Effectors Enabling Adaptation to Mitochondrial Complex I Loss in Hürthle Cell Carcinoma

Oncocytic (Hürthle cell) carcinoma of the thyroid (HCC) is genetically characterized by complex I mitochondrial DNA mutations and widespread chromosomal losses. Here, we utilize RNA sequencing and metabolomics to identify candidate molecular effectors activated by these genetic drivers. We find glutathione biosynthesis, amino acid metabolism, mitochondrial unfolded protein response, and lipid peroxide scavenging to be increased in HCC. A CRISPR-Cas9 knockout screen in a new HCC model reveals which pathways are key for fitness, and highlights loss of GPX4, a defense against lipid peroxides and ferroptosis, as a strong liability. Rescuing complex I redox activity with the yeast NADH dehydrogenase (NDI1) in HCC cells diminishes ferroptosis sensitivity, while inhibiting complex I in normal thyroid cells augments ferroptosis induction. Our work demonstrates unmitigated lipid peroxide stress to be an HCC vulnerability that is mechanistically coupled to the genetic loss of mitochondrial complex I activity.

SIGNIFICANCE

HCC harbors abundant mitochondria, mitochondrial DNA mutations, and chromosomal losses. Using a CRISPR-Cas9 screen inspired by transcriptomic and metabolomic profiling, we identify molecular effectors essential for cell fitness. We uncover lipid peroxide stress as a vulnerability coupled to mitochondrial complex I loss in HCC. See related article by Frank et al., p. 1884. This article is highlighted in the In This Issue feature, p. 1749.

American Head and Neck Society Endocrine Surgery Section and International Thyroid Oncology Group consensus statement on mutational testing in thyroid cancer: Defining advanced thyroid cancer and its targeted treatment

BACKGROUND

The development of systemic treatment options leveraging the molecular landscape of advanced thyroid cancer is a burgeoning field. This is a multidisciplinary evidence-based statement on the definition of advanced thyroid cancer and its targeted systemic treatment.

METHODS

An expert panel was assembled, a literature review was conducted, and best practice statements were developed. The modified Delphi method was applied to assess the degree of consensus for the statements developed by the author panel.

RESULTS

A review of the current understanding of thyroid oncogenesis at a molecular level is presented and characteristics of advanced thyroid cancer are defined. Twenty statements in topics including the multidisciplinary management, molecular evaluation, and targeted systemic treatment of advanced thyroid cancer are provided.

CONCLUSIONS

With the growth in targeted treatment options for thyroid cancer, a consensus definition of advanced disease and statements regarding the utility of molecular testing and available targeted systemic therapy is warranted.

Planar Hall effect and anisotropic magnetoresistance in polar-polar interface of LaVO3-KTaO3 with strong spin-orbit coupling

Among the perovskite oxide family, KTaO₃ (KTO) has recently attracted considerable interest as a possible system for the realization of the Rashba effect. In this work, we report a novel conducting interface by placing KTO with another insulator, LaVO₃ (LVO) and report planar Hall effect (PHE) and anisotropic magnetoresistance (AMR) measurements. This interface exhibits a signature of strong spin-orbit coupling. Our experimental observations of two fold AMR and PHE at low magnetic fields (B) is similar to those obtained for topological systems and can be intuitively understood using a phenomenological theory for a Rashba spin-split system. Our experimental data show a B² dependence of AMR and PHE at low magnetic fields that could also be explained based on our model. At high fields (~8 T), we see a two fold to four fold transition in the AMR that could not be explained using only Rashba spin-split energy spectra.

Two dimensional electron gas (2DEG) at oxide interfaces is promising in modern electronic devices. Here, Wadehra et al. realize 2DEG at a novel interface composed of LaVO₃ and KTaO₃, where strong spin-orbit coupling and relativistic nature of the electrons in the 2DEG, leading to anisotropic magnetoresistance and planar Hall effect.

Widespread Chromosomal Losses and Mitochondrial DNA Alterations as Genetic Drivers in Hürthle Cell Carcinoma

Hürthle cell carcinoma of the thyroid (HCC) is a form of thyroid cancer recalcitrant to radioiodine therapy that exhibits an accumulation of mitochondria. We performed whole-exome sequencing on a cohort of primary, recurrent, and metastatic tumors, and identified recurrent mutations in DAXX, TP53, NRAS, NF1, CDKN1A, ARHGAP35, and the TERT promoter. Parallel analysis of mtDNA revealed recurrent homoplasmic mutations in subunits of complex I of the electron transport chain. Analysis of DNA copy-number alterations uncovered widespread loss of chromosomes culminating in near-haploid chromosomal content in a large fraction of HCC, which was maintained during metastatic spread. This work uncovers a distinct molecular origin of HCC compared with other thyroid malignancies.

Linear magnetoresistance and surface to bulk coupling in topological insulator thin films

We explore the temperature dependent magnetoresistance of bulk insulating topological insulator thin films. Thin films of Bi₂Se₂Te and BiSbTeSe_1.6 were grown using the pulsed laser deposition technique and subjected to transport measurements. Magnetotransport measurements indicate a non-saturating linear magnetoresistance (LMR) behavior at high magnetic field values. We present a careful analysis to explain the origin of LMR taking into consideration all the existing models of LMR. Here we consider that the bulk insulating states and the metallic surface states constitute two parallel conduction channels. Invoking this, we were able to explain linear magnetoresistance behavior as a competition between these parallel channels. We observe that the cross-over field, where LMR sets in, decreases with increasing temperature. We propose that this cross-over field can be used phenomenologically to estimate the strength of surface to bulk coupling.

Internal medicine residents reject "longer and gentler" training

BACKGROUND

Increasing complexity of medical care, coupled with limits on resident work hours, has prompted consideration of extending Internal Medicine training. It is unclear whether further hour reductions and extension of training beyond the current duration of 3 years would be accepted by trainees.

OBJECTIVE

We aimed to determine if further work-hour reductions and extension of training would be accepted by trainees and whether resident burnout affects their opinions.

DESIGN

A postal survey was sent to all 143 Internal Medicine residents at the University of Colorado School of Medicine in May 2004.

MEASUREMENTS

The survey contained questions related to opinions on work-hour limits using a 5-point Likert scale ranging from strongly agree to strongly disagree. Burnout was measured using the Maslach Burnout Inventory, organized into three subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment, with burnout defined as high EE or DP.

RESULTS

Seventy-four percent (106/143) of residents returned the survey. The vast majority (84%) of residents disagreed or strongly disagreed with extending training to 4 or 5 years. Burnout residents were less averse to extending training (strongly agree or agree, 18.9% vs 4.3%, P = .04). The majority of residents (68.9%) disagreed or strongly disagreed with establishing a 60-hour/week limit. Residents who met the criteria for burnout were more likely to agree that a 60-hour limit would be better than an 80-hour limit (strongly agree or agree, 22% vs 8%, P = .02).

CONCLUSIONS

In this program, most Internal Medicine residents are strongly opposed to extending their training to 4 or 5 years and would prefer the current 80 hours/week cap. A longer, less intense pace of Internal Medicine training seems to be less attractive in the eyes of current trainees.

Absenteeism in the workforce, Klang Valley, Malaysia--preliminary report

The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the "lost time" percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.