased expression of various activation markers such as MHC class II, costimulatory molecules, and Sca-1/Ly6A proteins. Gene expression analysis showed that Salmonella treatment induced expression of iNOS, arginase-1 (ARG1), and IFN-γ in the spleen, but down-regulated IL-4 and TGF-β. Within the tumor, expression of iNOS, IFN-γ, and S100A9 was markedly increased, but ARG1, IL-4, TGF-β, and VEGF were inhibited. Functionally, splenic CD11b(+) cells maintained their suppressive capacity following Salmonella treatment, but intratumoral myeloid cells had significantly reduced suppressive capacity. Our findings demonstrate that administration of attenuated Salmonella leads to phenotypic and functional maturation of intratumoral myeloid cells making them less suppressive and hence enhancing the host's anti-tumor immune response. Modalities that inhibit myeloid suppressor cells may be useful adjuncts in cancer immunotherapy.

How to make a good egg!: The need for remodeling of oocyte Ca(2+) signaling to mediate the egg-to-embryo transition

The egg-to-embryo transition marks the initiation of multicellular organismal development and is mediated by a specialized Ca(2+) transient at fertilization. This explosive Ca(2+) signal has captured the interest and imagination of scientists for many decades, given its cataclysmic nature and necessity for the egg-to-embryo transition. Learning how the egg acquires the competency to generate this Ca(2+) transient at fertilization is essential to our understanding of the mechanisms controlling egg and the transition to embryogenesis. In this review we discuss our current knowledge of how Ca(2+) signaling pathways remodel during oocyte maturation in preparation for fertilization with a special emphasis on the frog oocyte as additional reviews in this issue will touch on this in other species.

Liver x receptors regulate the transcriptional activity of the glucocorticoid receptor: implications for the carbohydrate metabolism

GLUCOCORTICOIDS are steroid hormones that strongly influence intermediary carbohydrate metabolism by increasing the transcription rate of glucose-6-phosphatase (G6Pase), a key enzyme of gluconeogenesis, and suppress the immune system through the glucocorticoid receptor (GR). The liver X receptors (LXRs), on the other hand, bind to cholesterol metabolites, heterodimerize with the retinoid X receptor (RXR), and regulate the cholesterol turnover, the hepatic glucose metabolism by decreasing the expression of G6Pase, and repress a set of inflammatory genes in immune cells. Since the actions of these receptors overlap with each other, we evaluated the crosstalk between the GR- and LXR-mediated signaling systems. Transient transfection-based reporter assays and gene silencing methods using siRNAs for LXRs showed that overexpression/ligand (GW3965) activation of LXRs/RXRs repressed GR-stimulated transactivation of certain glucocorticoid response element (GRE)-driven promoters in a gene-specific fashion. Activation of LXRs by GW3965 attenuated dexamethasone-stimulated elevation of circulating glucose in rats. It also suppressed dexamethasone-induced mRNA expression of hepatic glucose-6-phosphatase (G6Pase) in rats, mice and human hepatoma HepG2 cells, whereas endogenous, unliganded LXRs were required for dexamethasone-induced mRNA expression of phosphoenolpyruvate carboxylase. In microarray transcriptomic analysis of rat liver, GW3965 differentially regulated glucocorticoid-induced transcriptional activity of about 15% of endogenous glucocorticoid-responsive genes. To examine the mechanism through which activated LXRs attenuated GR transcriptional activity, we examined LXRα/RXRα binding to GREs. Endogenous LXRα/RXRα bound GREs and inhibited GR binding to these DNA sequences both in in vitro and in vivo chromatin immunoprecipitation assays, while their recombinant proteins did so on classic or G6Pase GREs in gel mobility shift assays. We propose that administration of LXR agonists may be beneficial in glucocorticoid treatment- or stress-associated dysmetabolic states by directly and gene-specifically attenuating the transcriptional activity of the GR on glucose and/or lipid metabolism.

AMPK regulates metabolic actions of glucocorticoids by phosphorylating the glucocorticoid receptor through p38 MAPK

Glucocorticoids play central roles in the regulation of energy metabolism by shifting it toward catabolism, whereas AMP-activated protein kinase (AMPK) is the master regulator of energy homeostasis, sensing energy depletion and stimulating pathways of increasing fuel uptake and saving on peripheral supplies. We showed here that AMPK regulates glucocorticoid actions on carbohydrate metabolism by targeting the glucocorticoid receptor (GR) and modifying transcription of glucocorticoid-responsive genes in a tissue- and promoter-specific fashion. Activation of AMPK in rats reversed glucocorticoid-induced hepatic steatosis and suppressed glucocorticoid-mediated stimulation of glucose metabolism. Transcriptomic analysis in the liver suggested marked overlaps between the AMPK and glucocorticoid signaling pathways directed mostly from AMPK to glucocorticoid actions. AMPK accomplishes this by phosphorylating serine 211 of the human GR indirectly through phosphorylation and consequent activation of p38 MAPK and by altering attraction of transcriptional coregulators to DNA-bound GR. In human peripheral mononuclear cells, AMPK mRNA expression positively correlated with that of glucocorticoid-responsive glucocorticoid-inducible leucine zipper protein, which correlated also positively with the body mass index of subjects. These results indicate that the AMPK-mediated energy control system modulates glucocorticoid action at target tissues. Because increased action of glucocorticoids is associated with the development of metabolic disorders, activation of AMPK could be a promising target for developing pharmacological interventions to these pathologies.

A novel point mutation in helix 10 of the human glucocorticoid receptor causes generalized glucocorticoid resistance by disrupting the structure of the ligand-binding domain

CONTEXT

Generalized glucocorticoid resistance syndrome is a rare familial or sporadic condition characterized by partial insensitivity to glucocorticoids, caused by mutations in the glucocorticoid receptor (GR) gene. Most of the reported cases are adults, demonstrating symptoms associated with mineralocorticoid and/or adrenal androgen excess caused by compensatively increased secretion of the adrenocorticotropic hormone.

PATIENT

We identified a new 2-yr-old female case of generalized glucocorticoid resistance syndrome. The patient (TJ) presented with a generalized seizure associated with hypoglycemia and hypokalemia. She also had hypertension and premature pubarche, whereas dexamethasone effectively suppressed these clinical manifestations.

RESULTS

The patient's GR gene had a heterozygotic mutation (G-->A) at nucleotide position 2141 (exon 8), which resulted in substitution of arginine by glutamine at amino acid position 714 in the ligand-binding domain (LBD) of the GR alpha. Molecular analysis revealed that the mutant receptor had significantly impaired transactivation activity with a 2-fold reduction in affinity to ligand. It showed attenuated transactivation of the activation function (AF)-2 and reduced binding to a p160 nuclear receptor coactivator. Computer-based structural analysis revealed that replacement of arginine by glutamine at position 714 transmitted a conformational change to the LBD and the AF-2 transactivation surface, resulting in a decreased binding affinity to ligand and to the LXXLL coactivator motif.

CONCLUSIONS

Dexamethasone treatment is effective in controlling the premature pubarche, hypoglycemia, hypertension, and hypokalemia in this child case, wherein arginine 714 plays a key role in the proper formation of the ligand-binding pocket and the AF-2 surface of the GR alpha LBD.

Interactions of the circadian CLOCK system and the HPA axis

Organisms have developed concurrent behavioral and physiological adaptations to the strong influence of day/night cycles, as well as to unforeseen, random stress stimuli. These circadian and stress-related responses are achieved by two highly conserved and interrelated regulatory networks, the circadian CLOCK and stress systems, which respectively consist of oscillating molecular pacemakers, the Clock/Bmal1 transcription factors, and the hypothalamic-pituitary-adrenal (HPA) axis and its end-effector, the glucocorticoid receptor. These systems communicate with one another at different signaling levels and dysregulation of either system can lead to development of pathologic conditions. In this review, we summarize the mutual physiologic interactions between the circadian CLOCK system and the HPA axis, and discuss their clinical implications.

Sex hormone-binding globulin gene expression in the liver: drugs and the metabolic syndrome

Sex hormone-binding globulin (SHBG) is the main transport binding protein for sex steroid hormones in plasma and regulates their accessibility to target cells. Plasma SHBG is secreted by the liver under the control of hormones and nutritional factors. In the human hepatoma cell line (HepG2), thyroid and estrogenic hormones, and a variety of drugs including the antioestrogen tamoxifen, the phytoestrogen, genistein and mitotane (Op'DDD) increase SHBG production and SHBG gene promoter activity. In contrast, monosaccharides (glucose or fructose) effectively decrease SHBG expression by inducing lipogenesis, which reduces hepatic HNF-4alpha levels, a transcription factor that play a critical role in controlling the SHBG promoter. Interestingly, diminishing hepatic lipogenesis and free fatty acid liver biosynthesis also appear to be associated with the positive effects of thyroid hormones and PPARgamma antagonists on SHBG expression. This mechanism provides a biological explanation for why SHBG is a sensitive biomarker of insulin resistance and the metabolic syndrome, and why low plasma SHBG levels are a risk factor for developing hyperglycemia and type 2 diabetes, especially in women. These important advances in our knowledge of the regulation of SHBG expression in the liver open new approaches for identifying and preventing metabolic disorder-associated diseases early in life.

[MRI and prostatic cancer: measurements of kinetic perfusion parameters of gadolinium with a computerized-aided diagnostic tool (CAD)]

OBJECTIVES

To assess with a CAD in the peripheral (ZP) and transitional (ZT) zones the areas with modifications of the kinetic parameter Kep (ratio of exchanges between vascular compartment and extravascular extracellular spaces) in prostatic cancers with DCE MRI before radical prostatectomy.

METHODS

Forty-two consecutive patients (mean age 67 years, mean PSA: 8.9 ng/ml) with a prostatic cancer proved after a set of 12 biopsies underwent, before radical prostatectomy, a dynamic MRI (1.5T) with a surface coil after injection of gadolinium. We look with a CAD for foci of voxels with an abnormal Kep in ZP and/or in ZT. Foci of abnormal voxels computerized were compared with histological results of radical prostatectomies: prostates were shared in 12 sectors (six peripheral and six central) and a total of 504 sectors were studied. The links between prostatic capsule and foci of voxels with elevated Kep were systematically evaluated. The location and the local extension of the various cancerous foci were estimated. A comparison with the results of the T2W and T1 DCE MRI sequences without use of the CAD was made.

RESULTS

Eighty-eight percent of investigated patients revealed at least a cancerous focus associated with a group of pathological voxels. Hundred and seventy-eight of the 504 investigated prostatic sectors revealed a cancerous lesion after radical prostatectomy (RP) and 116 a focus of voxels with a pathological Kep being linked to 71 isolated lesions, some of them filling several sectors (47 peripheral and 24 transitional). The automatic research with the software of foci of voxels with a parameter Kep more than 2,2 per minute to detect a cancerous lesion had a sensitivity by sector less than the reading without CAD (69% in ZP and 58% in ZT against respectively, 85 and 66% (p<0.01) but seemed more specific: 98% in PZ and 95% in ZT against respectively, 80 and 82% (p<0.01). After RP, 16 cancers were classified Pt2, 10 Pt2R+ and 16 Pt3. The CAD had a better accuracy (74%) than T2W MRI (60%) to look for an extracapsular extension (EPE) or a risk of positive margins: 86% of extraprostatic extension and 60% of positive margins were near a focus of pathological voxels.

CONCLUSIONS

CAD allowed a computerized qualitative and quantitative study of DCE MRI. It identified and localized with a good specificity the significant foci. A focus of voxels with elevated Kep against the capsule increased significantly the risk of an extraprostatic extension or a positive margin after radical prostatectomy.

Noncoding RNA gas5 is a growth arrest- and starvation-associated repressor of the glucocorticoid receptor

The availability of nutrients influences cellular growth and survival by affecting gene transcription. Glucocorticoids also influence gene transcription and have diverse activities on cell growth, energy expenditure, and survival. We found that the growth arrest-specific 5 (Gas5) noncoding RNA, which is abundant in cells whose growth has been arrested because of lack of nutrients or growth factors, sensitized cells to apoptosis by suppressing glucocorticoid-mediated induction of several responsive genes, including the one encoding cellular inhibitor of apoptosis 2. Gas5 bound to the DNA-binding domain of the glucocorticoid receptor (GR) by acting as a decoy glucocorticoid response element (GRE), thus competing with DNA GREs for binding to the GR. We conclude that Gas5 is a "riborepressor" of the GR, influencing cell survival and metabolic activities during starvation by modulating the transcriptional activity of the GR.

Circadian rhythm transcription factor CLOCK regulates the transcriptional activity of the glucocorticoid receptor by acetylating its hinge region lysine cluster: potential physiological implications

Glucocorticoids, end products of the hypothalamic-pituitary-adrenal axis, influence functions of virtually all organs and tissues through the glucocorticoid receptor (GR). Circulating levels of glucocorticoids fluctuate naturally in a circadian fashion and regulate the transcriptional activity of GR in target tissues. The basic helix-loop-helix protein CLOCK, a histone acetyltransferase (HAT), and its heterodimer partner BMAL1 are self-oscillating transcription factors that generate circadian rhythms in both the central nervous system and periphery. We found that CLOCK/BMAL1 repressed GR-induced transcriptional activity in a HAT-activity- dependent fashion. In serum-shock-synchronized cells, transactivational activity of GR, accessed by mRNA expression of an endogenous-responsive gene, fluctuated spontaneously in a circadian fashion in reverse phase with CLOCK/BMAL1 mRNA expression. CLOCK and GR interacted with each other physically, and CLOCK suppressed binding of GR to its DNA recognition sequences by acetylating multiple lysine residues located in its hinge region. These findings indicate that CLOCK/BMAL1 functions as a reverse-phase negative regulator of glucocorticoid action in target tissues, possibly by antagonizing biological actions of diurnally fluctuating circulating glucocorticoids. Further, these results suggest that a peripheral target tissue circadian rhythm indirectly influences the functions of every organ and tissue inside the body through modulation of the ubiquitous and diverse actions of glucocorticoids.

Écho-Doppler et cancer de la prostate: option ou nécessité ?

PURPOSE

To evaluate the value of power Doppler sonography (PDS) in patients with a serum PSA level greater than 3.5 ng/ml and note the advantages of PDS in management of biopsy cores and staging in prostate cancer.

MATERIAL AND METHODS

A group of 579 patients with a serum PSA level greater than 3.5 ng/ml underwent sextant biopsies. PDS of the prostate was performed in all patients before biopsy indication. Patients underwent six initial sextant biopsies without Doppler. In 141 patients who retained an elevated serum PSA level, an additional series of six to eight ultrasound-guided biopsies with Doppler were indicated. A total of 299 cancers were diagnosed (126 palpable) after initial biopsies and 85 (13 palpable) after additional biopsies. One hundred seven patients with localized cancer (48 palpable) underwent a radical prostatectomy.

RESULTS

An echographic or vascular anomaly was detected in 335 patients; after biopsies this anomaly corresponded to 260 cancers, 39 of which were not visible (false-negative Doppler results). The negative predictive value was 84% and there was no significant relation between PSA level and negative predictive value. After initial biopsies, if an abnormal Doppler signal was present the risk of having positive additional biopsies was 83%. Abnormal disoriented irregular vessels were present in 69% of patients with a Gleason score of 7 or higher versus 31% in patients with a Gleason score less than 7 (p<0.01). Twenty out of 39 patients with T1c cancer invisible with PDS and not palpable (13% of all cancers) underwent a radical prostatectomy. Eleven of 16 cancers with a Gleason score of 6 or less were found insignificant, but in two cases the lesion was advanced (p<0.01). Of cancers with a tumor vessel crossing the capsule, 71% presented an extraprostatic extension (Se: 37.5%, Spe: 93%, PPV: 71%, NPV: 78%) (p<0.01).

CONCLUSION

In prostatic cancer, PDS allows evaluation of aggressiveness features and can optimize the number of useful biopsy cores.

Mitotane has an estrogenic effect on sex hormone-binding globulin and corticosteroid-binding globulin in humans

CONTEXT

Side effects of mitotane (o,p'-DDD) have suggested estrogenic effects.

OBJECTIVE

The objective of the study was to explore o,p'-DDD potential estrogenic effect on SHBG and corticosteroid-binding globulin (CBG).

DESIGN

Human hepatoma cell lines (HepG2), lacking estrogen receptor (ER)-alpha, and Hep89, stably transfected by ERalpha, were used.

SETTING

The study was conducted at an academic research laboratory and medical center.

PATIENTS AND OTHER PARTICIPANTS

The study included 10 male patients with recurrent adrenal carcinoma, receiving mitotane (4-6.5 g daily) for more than 6 months.

MAIN OUTCOME MEASURES

The main outcome measures were SHBG/CBG mRNA levels measured by real-time PCR, culture medium SHBG/CBG concentrations measured by specific immunoassays, and transient transfection experiments with human SHBG proximal promoter reporter constructs.

RESULTS

Increased serum SHBG and CBG concentrations, which exceeded normal male limits, were observed in most mitotane-treated patients. In the HepG2 cell line, 17beta-estradiol (E2) or o,p'-DDD treatment had no effect on mRNA or SHBG/CBG concentrations. In contrast, in the Hep89 cell line, E2 increased concentrations of SHBG (r = 0.44, P < 0.0001) and CBG (r = 0.585, P < 0.0001) secreted into culture media in a dose-dependent manner. o,p'-DDD significantly increased SHBG (150% vs. control, P < 0.05) and CBG (184% vs. control, P < 0.05) production by Hep89 cells, at a concentration of 2 x 10(-5) m. Transient transfection experiments in Hep89 cells showed that E2 or o,p'-DDD treatment did not increase the transcriptional activity of the minimal proximal promoter of human SHBG gene.

CONCLUSIONS

Mitotane increased SHBG/CBG gene expression and liver production by mechanisms requiring the presence of ERalpha.

[Obstructive malformation of the verumontanum]

The authors report the case of a 23-year-old man presenting with obstructive polypoid hyperplasia of the verumontanum, 4 cm long, inducing dysuria with residual urine, demonstrated on urethroscopy and requiring endoscopic resection. The symptoms resolved completely after treatment.

Single tooth replacement using a one-piece screw-retained restoration

This article reviews and illustrates several options available with single tooth implant prostheses. For use with internal hex implants, the authors prefer one-piece screw-retained restorations due to their easy retrievability, absence of cement, and remarkable aesthetics. The treatment procedure is outlined from presurgical prosthetic planning and surgery to the placement of the final prosthesis. The advantages and disadvantages of the technique are reviewed. The use of wide or narrow screw access channels is discussed. Selection of torque instruments and the proper levels of torque when tightening the screws are evaluated. Three clinical cases are presented to illustrate the principles reviewed in the text. The learning objective of this article is to provide up-to-date information on an implant system for screw-retained single tooth restorations.

The use of osseointegrated implants in the maxillary tuberosity

Because of the reduced amount of bone often found in the posterior maxilla, osseointegrated implants are rarely used distally to the first molar region. In order to provide adequate posterior support for a fixed bridge or a removable prosthesis and to avoid the potential problems related to cantilevers, a specific technique of placement is employed. This paper describes and evaluates a study on the clinical outcome of 65 osseointegrated implants using this technique, placed in 51 patients, with a maximum observation time of 4 years, in which the absolute success rate was 95%. Short-term results support the use of osseointegrated implants in the maxillary tuberosity. The learning objective of this article is to present this technique to a larger segment of the dental profession.

Control of two–spotted spider mite Tetranychus urticae Koch (Acari: Tetranychidae) by some selected chemicals

The experiment was conducted to study the effectiveness of four commonly used chemicals viz., deltamethrin, cypermethrin, malathion and sulphur against two-spotted spider mite (TSSM), Tetranychus urticae Koch on potted bean plants and on excised leaf discs. Mite population remained significantly lower in all treated plots except malathion treatment. The population of T. urticae differed significantly due to different chemicals and it remained lower up to 4th week on single-sprayed plants, which again increased. But in double-sprayed plants mite population was checked and remained significantly lower. The estimated LC50 values for cypermethrin, malathion, deltamethrin and sulphur were 2.9956, 15.8663, 0.5386 and 20.7045 nl.cm-2 respectively when the chemicals were sprayed before mite release. But the LC50 values for these chemicals sprayed after mite release were estimated 1.8110, 8.2746, 0.2192 and 6.8308 nl.cm-2. The use of chemicals is essential for better yield of crops. Among the four tested chemicals the pyrithroids (cypermethrin and deltamethrin) were found more effective against the TSSM than the other two. Key words: Two-spotted spider mite, Tetranychus urticae, bean, deltamethrin, cypermethrin, malathion, sulphur Univ. j. zool. Rajshahi Univ. Vol.25 2006 p.15-18