[Long-term quality of life in patients with BrownⅡ maxillary defect repaired by different methods]

Objective: To analyze the long-term quality of life of patients with Brown Ⅱ maxillary defect repaired by tissue flap or prosthesis. Methods: Patients who underwent surgery for maxillary malignant tumors in the First Affiliated Hospital of Bengbu Medical College from 2014 to 2017 were selected to investigate the postoperative long-term (>5 years) quality of life using the fourth edition of the University of Washington quality of life questionnaire (UW-QOL). Mann Whitney U test was used to examine the differences between two groups. Results: In this study, 4 cases were lost to follow-up, 9 died, and a total of 46 valid questionnaires were collected, including 24 males and 22 females, aged 19-86 years. There were 26 cases of class Ⅱb/c and 20 cases of class Ⅱd. Tissue flap reconstruction was performed in 29 cases (tissue flap group) and prosthesis restoration in 17 cases (prosthesis group). The score of chewing QOL in the prosthesis group was higher than that in the tissue flap reconstruction group (Z=-2.787, P=0.005), but the scores of entertainment, swallowing, speech and emotion QOL in the former group were respectively lower than those in the latter group (Z=-3.185, -2.091, -2.556 and -1.996, respectively, all P values<0.05). In patients with Brown Ⅱb/c defect, the prosthesis repair could improve the chewing QOL score (Z=-2.830, P=0.005), but no statistically significant differences in other QOL scores between two groups. In patients with Brown Ⅱd defect, the tissue flap reconstruction could improve the scores of pain, entertainment, swallowing and speech QOL (Z=-2.741, -2.517, -2.320 and -2.843, respectively, all P values<0.05), and the average QOL score in tissue flap reconstruction group was also higher than that of the prosthesis group (Z=-2.276, P=0.023). Conclusion: For postoperative long-term quality of life, both prosthesis and tissue flap reconstruction can offer satisfactory results in patients with Brown Ⅱb/c defect, and patients with Brown Ⅱd defect repaired by tissue flap reconstruction have better speech and swallowing functions. Tissue flap reconstruction may bring more entertainment and emotional benefits.

[Application of superficial inferior epigastric artery flaps to repair oral and maxillofacial defects with the aid of digital three-dimensional reconstruction technique]

Objective: To explore the application value of digital three-dimensional(3D) reconstruction technology in the repair of oral and maxillofacial defects with superficial inferior epigastric artery (SIEA) flap. Methods: Twelve cases of oral cancer patients, including 8 males and 4 females; aged (57.4±12.6) years, were selected from the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Bengbu Medical College from January 2018 to October 2019 and were proposed to repair with SIEA flap. There were 10 cases of squamous cell carcinoma, one case of adenoid cystic carcinoma and 1 case of mucinous epidermal carcinoma. The data were imported into AW4.7 software for post-processing. The left or right dominant donor area was selected to clarify the origin, diameter, alignment, and location of penetration point of the flap blood supply, and digital 3D reconstruction technology was used to guide the flap preoperative design. Results: Eleven cases were repaired by SIEA flap in 12 patients, one case was repaired by superficial iliac artery flap because the source artery was undiscovered, one case had venous vascular crisis after surgery, and the rest of the flap survived. In 11 patients repaired with SIEA flap, there was no significant difference between the preoperative SIEA diameter measured by CTA [(1.0±0.3) mm] and the actual measured value [(1.1±0.3) mm] (P>0.05). The follow-up was 6 to 12 months, with an average of 10 months, and the donor-receiver areas were all healed in phase Ⅰ. No obvious complications occurred, and the abdominal scar was hidden. Conclusions: In the SIEA flap repair oral and maxillofacial defect reconstruction surgery, the use of digital 3D reconstruction technology can objectively reflect the diameter and the location of the superficial artery of the abdominal wall before surgery, effectively reduce the difficulty and risk of flap surgery.

Differential expression of CD44 and CD24 markers discriminates the epitheliod from the fibroblastoid subset in a sarcomatoid renal carcinoma cell line: evidence suggesting the existence of cancer stem cells in both subsets as studied with sorted cells

Epithelioid and fibroblastoid subsets coexist in the human sarcomatoid renal cell carcinoma (sRCC) cell line, RCC52, according to previous clonal studies. Herein, using monoclonal antibodies to CD44 and CD24 markers, we identified and isolated these two populations, and showed that CD44^bright/CD24^dim and CD44^bright/CD24^bright phenotypes correspond to epithelioid and fibroblastoid subsets, respectively. Both sorted subsets displayed different levels of tumorigenicity in xenotransplantation, indicating that each harbored its own cancer stem cells (CSCs). The CD44^bright/CD24^bright subset, associated with higher expression of MMP-7, -8 and TIMP-1 transcripts, showed greater migratory/invasive potential than the CD44^bright/CD24^dim subset, which was associated with higher expression of MMP-2, -9 and TIMP-2 transcripts. Both subsets differentially expressed stemness gene products c-Myc, Oct4A, Notch1, Notch2 and Notch3, and the RCC stem cell marker, CD105 in 4-5% of RCC52 cells. These results suggest the presence of CSCs in both sRCC subsets for the first time and should therefore be considered potential therapeutic targets for this aggressive malignancy.

Molecular Characteristics of the Endometrium in Uterine Adenomyosis and Its Biochemical Microenvironment

Adenomyosis, which manifests with focally or diffusely scattered endometrial tissue within the uterine myometrium, is an endometriosis-like disease with controversial pathogenesis and compromised reproductive outcomes. This review, including the in vitro and in vivo studies performed on human or mouse models, is aimed to summarize the specific molecular characteristics of endometrium in the biochemical microenvironments of uterine adenomyosis. Many studies attributed the endometrium as the main cause of pathogenesis, with evidence of differential genetic expression and/or epigenetic modulation as well as estrogen-induced epithelial-mesenchymal transition. However, some studies indicated that the myometrium could play a role in the development of disease, based on findings of smooth muscle metaplasia and/or fibroblast-to-myofibroblast transdifferentiation by the influence of local biochemical factors. To date, it remains unclear whether adenomyosis is a genetically determined or a microenvironmentally induced disorder or whether the dysregulation of local factors may elicit the alteration of genetic expression in the endometrium. Similarly, it is uncertain whether the endometrial characteristics would remain consistent or could change along with a woman's reproductive life. Further longitudinal studies of the epigenetic controls or system biology are needed to elucidate the pathogenesis. Discovery of effective conservative treatments to improve the reproductive outcomes of patients with adenomyosis is still warranted.

Increased expression of integrin-linked kinase during decidualization regulates the morphological transformation of endometrial stromal cells

OBJECTIVE

To study the impact of integrin-linked kinase (ILK) in endometrial stromal cells (ESCs) during decidualization.

DESIGN

Laboratory study with the use of human endometrium.

SETTING

University hospital.

PATIENT(S)

Fertile reproductive-age women who had not received hormonal treatment for 3 months before tissue collection.

INTERVENTION(S)

Endometrium tissue collection, in vitro decidualization of isolated ESCs, and small interfering (si) RNA transfection.

MAIN OUTCOME MEASURE(S)

Immunohistochemistry, ELISA, Western blot analysis, methylthiazolyl tetrazolium assay, and immunofluorescence staining.

RESULT(S)

In vivo expression of ILK is significantly increased in distended-fusiform stromal cells of late secretory endometrium and in cobblestone-shaped decidual cells of early pregnancy. During in vitro decidualization for up to 8 days, confluent cultures of isolated ESCs consistently displayed increased ILK expression and morphologic transformation from fibroblast-like to polygonal cells. Subsequent ILK knockdown by siRNA transfection reversed this transformation, accompanied by decreased phosphorylation of glycogen synthase kinase (GSK) 3β and decreased viable cell numbers. Immunofluorescence staining of the decidualized ESCs demonstrated linkage of increased levels of ILK at the tips of the fan-shaped organization of actin stress fibers located in the submembranous area, which expanded the decidual cells into a typical polygonal appearance. Knock-down of ILK abrogated the polymerization and organization of actin fibers, which reverted the cells to their undecidualized morphology.

CONCLUSION(S)

During human endometrial decidualization, ILK is essential for morphologic transformation of ESCs through organization of the actin cytoskeleton; it may also function through subsequent GSK3β signaling, which requires further studies.

Decreased Endometrial Expression of Leukemia Inhibitory Factor Receptor Disrupts the STAT3 Signaling in Adenomyosis During the Implantation Window

BACKGROUND

Adenomyosis was found to have negative impacts on embryo implantation. Leukemia inhibitory factor (LIF), proposed to be a molecular marker for endometrial receptivity, works through the LIF receptor (LIFR) on both the embryo and the endometrium. We aimed to evaluate the endometrial expression of LIF and LIFR and its subsequent signaling in patients with adenomyosis during the window of implantation (WOI).

METHODS

Endometrium was obtained during the WOI from patients with adenomyosis (age <45 years) who underwent hysterectomy and from age-matched controls who had no endometriosis or adenomyosis. The LIF and LIFR expressions were measured by polymerase chain reaction for messenger RNA expression, immunohistochemistry for protein intensity and localization, and immunofluorescent staining for colocalization. The ratio of signal transducer and activator of transcription 3 (STAT3) to extracellular signal-regulated kinase (ERK) phosphorylation was measured by Western blot of both the endometrium and the isolated human endometrial stromal cells (ESCs).

RESULTS

Patients with adenomyosis showed significantly and parallelly reduced LIF and LIFR expressions in the eutopic endometrium during WOI as compared with the control women and subsequently with remarkably reduced activation of STAT3 and ERK signaling. The significantly increased STAT3 and ERK phosphorylation induced by the LIF treatment in the cultured ESCs supported the linkage between the LIF-LIFR reaction and the signaling cascade.

CONCLUSION

Significant reduction in LIFR expression and the reduced activation of subsequent signaling strongly suggest a working model of how the implantation markers, LIF, may affect the endometrium of patients with adenomyosis. These molecular changes supported the declined implantation rates reported in patients with adenomyosis.

Abstract 1729: Withaferin A blocks formation of IFN-γ-induced metastatic cancer stem cells through inhibition of the CXCR4/CXCL12 pathway in the UP-LN1 carcinoma cell model

As our understanding of cancer stem cell (CSC) biology improves, there is an urgent need to search for inhibitory agents of CSCs and metastatic CSCs (mCSCs) positive for CXCR4. Withaferin A (WA), a withanolide extracted from the medicinal plant Withania somnifera, has been shown to exhibit anti-cancer effects through multiple mechanisms. Whether WA could selectively target CSCs, mCSCs, or non-CSCs of a gastrointestinal (GI) carcinoma tumor remains unclear. Side population analysis, flow cytometric phenotyping and sorting, non-invasive imaging in conjunction with xenotransplantation, and immunohistology were used in this investigation. Using the lymph node metastatic GI cancer cell line UP-LN1, consisting of CD44high/CD24low grape-like floating (F) and CD44low/CD24high adherent (A) cell subsets, this study demonstrated that, as compared with parental UP-LN1 cells or A cells, WA preferentially reduced F-cell proliferation, tumor sphere formation, and side population cells in vitro in greater efficiencies by apoptosis. This action was mechanistically mediated via the down-regulation of CXCR4/CXCL12 and STAT3/IL-6 pathways, both of which are instrumental in the acquisition of metastatic ability. Attenuation of IFN-γ-induced CXCR4 expression in F cells by knockdown with siRNA or blocking with anti-CXCR4 antibody, followed by Western blot analysis, showed significantly reduced metastatic potential in vitro. The extent of in vitro anti-invasive effect of WA on the IFN-γ-treated F cells was significantly greater than on the F cells without WA treatment, or F cells treated with control siRNA or with control IgG antibody. The observed in vitro effects of WA on the CSC and mCSC targeting were validated by data obtained with non-invasive imaging in NOD/SCID mouse xenotransplantation. We conclude that WA could efficiently block the formation of both CSCs and mCSCs in the UP-LN1 cell line, suggesting that WA may be considered an effective therapeutic agent for GI malignancies exhibiting grape-like tumor sphere.

Citation Format: Andy Shau-Bin Chou, Li-Lei Ting, Chin-Hsuan Hsieh, See-Tong Pang, Shuen-Kuei Liao. Withaferin A blocks formation of IFN-γ-induced metastatic cancer stem cells through inhibition of the CXCR4/CXCL12 pathway in the UP-LN1 carcinoma cell model. [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 1729.

Abstract 3349: Differential expression of CD44 and CD24 markers discriminates the epithelioid from fibroblastoid subset in a sarcomatoid renal cell carcinoma cell line: evidence of the existence of cancer stem cells in both subsets

The co-existence of epithelioid and fibroblastoid subsets in the human sarcomatoid renal carcinoma cell line, RCC52, has been demonstrated previously based on clonal studies, in which only the epithelioid subset was found to be tumorigenic in NOD/SCID mice. Since only few clonal isolates were used to analyze in that study, we argued that the tumorigenicity results might not be truly reflective of this tumor line. We therefore in this study determined to use cytofluorometrically sorted cells to re-evaluate certain biological parameters including xenotransplantation. Using two monoclonal antibodies to CD44 and CD24 markers, we succeeded in identification and isolation of the two populations, and showed the CD44bright/CD24dim and CD44bright/CD24bright phenotypes corresponding to the epithelioid and fibroblastoid subsets, respectively. At variance with the results of clonal studies, both cytofluorometrically sorted subsets displayed different but significant degrees of tumorigenicities, indicating that each subset harbored its own cancer stem cells (CSCs). In consistence with the tumorigenicity findings, both sorted subsets showed in vitro migratory/invasive potential with greater ability exhibited by the CD44bright/CD24bright subset which was associated with higher expression of MMP-7, -8 and TIMP-1 transcripts. On the other hand, the CD44bright/CD24dim subset was found to be associated with higher expression of MMP-2, -9 and TIMP-2 transcripts. Furthermore, both sorted subsets expressed the RCC stem cell marker CD105 in a small proportion of cells (4-5%), and were able to covert to PAX2+ clear cells in areas in the xenografts to a greater extent by the CD44bright/CD24dim subset, highlighting high plasticity of each subset in different ways. Collectively, our findings confirm the co-existence of two morphologically and phenotypically distinct subsets, and document the presence of CSCs in both subsets for the first time in sarcomatoid RCC. The CSCs/mCSCs in the two subsets should therefore be considered as emerging therapeutic targets in the design of future treatment strategies for this subtype of renal cancer.

Citation Format: Chin-Hsuan Hsieh, Cheng-Keng Chuang, See-Tung Pang, Samuel Chien, Paul Lin, Shuen-Kuei Liao. Differential expression of CD44 and CD24 markers discriminates the epithelioid from fibroblastoid subset in a sarcomatoid renal cell carcinoma cell line: evidence of the existence of cancer stem cells in both subsets. [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 3349.

EBV oncogene N-LMP1 induces CD4 T cell-mediated angiogenic blockade in the murine tumor model

Antivascular immunity may provide long-term protection by preventing neovascularization that precedes tumor progression. Although the tumorigenesis promoted by EBV-encoded oncogene latent membrane protein 1 derived from Taiwanese nasopharyngeal carcinoma (N-LMP1) has been demonstrated, the potential of N-LMP1 for inducing immune surveillance remains elusive. In this article, we describe the immunogenicity of N-LMP1 (1510) and its induction of antivascular immunity in a transplantable tumor model in immunocompetent BALB/c mice. The immunogenicity of N-LMP1 was evaluated on the basis of tumor rejection following immunization. The impact of the immunization on the dynamics of tumor angiogenesis was assessed by temporal noninvasive dynamic contrast-enhanced magnetic resonance imaging and was further confirmed by histologic study and vascular count. Through the experiments of in vivo depletion and adoptive transfer, CD4 T cells were identified as effectors that depend on IFN-γ for tumor prevention. The response was further verified by the identification of an MHC H-2 I-E(d)-restricted peptide derived from N-LMP1 and by the immunization of mice with N-LMP1 peptide-loaded dendritic cells. These studies provide insight into N-LMP1-specific immunity in vivo, which suggests that CD4 T cells may play an important role in angiogenic surveillance against LMP1-associated cancer via tumor stroma targeting.

Enhanced cytotoxicity of natural killer cells following the acquisition of chimeric antigen receptors through trogocytosis

Natural killer (NK) cells have the capacity to target tumors and are ideal candidates for immunotherapy. Viral vectors have been used to genetically modify in vitro expanded NK cells to express chimeric antigen receptors (CARs), which confer cytotoxicity against tumors. However, use of viral transduction methods raises the safety concern of viral integration into the NK cell genome. In this study, we used trogocytosis as a non-viral method to modify NK cells for immunotherapy. A K562 cell line expressing high levels of anti-CD19 CARs was generated as a donor cell to transfer the anti-CD19 CARs onto NK cells via trogocytosis. Anti-CD19 CAR expression was observed in expanded NK cells after these cells were co-cultured for one hour with freeze/thaw-treated donor cells expressing anti-CD19 CARs. Immunofluorescence analysis confirmed the localization of the anti-CD19 CARs on the NK cell surface. Acquisition of anti-CD19 CARs via trogocytosis enhanced NK cell-mediated cytotoxicity against the B-cell acute lymphoblastic leukemia (B-ALL) cell lines and primary B-ALL cells derived from patients. To our knowledge, this is the first report that describes the increased cytotoxicity of NK cells following the acquisition of CARs via trogocytosis. This novel strategy could be a potential valuable therapeutic approach for the treatment of B-cell tumors.

Abstract 1198: Co-existence of epithelioid and fibroblastoid subsets in a sarcomatoid renal cell carcinoma: Comparative studies between clonal sublines and cytofluorometrically sorted cells

Currently, understanding of the pathobiology of sarcomatoid renal cell carcinoma (sRCC) is incomplete. We previously reported the co-existence of epithelioid and fibroblastoid subsets in the sRCC cell line known as RCC52 with total loss of HLA class I expression through genetic and clonal cell studies (Cancer Immunol Immunother, 2009;58:395-408; Anticancer Res, 2013;35:4875-90). We argued that the conclusions drawn from data generated by clonal studies might have not been objective, since only a limited number of sublines from each morphologically distinct cell type were investigated. In this study, using anti-CD44 and anti-CD24 mAbs, we have been able to sort out the two subsets revealing that the CD44+/CD24- phenotype is for the epithelioid subset and the CD44+/CD24+ phenotype is for the fibroblastoid subset. The differential expression of two markers could also be used to identify the two morphologically distinct clonal sublines and the phenotypic results turned out to be consistent with those of sorted cell subsets, for examples: (i) in both differently prepared subsets, the respective phenotypic features in terms of the differential expression of CD44 and CD24 remained persistently stable after 12 in vitro passages; (ii) only epithelioid but not fibroblastoid cells expressed surface E-Cadherin; (iii) expression of surface CD105 was found much more abundant in epithelioid cells as compared with fibroblastoid ones; (iv) epithelioid cells exhibited stronger clonogenicity in semisolid agar as compared with fibroblastoid ones; and (v) fibroblastoid cells displayed greater migratory/invasive ability than epithelioid ones in in vitro assays. However, one inconsistent result between clonal and sorted cells was found that in xenotransplantation experiments with NOD/SCID immunodeficient mice, only epithelioid, but not fibroblastoid clonal sublines, developed tumors at the injection site, in contrast to sorted fibroblastoid cells which gave rise to larger tumor masses and faster growth rates than sorted epithelioid cells. The results obtained with sorted cells were more reflective of the whole tumor population and in vivo situations. Our findings highlight the difference in the functional properties of the two distinct subsets in this sRCC cell line. Further investigations with additional sRCC cell lines/tumors are needed to determine if the co-existence of epithelioid and fibroblastoid subsets, the total loss of HLA class I and other noted characteristics are indeed the common features of all sRCCs. Improved understanding of tumor heterogeneity, metastatic niche and stromal progression may have a profound consequence on disease progression and metastasis, and promises to open up new strategies for therapy of this type of malignancy.

Citation Format: Chin-Hsuan Hsieh, Ming-Ling Kuo, Cheng-Keng Chuang, Shuen-Kuei Liao. Co-existence of epithelioid and fibroblastoid subsets in a sarcomatoid renal cell carcinoma: Comparative studies between clonal sublines and cytofluorometrically sorted cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1198. doi:10.1158/1538-7445.AM2014-1198

Abstract 3622: Total loss of HLA class I expression by two sarcomatoid hepatocellular carcinoma cell lines sHCC29 and sHCC63 was caused by a ∼49-kbp deletion at chromosome 15q15 across the β2m gene locus

Scanty information is available concerning the abnormalities in HLA class I antigen presentation in sarcomatoid hepatocellular carcinoma (sHCC), although this information can improve our understanding of sHCC-host interactions and assist in a rational design of T cell immunotherapy. In this study, we have established three sarcomatoid HCC cell lines, namely sHCC29, sHCC63, and sHCC74, from the tumor lesions in three patients; two of them were HBV carriers from which sHCC29 and sHCC63 were derived, while the other was a HCV carrier from which sHCC74 was generated. No viral DNA was detected in the culture supernatants or cell extracts from any of the three HCC cell lines by COBAS AmpliPre/TaqMan qPCR. In monolayer cell culture, both sHCC29 and sHCC74 showed similar elongated fibroblastic morphology, while sHCC63 exhibited a short-spindle shape and expanded in a density-sensitive manner. HLA class I molecules were abundantly expressed on sHCC74, but were not detected on sHCC29 and sHCC63 by cytofluorometric analysis. Cytoplasmic β2-microglobulin (β2m) was also undetected in the latter two cell lines, in spite of their baseline level of low-moderate cytoplasmic HLA class I heavy chain expression, which was 33-50% of that expressed by sHCC74 in terms of % positive cells. The observed HLA class I-loss phenotype was IFN-γ (300 μg/ml, 48 h)-uncorrectable. Inactivation of the β2m genes in both sHCC29 and sHCC63 was supported by the failure to detect their β2m mRNA transcripts and by the identification of a large (∼49,187 bp) deletion across the β2m gene locus at chromosome 15q15. This deletion, the largest reported to date, explains the loss of β2m protein and lack of assembly of HLA class I molecules in the sHCC29 and sHCC63 cell lines. Mapping of the deletion breaking point and validation by immunohistochemistry of β2m loss in the corresponding tumor lesions from which sHCC29 and sHCC63 were derived are currently underway.

Citation Format: Wei-Yi Lei, Chin-Hsuan Hsieh, Chien-Chung Chang, Shao-Hsuan Wen, Chi-Tan Hu, Shuen-Kuei Liao. Total loss of HLA class I expression by two sarcomatoid hepatocellular carcinoma cell lines sHCC29 and sHCC63 was caused by a ∼49-kbp deletion at chromosome 15q15 across the β2m gene locus. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3622. doi:10.1158/1538-7445.AM2014-3622

Astragalus membranaceus modulates Th1/2 immune balance and activates PPARγ in a murine asthma model

Astragalus membranaceus, a traditional Chinese herb, has been used to improve airway inflammation and asthma. The present study investigated whether A. membranaceus has immunotherapeutic effects on asthma, a chronic inflammatory mucosal disease that is associated with excess production of IgE, eosinophilia, T helper 2 (Th2) cytokines, and bronchial hyperresponsiveness. An ovalbumin (OVA)-induced, chronic inflammatory airway murine asthma model was used to examine the status of pulmonary inflammation after the administration of A. membranaceus. The IgE levels in serum and bronchoalveolar lavage fluid showed a tendency to decrease after the administration of A. membranaceus. The number of eosinophils decreased and infiltration of inflammatory cells and collagen deposition declined in lung sections after A. membranaceus administration. The RNA and protein levels of Th2 cytokines and the ratio of the GATA3/T-bet mRNA levels decreased after A. membranaceus treatment. Furthermore, the mRNA level of peroxisome proliferator-activated receptor γ (PPARγ), a nuclear hormone receptor, increased in the lung tissues of A. membranaceus-treated mice. Finally, an A. membranaceus water extract activated PPARγ activity in either human embryonic kidney 293 (HEK293) or A549 cells in a PPARγ-responsive element-containing luciferase reporter assay. These results indicate that A. membranaceus has an inhibitory effect on airway inflammation in a murine model of asthma through modulating the imbalanced relationship between Th1 and Th2 cytokines.

Combined treatment with regulatory T cells and vascularized bone marrow transplantation creates mixed chimerism and induces donor-specific tolerance to vascularized composite allografts without cytoreductive conditioning

We demonstrate herein that combination treatment with regulatory T cells (Tregs) and vascularized bone marrow transplantation (VBMT) can achieve stable mixed chimerism and long-term transplantation tolerance to vascularized composite allografts (VCA) without requiring cytoreductive recipient conditioning in rats. An appreciable number of Tregs of recipient origin was shown at the interface between recipient and transplanted VCA tissues, implicating a significant role for Tregs in protecting VCA from rejection. This cytoreduction-free protocol using co-treatment with Tregs and VBMT warrants further investigation toward potential clinical application for VCA transplantation.

Co-existence of epithelioid and fibroblastoid subsets in a sarcomatoid renal carcinoma cell line revealed by clonal studies

BACKGROUND

The biology of sarcomatoid renal cell carcinoma (RCC) and its conversion from and to the clear cell RCC are not fully-understood. We aimed to analyze the sarcomatoid RCC cell line, RCC52, derived from a lymph node metastatic lesion consisting mostly of sarcomatoid RCC cells with occasional clear cell areas.

MATERIALS AND METHODS

Representative clonal epithelioid and fibroblastoid sublines isolated from the RCC52 cell line were analyzed alongside the parental line. Cytofluorometric and western blot analyses were used for phenotypic study. Xenotransplantation and in vitro invasive assays were used to determine tumorigenicity and invasiveness. Immunohistology in conjunction with antibodies to paired box gene-2 (PAX2) were used to determine if xenografts or tumor biopsies had the clear cell component.

RESULTS

RCC52 cells grown as monolayers in vitro were all PAX2-negative, and consisted mostly of epithelioid cells and partly of fibroblastoid cells as noted in a previous study, confirming the co-existence of these two cell types in the in vitro growth of exclusive sarcomatoid RCC cells. Immunohistology revealed that the parental line and all epithelioid sublines tested were able to develop into solid tumors consisting mostly of sarcomatoid cells with PAX2-positive clear cells in some areas. The RCC stem cell marker CD105 was selectively expressed by a small proportion of the epithelioid, but not fibroblastoid, sublines, which was in line with the tumorigenic property of the epithelioid sublines containing cancer stem cells (CSCs). In contrast, only fibroblastoid sublines exhibited migratory/invasive properties, as determined by in vitro assays.

CONCLUSION

Our findings confirm the presence of two distinct subsets in the RCC52 line, and suggest the epithelioid subset being able to de-differentiate to clear cells, albeit partially, and harboring CSCs as an emerging therapeutic target in order to achieve effective treatment of this malignancy.

Abstract 3780: Tumorigenicity and partial clear cell conversion of the epithelioid, but not fibroblastoid, subset of a sarcomatoid renal carcinoma cell line

The biology of sarcomatoid renal cell carcinoma (RCC) and its conversion from and to the clear cell RCC cells are not fully understood. In this study, we analyzed the sarcomatoid RCC cell line, RCC52, derived from a clear cell RCC lesion with extensive sarcomatoid differentiation. When grown as monolayers, RCC52 cells consisted of mostly epithelioid cells and partly fibroblastoid cells, and were all PAX-2 negative, suggestive of in vitro growth of the sarcomatoid, but not clear cell, component. Immunohistology of xenografts resulted from subcutaneous injection of tumor cells revealed that only the parental line and all epithelioid sublines tested could develop solid tumors consisting of mostly sarcomatoid cells and PAX-2+ clear cells in areas. Our findings revealed (i) the coexistence of the two phenotypically distinct epithelioid and fibroblastoid subsets in this sarcomatoid RCC52 cell line, (ii) the dissociation of the abilities to display tumorigenicity and migratory/invasive potential by the epithelioid and fibroblastoid subsets, respectively, (iii) the capability of only epithelioid subset to undergo partial conversion to a clear cell type, and (iv) the identification of epithelioid subset as the niche for cancer stem cells within the RCC52 cell line. Importantly, using CD44 and CD24 markers in cytofluorometric analysis, we identified the phenotypes of the epithelioid and fibroblastoid subsets to be CD44+/CD24− and CD44+/CD24+, respectively. Collectively, our findings highlight the phenotypical and functional properties of the two distinct subsets in a sarcomatoid RCC. Thus, improved understanding of tumor heterogeneity, metastatic niche and stromal progression has profound consequence of metastatic disease, and promises to open up new strategies for therapy of cancer.

Citation Format: Chin-Hsuan Hsieh, Hung-Chang Chen, Cheng-Keng Chuang, See-Tong Pang, Ying-Hsu Chang, Shuen-Kuei Liao. Tumorigenicity and partial clear cell conversion of the epithelioid, but not fibroblastoid, subset of a sarcomatoid renal carcinoma cell line. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3780. doi:10.1158/1538-7445.AM2013-3780

Abstract 222: Anticancer effects of Withaferin A on UP-LN1 carcinoma cells through the inhibition of STAT3 phosphorylation and IFN-γ-mediated induction of metastatic cancer stem cells

Cancer stem cells (CSCs) have been defined as a subpopulation of cancer cells with the ability of self-renewal, giving rise to different progenies, and transition between epithelial and mesenchymal status in response to the tumor microenvironment. Due to the lack of an appropriate cell model, our understanding of CSC biology remains poor and the development of CSC antagonists is challenging. We herein used the UP-LN1 cell line as a CSC model which was derived from a gastrointestinal tumor-to-lymph node metastasis lesion. UP-LN1 cells constitute two major components, the floating (F) and adherent (A) cells. F cells were identified as the primary niche of CSCs, and could be serially subcultured while maintaining their stem-like properties including high self-renewal potential, formation of suspended grape-like aggregates and/or spheres, resistance to multiple drugs and NK/LAK effectors, as well as an increased CDY1 (a novel iPS probe) dye retention. Using this cell model, we demonstrated that Withaferin A (WA) dramatically reduced the proliferation of F cells and their ability to form aggregates in vitro. WA also dose-dependently reduced the side population cells. Mechanistically, WA treatment resulted in the down-regulation of two axes, CXCR4 and STAT3, both instrumental in the acquisition of metastatic ability and the development/maintenance of CSCs. We validated the in vitro results using non-invasive imaging technique in a xenograft mouse model. WA-treated animals demonstrated a marked decrease in tumor burden and metastasis, indicating that WA is potentially an effective agent for targeting CSCs.

Citation Format: Chi-Tai Yeh, Alexander TH Wu, Hung-Chang Chen, Cheng-Keng Chuang, See-Tong Pang, Shuen-Kuei Liao. Anticancer effects of Withaferin A on UP-LN1 carcinoma cells through the inhibition of STAT3 phosphorylation and IFN-γ-mediated induction of metastatic cancer stem cells . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 222. doi:10.1158/1538-7445.AM2013-222

Abstract 1358: Epithelioid and fibroblastic cell elements coexisting within the sarcomatoid renal carcinoma RCC52 cell line ensue divergent routes of tumor differentiation and progression

The immunobiology of sarcomatoid renal cell carcinoma and its transformation from and to the clear cell RCC cells are not fully understood. We analyzed a human sarcomatoid RCC cell line known as RCC52, derived from a primary lesion of clear cell RCC with extensive sarcomatoid differentiation. When grown as monolayers, RCC52 cells were all PAX-2 negative and consisted of mostly epithelioid cells and occasionally spindle/fibroblastic cells, suggestive of in vitro growth of the sarcomatoid, but not clear cell, component of the tumor. PAX-2 is a transcription factor found in all major RCC types including clear cell RCCs, but not in sarcomatoid RCCs. We next isolated and maintained a panel of epithelioid and fibroblastic clonal sublines. As determined by cDNA microarray analysis, cancer stem cell (CSC) marker genes, such as ALDH1L1, PSCA and ABCA2, were expressed greater in the epithelioid sublines, while mesenchymal-like cell marker genes including vimentin, snail, fibronectin and MMPs were expressed in much higher levels in the fibroblastic counterpart. Xenotransplantation in NOD/SCID mice showed that in contrast to fibroblastic sublines failing to developed tumors, epithelioid sublines invariably developed tumors at the injection sites. These results point to the existence of CSCs in the epithelioid, but not fibroblastic sublines. In order to investigate the self-renewal/colongenicity ability of these two types of clonal sublines, we used soft agar assay to assess their differential anchorage-independent colony forming abilities. Results showed the mean colony number in the parental RCC52 cells at day 28 was 293.3 ± 81.3 colonies/well, in the epithelioid sublines, the mean colony number was 322.2 ± 92.0 colonies/well. In contrast, no visible colonies were detected in any of the fibroblastic sublines tested. These results are consistent with those obtained in the xenotransplantation studies. Another important observation was that only epithelioid sublines developed xenografts in which clear cell component which was identified by its positive PAX-2 reactivity by immunostaining in some areas of tissue sections. Surprisingly, xenografts resulting from subcutaneous injection of RCC52 cells and the original patient tumor shared similar histopathology in that mostly sarcomatoid cells were noted with occasional clear cell areas. In conclusion, our results strongly point to the capability of sarcomatoid RCCs to undergo dedifferentiation or transdifferentiation. Further investigations into the molecular events responsible for sarcomatoid transformation from clear cell RCCs and for the progression of clear cell RCCs to sarcomatoid ones using additional tissues and cell lines of either types are warranted.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1358. doi:1538-7445.AM2012-1358

Optimizing chimerism level through bone marrow transplantation and irradiation to induce long-term tolerance to composite tissue allotransplantation

BACKGROUND

Mixed chimerism with long-term composite tissue allotransplant (CTA) acceptance can be achieved through allogeneic bone marrow transplantation (BMT). The present study investigated the optimal chimerism level by giving different irradiation dosages to recipients to induce tolerance to CTA.

METHODS

Chimera were prepared using Brown-Norway and Lewis rats with strong major histocompatibility complex incompatibility. The Lewis rats received 5 mg antilymphocyte globulin (day -1 and 10) and 16 mg/kg cyclosporine (day 0-10) and were separated into groups 1, 2, 3, 4, and 5 according to the day -1 irradiation dosage: 0, 200, 400, 600, and 950 cGy, respectively. The Lewis rats were then reconstituted with 100 × 10(6) T-cell-depleted Brown-Norway bone marrow cells (day 0) and received vascularized Brown-Norway-CTA on day 28. Chimerism was assessed monthly by flow cytometry starting on day 28 after BMT. Graft-versus-host disease (GVHD) was assessed clinically and histologically.

RESULTS

Chimerism, 4 weeks after BMT, averaged 0.2%, 9.2%, 30.7%, 58%, and 99.3% in groups 1 to 5, respectively. GVHD occurred as follows: groups 1 and 2, none; group 3, 1 case of GVHD; group 4, 7 cases of GVHD (of which 3 died); and group 5, 10 cases of GVHD (of which 6 died). The percentage of long-term CTA acceptance was 0%, 0%, 90%, 70%, and 40% in groups 1 to 5, respectively. The percentage of regulatory T cells was significantly lower in high-chimerism (≥ 20%, n = 15) than in low-chimerism (<20%, n = 5) rats that accepted CTA long-term .

CONCLUSIONS

The chimerism level correlated positively with GVHD occurrence and long-term CTA acceptance but correlated negatively with regulatory T-cell levels. Optimal chimerism for CTA acceptance through pre-CTA BMT and irradiation occurs at 20-50% at day 28 after BMT in the rat model.

Enhanced IL-10 production by CD4+ T cells primed in IL-15Rα-deficient mice

In this study, we investigated the functional outcomes of CD4(+) T cells primed in the absence of IL-15 transpresentation. Compared with their WT counterparts primed in WT mice, IL-15Rα KO CD4(+) T cells primed in KO mice were found to exclusively overproduce IL-10 upon in vitro restimulation(.) The comparable expression of IL-4 and Foxp3 in CD4(+) T cells primed in the WT and IL-15Rα KO mice indicated that this was neither due to T(H) 2- nor Treg cell-differentiation. IL-10 overproduction was also observed when OVA-specific TCR transgenic CD4(+) T (OT-II) cells were primed in KO mice, excluding an intrinsic deficiency of KO CD4(+) T cells. To investigate the WT and KO microenvironment, DCs from both WT and IL-15Rα KO mice were compared. DCs from both backgrounds were indistinguishable in their steady-state survival and in their expression of MHC class II and costimulatory molecules CD80, CD86, and CD40. However, IL-15Rα KO DCs primed OT-II cells in vitro to produce higher levels of IL-10 upon their restimulation. Additionally, IL-15Rα KO DCs produced significantly more IL-10 upon activation, and IL-10 neutralization during DC-mediated in vitro priming abolished IL-10 overproduction by CD4(+) T cells. Thus, IL-15Rα KO DCs provide an IL-10-enriched environment that preferentially primes CD4(+) T cells for more IL-10 production, highlighting a regulatory role for IL-15 transpresentation in CD4(+) T-cell priming.

Autoimmunity-related demyelination in infection by Japanese encephalitis virus

Japanese encephalitis (JE) virus is the most common cause of epidemic viral encephalitis in the world. The virus mainly infects neuronal cells and causes an inflammatory response after invasion of the parenchyma of the brain. The death of neurons is frequently observed, in which demyelinated axons are commonly seen. The mechanism that accounts for the occurrence of demyelination is ambiguous thus far. With a mouse model, the present study showed that myelin-specific antibodies appeared in sera, particularly in those mice with evident symptoms. Meanwhile, specific T cells proliferating in response to stimulation by myelin basic protein (MBP) was also shown in these mice. Taken together, our results suggest that autoimmunity may play an important role in the destruction of components, e.g., MBP, of axon-surrounding myelin, resulting in demyelination in the mouse brain after infection with the JE virus.

New sarcomatoid cancer cell line SAR-HCV established from a hepatitis C virus-related liver tumour lesion

A sarcomatoid carcinoma cell line (SAR-HCV) was established from a malignant liver lesion of a patient infected with hepatitis C virus. SAR-HCV cells were successfully xenografted in SCID mice. Vimentin was strongly positive in cultured SAR-HCV cells, the primary tumour lesion and the xenografts. Hepatocyte paraffin 1 protein and certain cytokeratin markers, CK8, CK18 and AE1/AE3 were not detected in cultured cells, but were focally positive in the tumour lesion and xenografts, suggesting that this cancer cell line preserves some features of hepatocyte differentiation when grown in vivo. HLA class I, N-cadherin, vascular endothelial growth factor, CD44, and heat-shock protein 70 were moderately expressed in this cell line. Spectral karyotyping analysis revealed a nearly triploid karyotype, 34-63<3n>, XXY[12] with complicated genetic abnormalities of chromosomal structure in all metaphases examined. This cell line will be useful in further studying hepato-sarcomatoid carcinoma cells and in understanding carcinogenesis and epithelial-mesenchymal transition in hepatitis C virus-related liver tumour.

Streptococcal collagen-like surface protein 1 promotes adhesion to the respiratory epithelial cell

Background

Collagen-like surface proteins Scl1 and Scl2 on Streptococcus pyogenes contain contiguous Gly-X-X triplet amino acid motifs, the characteristic structure of human collagen. Although the potential role of Scl1 in adhesion has been studied, the conclusions may be affected by the use of different S. pyogenes strains and their carriages of various adhesins. To explore the bona fide nature of Scl1 in adherence to human epithelial cells without the potential interference of other streptococcal surface factors, we constructed a scl1 isogenic mutant from the Scl2-defective S. pyogenes strain and a Scl1-expressed Escherichia coli.

Results

Loss of Scl1 in a Scl2-defective S. pyogenes strain dramatically decreased the adhesion of bacteria to HEp-2 human epithelial cells. Expression of Scl1 on the surface of the heterologous bacteria E. coli significantly increased adhesion to HEp-2. The increase in adhesion was nullified when Scl1-expressed E. coli was pre-incubated with proteases or antibodies against recombinant Scl1 (rScl1) protein. Treatment of HEp-2 cells with rScl protein or pronase drastically reduced the binding capability of Scl1-expressed E. coli. These findings suggest that the adhesion is mediated through Scl1 on bacterial surface and protein receptor(s) on epithelial cells. Further blocking of potential integrins revealed significant contributions of α2 and β1 integrins in Scl1-mediated binding to epithelial cells.

Conclusions

Together, these results underscore the importance of Scl1 in the virulence of S. pyogenes and implicate Scl1 as an adhesin during pathogenesis of streptococcal infection.

Identification of genetic alterations in upper urinary tract urothelial carcinoma in end-stage renal disease patients

Clinical presentations of end-stage renal disease (ESRD) patients on dialysis with upper urinary tract urothelial carcinoma (UUT-UC) are different from those with normal renal function. The pathogenesis remains unknown. We investigated the pathogenetic influence of chromosomal aberrations in patient on dialysis with UUT-UC. The chromosomal aberrations of UUT-UC specimens from seven dialysis patients were assessed by conventional comparative genomic hybridization (cCGH). Subsequently, we further investigated 20 cases by whole genome and fine-tiling oligonucleotide array-based CGH to demonstrate gains and losses, and compared with the clinicopathologic background. The chromosomal aberrations in UUT-UC specimens from dialysis patients were more complex than in bladder urothelial carcinoma (B-UC). Our data showed that gains at 5p, 7, 19q, and losses at 4q, 9p, and 15q are common in UUT-UC of ESRD patients. Gains in regions associated with DNA repair genes were noted in this study. High-stage and high-grade tumors displayed more copy number variants. In addition, female ESRD patients with UUT-UC had more frequent chromosomal aberrations than their male counterparts. In conclusion, unique chromosomal aberrations were indentified in UUT-UC in ESRD patients.

Epstein-Barr virus-infected cell line TCC36B derived from B lymphocytes infiltrating renal pelvis urothelial carcinoma

This study reports an initial analysis of an EBV-infected B cell line (TCC36B), established from an urothelial carcinoma (UC) lesion of the renal pelvis.

MATERIALS AND METHODS

Cytofluorometric and G-banding analyses were performed for phenotyping and cytogenetics. PCR was used to detect EBV DNA, and sequence analysis to investigate mutations and deletions of the latent membrane protein (LMP)-1 gene of EBV.

RESULTS

TCC36B cells proliferated in vitro and showed positivity for surface CD19, CD20, HLA-DR and IgG(λ), indicating that they belong to B-cells. Cytogenetic analysis showed 46,XX with a unique clonal abnormality of dup(2)(p13p25). EBV DNA was detected in TCC36B cells. Sequence analysis revealed a 30-bp deletion and 7 point mutations on the LMP-1 gene in TCC36B cells.

CONCLUSION

These results suggest the involvement of an EBV variant in the pathogenesis of UC. This cell line should thus facilitate further investigations on the aetiological role of EBV in urothelial cancer.

Epstein-Barr virus DNA load in tumour tissues correlates with poor differentiation status in non-muscle invasive urothelial carcinomas

OBJECTIVE

To detect the correlation between the clinical staging, grading and genomic Epstein-Barr virus (EBV) viral numbers in tumour tissues of urothelial carcinoma patients.

PATIENTS AND METHODS

From June 2004 to May 2008, 60 urothelial carcinoma patients (50 cases of bladder carcinoma and 10 of upper tract urothelial carcinoma (UTUC) were enrolled in the study. Eight patients who underwent transurethral resection of prostate for prostate hyperplasia and two patients receiving nephrectomy for non-function kidney were used as normal controls. The EBV viral copy numbers in genomic DNA were evaluated using a real-time PCR-based study. The BamHI W region of the Namalwa cell line was constructed to the plasmid clone and was used as standard curve for absolute quantitative PCR (Q-PCR).

RESULTS

Epstein-Barr virus DNA was detected in 56% (28/50) and 60% (6/10) of the bladder and UTUC patients, respectively. The EBV DNA could not be detected in the normal control group. By pooling the UTUC and bladder patients in stage Ta,T1, the high copy number in fixed genomic DNA amount (100 ng/20 µL) was correlated with the high grading in stage Ta,T1 urothelial carcinoma (P = 0.014). The overall grading was not statistically associated with EBV copy number (P = 0.25). Although the copy numbers between paired tumour and normal tissues were not statistically different (P= 0.169), there were more copies of EBV in the normal tissues adjacent to the tumours than in those free from urothelial carcinoma. There was no significant difference between recurrence of non-muscle invasive bladder cancer and the presence of EBV (P > 0.05).

CONCLUSIONS

Epstein-Barr virus DNA could be detected in the genome of the urothelial carcinoma specimens. The poor differentiation status was correlated with the high load of the EBV genome in non-muscle invasive urothelial carcinoma. However, recurrence-free survival was not greater in EBV-positive patients than in EBV-negative patients.

Profiling of matrix metalloproteinases and tissue inhibitors of metalloproteinases proteins in bladder urothelial carcinoma

We investigated the matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) proteins in transitional cell carcinoma (TCC) cell lines and surgical specimens of the bladder neoplasm. The expression level was correlated to the degree of cellular differentiation and invasiveness of bladder cancer. Panels of six TCC cell lines with different degrees of differentiation were tested with monoclonal antibodies (mAbs) to MMP-1, MMP-2, MMP-3, MMP-9a, MMP-9b, TIMP-1 and TIMP-2 by immunocytochemistry. Gelatin zymography was also conducted on the cell lines for MMP-2 and -9. In addition, immunohistochemistry with the mAbs to MMP and TIM molecules was performed on 30 TCC specimens. We found that TCC cell lines were stained positively for MMP-1 (6/6), weakly for MMP-9a (2/6), MMP9b (5/6) and TIMP-1 (3/6), and negatively for MMP-2 (3/6) and MMP-3 (3/6). Zymographic analysis of the cell lines showed a high level of MMP2 in the MGH-U4 cell line. In bladder cancer surgical specimens, all specimens were positive for MMP1 (30/30), 19 were positive for MMP-2 (63.3%), 21 positive for MMP-9a (70%) and 15 positive for MMP-9b (50%). The expression of MMP-2 was found to be positively correlated with higher-grade tumors (p=0.036) and the expression of MMP-9a and -9b was found to be positively correlated with tumor stage (p=0.012 and 0.023, respectively). However, the expression of MMP-1, MMP-3, TIMP-1 and TIMP-2 was not correlated with either tumor staging or grading. In conclusion, the expression of MMP-2 and -9 was correlated with high-grade or high-stage bladder tumors, respectively. However, this correlation was not observed with TCC cell lines in which high- and low-grade tumors are included. Immunohistochemical results on tumor lesions may have more clinical relevance, since in a given tumor microenvironment the interaction among tumor cells in situ and tumor-associated cells, such as neutrophils, macrophages, lymphocytes and endothelial cells, as well as environmental factors (hypoxia and pH), cytokines and growth factors released by these cells may be required for TCC to express selective MMPs and TIMPs. The selective expression of these molecules then regulates tumor progression.

Abstract 3348: Immunophenotyping, xenotransplantability and molecular cytogenetic features of the sarcomatoid renal carcinoma cell line RCC52: Pathobiological significance

The immunobiology of sarcomatoid renal cell carcinoma (RCC) and how it has been transformed or progressed from clear cell-RCC are currently poorly understood. We analyzed a sarcomatoid renal carcinoma cell line (RCC52) derived from a primary clear cell renal carcinoma with intensive sarcomatoid differentiation, with respect to its immunophenotyping, molecular cytogenetic features and xenotransplantability. RCC52 cells grown as monolayers consisted of mostly small-sized epithelioid cells along with a small proportion of spindle/fibroblast-like cells, suggestive of growth of the sarcomatoid, but not clear cell component of the tumor. Cytofluorometric analysis revealed a phenotype of cell surface HLA-I−, E-CDH−, N-CDH−, EpCAM−, CD44+, CD54+, CD58+, URO1+ and URO10+ and cytoplasmic AE1+, E-CDH−, N-CDH+, Vimentin+, S100+ and VEGF+. Spectral karyotyping (SKY) show the chromosomal abnormalities in 22 metaphases examined to be 40-42&lt;2n&gt;,X,-Y[22]; der(2)t(2,3)(q35;q21)[20]; der(14)(14;17)(p11;q12)[22]; −3[11]; +7,+7[14]; −14[9]; −15[14]; −10[10]; −22[16]. Numerical imbalances were also assessed by comparative genomic hybridization, which are found to be consistent with the findings determined by banding and SKY. These results along with the documented genotype have established the identity of the RCC52 cell lines. Nude mouse xenografts resulting from RCC52 cell s.c. injection and the original tumor shared similar histopathology with mostly sarcomatoid elements with occasional clear cell areas, suggesting malignant potential of this cell line and the capability of sarcomatoid RCC cells to undergo transdifferentiation or dedifferentiation. The total HLA class I loss caused by the two distinctive mutations in the β2-microglobulin gene and loss of heterozygosity (LOH) in chromosome 15 observed recently (Cancer ImmunoI Immunother, 58:395-408, 2009) did not prevent sarcomatoid RCC52 cells from undergoing such transdifferentiation. Overall our results is of immunological (evasion of the host immunosurveillance) and pathobiological (progression/differentiation/transdifferentiation) significance, which forms the basis of further investigations with additional cell lines/ clones and tissues of clear cell-RCCs with sarcomatoid differentiation to confirm (i) loss HLA class I expression in most, if not all, sarcomatoid RCCs, and (ii) the proposed sequence of clear cell-RCC → fibroblast-like sarcomatoid RCC → epithelioid sarcomatoid RCC, which could in turn transdifferentiate into clear cell-RCC.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3348.

Abstract 4265: Identification of depressed HLA class I expression and CD44bright/CD24dim as the phenotype of floating but not adherent subpopulation harboring most tumor-initiating cells in the UP-LN1 carcinoma cell line

UP-LN1 is a poorly differentiated carcinoma cell line established from a lymph node (LN) metastatic lesion of the neck of a male patient with unknown primary. The CK7−/CK20+/CEA+/SCCA− phenotype detected in the original metastatic lesion and cultured cells led us to believe this cell line to be originated from a primary cancer of the gastrointestinal tract. UP-LN1 exhibited unique in vitro growth characteristics with naturally occurring floating (F) and adherent (A) cells. We hypothesize that the tumor-initiating cells (TICs) with cancer stem cell (CSC) properties may have differentially distributed in F and A cells of the UP-LN1 cell line contributing to cancer metastasis. We first made comparisons of TIC properties between F and A cells in terms of tumorigenicity in NOD/SCID mice. F and A cells were further examined for the expression of selected tumor markers and genes associated with TICs by DNA-microarray, RT-PCR and cytofluorometric analyses. Comparative sensitivities of the two cell types to cytolysis of non-MHC-restricted effector cells were also determined using 51Cr release cytotoxicity assays. Results can be summarized as follows. (i) Injection of F cells at as low as 103 cells could initiate tumor formation in NOD/SCID mice, while an equivalent value for A cells was 105. (ii) A panel of drug resistant gene mRNAs were tested, of which ABCG2, ABCA7, ABCB1, ABCC1 and ABCC4 were expressed in greater amounts in F cells as compared with A cells. (iii) F and A cells exhibited different phenotypes, CD44bright/CD24dim and CD44dim/CD24bright, respectively. (iv) Surface HLA class I expression was down-regulated in F cells, which could be restored after exposure to IFN-γ as low as 1 U/ml for 48 h. (v) F cells but not A cells exhibited extreme resistance to activated NK cells (CD56dim/CD16+ cytotoxic subset) sorted out from peripheral blood mononuclear cells followed by IL-2 (100 U/ml, 72 h) activation. Moreover, F cells turned out to be highly sensitive to be modulated by IFN-γ to express CXCR4, a receptor of CXCL12. Up-regulation of surface CXCR4 expression with a concomitant down-regulation of cytoplasmic expression of CXCL12 was observed in F cells which are highly resistant to activated NK killing. Such modulation was found to be mediated via IFN-γ, a mediator which could be secreted by the immunomodulatory NK subset (CD56bright/CD16−) within activated NK cell population. In summary, we have here identified resistance to activated NK killing, depressed HLA class I expression and CD44bright/CD24dim to be the phenotype of highly tumorigenic F cells, in which TICs/CSCs predominantly reside. IFN-γ-mediated induction of surface CXCR4 expression and enhancement of HLA class I expression in F cells might have occurred in the patient bearing UP-LN1 cells, resulting in invasive and metastatic events.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4265.

Abstract 330: Genomic comparison of different subtypes of renal cell carcinoma using SKY, CGH

The cytogenetic biomarkers to monitor tumor progression and treatment efficacy for renal cell carcinoma (RCC) are lacking. There are few known prognostic biomarkers that limited to tumor vascularization. In almost all sporadic clear cell RCC (ccRCC), the VHL gene in either mutated or methylated form is inactivated and often involved in cellular oxygen homeostasis. Herein, we compared different subtypes of RCC: ccRCC, chromophobe RCC (CRCC), and sarcomatoid clear cell RCC (sccRCC) in culture by using SKY and CGH. In addition, cytofluorometric analysis was performed on these tumors to give an overall immunophenotyping profile of these RCCs. By comparison of genomic characteristics of these RCC subtypes, deletion of chromosome 3p has been frequently found in sporadic ccRCC; and more complex genetic patterns of the high frequencies losses of heterozygous on chromosomes 1p, 2p, 6p, 10p, 13q, 17q, and 21q have also been documented in CRCC. However, for the sarcomatoid RCC subtype, such characteristcs have rarely been studied so far. In the current study, the genetic profile of CRCC revealed by SKY was shown: 74-84&lt;4n&gt; XXXX, dic(1;11)(p21;q21)×2, −3, −4, −4, der(10)(q21.1- qter), −11, −11, −18, −18, der(19)t(5;19)(q31;q?)×2, −21, −21[21]; and SCCRCC cell line showed: 40-42&lt;2n&gt;, X,-Y; der(2)t(2,3)(q35;q21); −3; +7,+7; der(14)(14;17)(p11;q12); −14; −15; −10; −22 [22], the data were then further confirmed by CGH for gene copy number changes of the certain specific chromosomal regions. However, for the CRCC, except loss of chromosome 21, most of genetic aberrations were different from the previous reports. On the other hand, the genetic features of current sccRCC seemed not only similar to the characteristic of ccRCC (deletion 3p), but also the genetic changes sharing the those of familial RCC (t(2;3)(q35;q21)) and papillary RCC (gain of chromosome 7 and 17, and loss of Y) documented previously. Cytofluorometric analysis revealed that there were immunophenotypic differences between CRCC and sccRCC in that surface HLA class I expression was found total loss in sccRCC, whereas CRCC expressed HLA class I abundantly on the cell surface. Furthermore, bcl-2 and URO-7 were detected in the cytoplasm of CRCC, but not in sccRCC. On the other hand, CD54 was shown on cell surface; AE3, CD44v6, Hsp70, S100-β, URO-2, URO-5, URO-9 on cell cytoplasm only observed on sccRCC. In conclusion, gain of chromosome 7 and the region harbored the oncogene c-Met were found in sccRCC, which could be related with the expression of pY1349 HGFR/c-Met associated with a high pT stage and a high metastasis rate. Therefore, it is worth to further investigate the role of c-Met and its ligand HGF in sccRCC tumorigenesis, and may help to develop clinical therapeutic strategies in sccRCC. Moreover, the immunobiological evidences clarified the significant profile of these subtypes, the information is useful on predicting the patients prognosis.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 330.

Mixed germ cell tumor metastatic to the skin: case report and literature review

Background

Testicular cancer is the most common cancer for males aged 15~35 years old. The initial presentation is typically an asymptomatic enlarged testicle. The retroperitoneum is the most common metastatic area. Other metastatic sites include the lung, liver, brain, adrenal glands, gastrointestinal tract and spleen. Skin metastasis is a rare event and frequently associated with poor prognosis.

Case presentation

A 19-year old male was diagnosed testicular mixed germ cell tumor with initial presentation of cutaneous metastasis at scalp and upper abdomen. After radical orchiectomy and four courses of cisplatin-based chemotherapy, the scalp and upper abdominal lesions regressed completely. The size of lung metastases remained unchanged.

Conclusions

For advanced stage testicular cancer, cisplatin-based chemotherapy is still effective to achieve partial response.

The impact of regular biopsy in the first cystoscopic follow-up and other predictors on the recurrence of superficial bladder tumors

BACKGROUND

To evaluate whether cystoscopic evaluations with bladder biopsy can serve as a significant predictor of superficial bladder tumor recurrence.

METHODS

This study examined patients with superficial bladder cancer (Ta/T1). At the first three-month cystoscopic follow-up, subjects were divided into two groups: group 1 received cystoscopic examinations with transurethral bladder biopsy, and group 2 had a cystoscopic examination only. Patients without evidence of recurrence at the first three-month follow-up in these 2 groups (groups 1A and 2A) were compared with respect to recurrence rates and average recurrence time.

RESULTS

One hundred and thirty patients were diagnosed with superficial bladder tumors. The mean follow-up time was 22.9 months. The two-year recurrence rates were 33.8% for Ta, 29.8% for T1, 30.4% for low-grade tumors, 31.9% intravesical for high-grade tumors, 26.4% in those treated with bacillus Calmette-Guerin therapy, 33.4% in those who had chemotherapy, 60% in the non-therapy group, 21.8% for single tumors and 47.9% for multiple tumors. Univariate and multivariate analysis revealed that tumor number and intravesical therapy were important predictive factors for tumor recurrence. The average recurrence times in groups 1A and 2A were 18.3 and 12.6 months, respectively, while the respective one-year/two-year recurrence rates were 2.4%/23.8% and 16.9%/22.1%. Univariate analysis showed no statistically significant differences between these two groups.

CONCLUSIONS

Our data support tumor number and intravesical therapy as important predictive factors for tumor recurrence. Cystoscopy combined with transurethral bladder biopsy mitigates tumor recurrence in the early years, but not in later years. Therefore, regular cystoscopic evaluation alone is sufficient for longterm patient surveillance.

Characterization of the response of dendritic cells and regulatory T cells to tumor antigens in patients with renal cell carcinoma

BACKGROUND

This study characterized dendritic cells (DCs), regulatory T cells (Tregs) and the immune responses to tumor antigens in renal cell carcinoma (RCC) patients.

METHODS

Thirty patients with RCC and five healthy donors were studied. DCs were generated from the adherent cells among peripheral blood mononuclear cells (PBMCs), then cultured in medium containing granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-4 for 7 days. The phenotypes of the DCs and Tregs were analyzed by flow cytometry. A mixed lymphocyte reaction (MLR) was performed to assess the functioning of the DCs and Tregs. A cytotoxic assay was performed to measure the antigen presentation ability of the DCs from the RCC patients (RCC-DCs). These DCs were pretreated with TNF-alpha (TNF-DCs) or tumor lysate (TuLy-DCs) on the 3rd day of DC culture.

RESULTS

The RCC-DCs expressed significantly less CD40 (p = 0.03) and CD80 (p = 0.007) upon TNF-alpha cultivation than the DCs from healthy donors. Theperipheral Tregs during stage I disease were significantly less (p = 0.032) than during stages II-IV. The RCC-DCs were as efficient as DCs from healthy donors (p = 0.83) when stimulating the proliferation of allogeneic T cells; however, these RCC-DCs were less efficient when stimulating autologous T cells than allogeneic T cells (p = 0.023). Tregs inhibited autologous T cell proliferation rather than allogeneic T cell proliferation in response to TuLy-DCs stimulation. Prostaglandin E(2) did not increase the ability of immature DCs to stimulate T cell proliferation.

CONCLUSIONS

Patients with RCC have less potent anti-tumor immune responses.

Molecular events associated with epithelial to mesenchymal transition of nasopharyngeal carcinoma cells in the absence of Epstein-Barr virus genome

Epithelial-mesenchymal transition (EMT) is an important process in tumor metastasis. The EMT-related events associated with metastasis of NPC in the absence of EBV have not been elucidated. We established an EBV-negative NPC cell line from a bone marrow biopsy of an NPC patient. Using a Matrigel system we isolated an invasive and non-invasive sublines, designated NPC-BM29 and NPC-BM00. NPC-BM29 acquired an invasive-like phenotype characterized by EMT, marked by down-regulation of E-cadherin and β-catenin with concomitant increased expression of Ets1. NPC-BM29 cells expressed ≥ 10-fold higher of MMP-9 than NPC-BM00 cells. NPC-BM29 cells grew better in 2% serum than NPC-BM00 cells, with a population doubling-time of 26.8 h and 30.7 h, respectively. A marked reduction in colony-formation ability of NPC-BM00 cells compared to NPC-BM29 was observed. Wound-healing assay revealed that NPC-BM29 cells displayed higher motility than NPC-BM00 and the motility was further enhanced by cell treatment with TPA, a PKC activator. Cell surface markers and tumor-associated molecules, AE3, MAK6 and sialyl-Tn, were up-regulated in NPC-BM29 cells, whereas the expression of HLA-DR and CD54 was significantly increased in NPC-BM00 cells. NPC-BM29 consistently released higher levels of IL-8 and IL-10 than NPC-BM00, with low levels of IL-1α expression in both cell lines. Higher level of VEGF production was detected in NPC-BM00 than NPC-BM29 cells. These data show that EBV is not required for exhibiting multiple metastatic phenotypes associated with EMT. More studies that target right molecules/signalings associated with the EMT may offer new therapeutic intervention options for NPC invasion and metastasis.

Role for nuclear factor-kappaB in augmented lung injury because of interaction between hyperoxia and high stretch ventilation

High-tidal-volume mechanical ventilation and hyperoxia used in patients with acute lung injury (ALI) can induce alveolar coagulopathy and fibrin depositions within the airways. Hyperoxia has been shown to increase ventilator-induced lung injury (VILI), but the mechanisms that regulate interaction between high-tidal-volume mechanical ventilation and hyperoxia are unclear. We hypothesized that mechanical stretch with hyperoxia synergistically augmented neutrophil infiltration and production of plasminogen activator inhibitor-1 (PAI-1) via the nuclear factor-kappaB (NF-kappaB) pathway. C57BL/6 mice (n=5 per group) were exposed to high-tidal-volume (30 mL/kg) or low-tidal-volume (6 mL/kg) mechanical ventilation with room air or hyperoxia for 1 to 5h after 2-microg/g NF-kappaB inhibitor (SN-50) administration. Nonventilated mice with room air or hyperoxia served as control groups. Evans blue dye, myeloperoxidase, electrophoretic mobility shifting of nuclear protein, and inflammatory cytokine were measured. The expression of tumor necrosis factor-alpha (TNF-alpha) and PAI-1 were studied by immunohistochemistry. The addition of hyperoxia to high-tidal-volume ventilation-augmented lung injury, as demonstrated by increased microvascular leak, neutrophil migration into the lung, TNF-alpha and active PAI-1 production, DNA binding activity of NF-kappaB, and NF-kappaB activation. No statistically significant increase of neutrophil infiltration and inflammatory cytokine production was found in the mice ventilated at 6 mL/kg using hyperoxia. Hyperoxia-induced augmentation of VILI was attenuated in mice with pharmacologic inhibition of NF-kappaB activity by SN-50. We conclude that hyperoxia increased high-tidal-volume-induced cytokine production and neutrophil influx through activation of the NF-kappaB pathway.

Urinary fluorescence in situ hybridization assay for detecting urothelial carcinoma in Taiwanese patients

OBJECTIVES

To investigate the cytogenetic marker detected by fluorescence in situ hybridization (FISH; UroVysion, Vysis, Inc., Abbott Laboratories, Des Plaines, IL, USA) in the diagnosis of bladder cancer and upper tract urothelial carcinoma (UC) in Taiwanese patients, as FISH has been used in Western countries for detecting UC, but there are limited results in Asian populations.

PATIENTS AND METHODS

We analysed polyploidy of chromosome 3, 7, 17 and aneuploidy of chromosome 21, using uroepithelial cells collected at the first void or by instrumental extraction of urine, for bladder cancer, and shedding cells from the upper tract flushed by normal saline via ureteric catheterization or ureterorenoscopy. The criteria for positive tumour cells included three or more positive staining in two or more chromosomes showing polyploidy or <50% staining of the chromosome 9p21.

RESULTS

In all, 32 patients with bladder UC and 12 with upper tract UC were assessed. The overall sensitivity for bladder cancer by UroVysion was 96.8%. The sensitivity of the cytology test was 36% for UC of the bladder. The sensitivity for UroVysion in upper tract UC was 12/12 but the specificity was three of nine.

CONCLUSIONS

This preliminary report shows that UroVysion was a sensitive screening method for UC of the bladder and upper urinary tract.

Evaluation of CA19-9 as a tumor marker in urothelial malignancy

OBJECTIVE

Carbohydrate antigen 19-9 (CA19-9) is known to be a marker with a high positive rate in pancreatic cancer. There are limited data on the use of CA19-9 as a tumor marker in bladder carcinoma. We tested the expression of CA19-9 in transitional cell carcinoma (TCC) cell lines and bladder cancer patients to determine its usefulness in clinical applications.

MATERIAL AND METHODS

The expression of CA19-9 was determined in six TCC cell lines and 42 bladder carcinoma tissues using two approaches: immunohistochemistry and enzyme immunoassay (EIA) analysis. EIA was used for testing CA19-9 levels in spent medium of cultured TCC cells and the urine of bladder tumor patients.

RESULTS

The CA19-9 value was low in spent media of the MGH-U1, MGH-U1R and MGH-U3 cell lines, but high in that of reactivity in MGH-U4 cells, while negative reactivity was found in high-grade MGH-U1 and MGH-U1R cells, both of which were derived from a stage B, grade 3 TCC. High incidences of negative CA19-9 staining were found in high-grade and invasive tumor tissues: 69.6% (16/23) and 70.8% (17/24), respectively. The sensitivity and specificity of urinary CA19-9 for detecting tumor recurrence were 83.3% and 50.8%, respectively. However, urinary tract infection also resulted in a high false-positive rate.

CONCLUSION

CA19-9 is promising for use as a biomarker for the detection and monitoring of low-grade and low-stage bladder cancer, with the proviso that patients to be tested should be free of infection.

Unfractionated heparin and enoxaparin reduce high-stretch ventilation augmented lung injury: a prospective, controlled animal experiment

Introduction

Dysregulation of coagulation and local fibrinolysis found in patients with acute lung injury often results in the need for the support of mechanical ventilation. High-tidal-volume mechanical ventilation can increase lung damage and suppression of fibrinolytic activity, but the mechanisms are unclear. We hypothesized that subcutaneous injections of unfractionated heparin and enoxaparin would decrease neutrophil infiltration, lung edema, and plasminogen-activator inhibitor-1 (PAI-1) production in mice exposed to high-tidal-volume ventilation.

Methods

Male C57BL/6 mice, weighing 20 to 25 g, were exposed to either high-tidal-volume (30 ml/kg) or low-tidal-volume (6 ml/kg) mechanical ventilation with room air for 1 to 5 hours after 200 IU/kg or 400 IU/kg unfractionated heparin and 4 mg/kg or 8 mg/kg enoxaparin administration. Nonventilated mice served as a control group. Evan blue dye, lung wet- to dry-weight ratio, histopathologic grading of epithelium, myeloperoxidase, and gene expression of PAI-1 were measured. The expression of PAI-1 was studied by immunohistochemistry.

Results

High-tidal-volume ventilation induced increased microvascular permeability, neutrophil influx, PAI-1 mRNA expression, production of PAI-1 protein, and positive staining of PAI-1 in epithelium in a dose-dependent manner. Lung injury induced by high-tidal-volume ventilation was attenuated with PAI-1-deficient mice and pharmacologic inhibition of PAI-1 activity by low-dose unfractionated heparin and enoxaparin.

Conclusions

We conclude that high-tidal-volume mechanical ventilation increased microvascular permeability, neutrophil influx, lung PAI-1 mRNA expression, production of active PAI-1. The deleterious effects were attenuated by low-dose unfractionated heparin or enoxaparin treatment. Understanding the protective mechanism of unfractionated heparin and enoxaparin related to the reduction of PAI-1 may afford further knowledge of the effects of mechanical forces in the lung and development of possible therapeutic strategies involved in acute lung injury.

Differential baseline and response profile to IFN-gamma gene transduction of IL-6/IL-6 receptor-alpha secretion discriminate primary tumors versus bone marrow metastases of nasopharyngeal carcinomas in culture

BACKGROUND

Understanding of immunobiology of bone marrow metastases (designated BM-NPC) versus primary tumors (P-NPC) of the nasopharynx is far from complete. The aim of this study was to determine if there would be differences between cultured P-NPCs and BM-NPCs with respect to (i) constitutive IL-6 and the IL-6 receptor gp80 subunit (IL-6Ralpha) levels in the spent media of nontransduced cells, and (ii) IL-6 and IL-6Ralpha levels in the spent media of cells transduced with a retroviral vector containing the IFN-gamma gene.

METHODS

A panel of NPC cell lines were transduced with the IFN-gamma gene through a retroviral vector. Four clonal sublines were isolated via limiting dilution methods. Cytofluorometric analysis was performed for the detection of cell surface antigens of HLA class I, HLA class II and ICAM-1. ELISA was used to assay for IFN-gamma, IL-6 and IL-6Ralpha in the spent media of cultured cell lines.

RESULTS

Our results showed that in day 3 culture supernatants, low levels of soluble IL-6 were detected in 5/5 cultured tumors derived from P-NPCs, while much higher constitutive levels of IL-6 were detected in 3/3 metastasis-derived NPC cell lines including one originated from ascites; the difference was significant (p = 0.025). An inverse relationship was found between IL-6Ralpha and IL-6 in their release levels in cultured P-NPCs and metastasis-derived NPCs. In IFN-gamma-transduced-P-NPCs, IL-6 production increased and yet IL-6Ralpha decreased substantially, as compared to nontransduced counterparts. At variance with P-NPC cells, the respective ongoing IL-6 and IL-6Ralpha release patterns of BM-NPC cells were not impeded as much following IFN-gamma transduction. These observations were confirmed by extended kinetic studies with representative NPC cell lines and clonal sublines. The latter observation with the clonal sublines also indicates that selection for high IL-6 or low IL-6Ralpha producing subpopulations did not occur as a result of IFN-gamma-transduction process. P-NPCs, which secreted constitutively only marginal levels of IFN-gamma (8.4 ~ 10.5 pg/ml), could be enhanced to produce higher levels of IFN-gamma (6.8- to 10.3-fold increase) after IFN-gamma transduction. Unlike P-NPCs, BM-NPCs spontaneously released IFN-gamma at moderate levels (83.8 ~ 100.7 pg/ml), which were enhanced by 1.3- to 2.2-fold in the spent media of their IFN-gamma-transduced counterparts.

CONCLUSION

Our results showed that cultured P-NPCs and BM-NPCs could be distinguished from one another on the basis of their differential baseline secretion pattern of IFN-gamma, IL-6 and IL-6Ralpha, and their differential response profiles to IFN-gamma gene transfer of the production of these three soluble molecules. These results suggest that the IL-6 and IFN-gamma pathways in a background of genetic instability be involved in the acquisition of metastatic behaviour in BM-NPCs.

Androgen deprivation modulates the inflammatory response induced by irradiation

Background

The aim of this study was to determine whether radiation (RT)-induced inflammatory responses and organ damage might be modulated by androgen deprivation therapies.

Methods

The mRNA and tissue sections obtained from the lungs, intestines and livers of irradiated mice with or without androgen deprivation were analyzed by real-time PCR and histological analysis. Activation of NF-kappa B was examined by measuring nuclear protein levels in the intestine and lung 24 h after irradiation. We also examined the levels of cyclooxygenase-2 (COX-2), TGF-β1 and p-AKT to elucidate the related pathway responsible to irradiation (RT) -induced fibrosis.

Results

We found androgen deprivation by castration significantly augmented RT-induced inflammation, associated with the increase NF-κB activation and COX-2 expression. However, administration of flutamide had no obvious effect on the radiation-induced inflammation response in the lung and intestine. These different responses were probably due to the increase of RT-induced NF-κB activation and COX-2 expression by castration or lupron treatment. In addition, our data suggest that TGF-β1 and the induced epithelial-mesenchymal transition (EMT) via the PI3K/Akt signaling pathway may contribute to RT-induced fibrosis.

Conclusion

When irradiation was given to patients with total androgen deprivation, the augmenting effects on the RT-induced inflammation and fibrosis should take into consideration for complications associated with radiotherapy.

Klatskin tumor with spermatic cord metastasis: a case report

Malignant spermatic cord tumor is quite uncommon. Metastatic spermatic cord tumor is even rarer. Here we report a case of metastatic spermatic cord tumor from a common hepatic duct tumor (Klatskin tumor). A 38-year-old man presented with right scrotal enlargement and chronic testicular pain. He had a Klatskin tumor (cholangiocarcinoma) stage IIIa, and underwent an extended right hepatectomy with resection of the extrahepatic bile duct, and portal vein and reconstruction by Roux-en-y hepatico-jejunostomy one year before this presentation. Scrotal ultrasound revealed a moderate hydrocele with clean content. Scrotal exploration showed turbid fluid and a fibrotic hyperemic spermatic cord. Excision biopsy of the spermatic cord was done, and the pathology revealed adenocarcinoma. The primary cholangiocarcinoma tumor and the spermatic cord tumor showed identical histologic patterns. Klatskin tumor with spermatic cord metastasis was diagnosed. To our knowledge, this case represents the first such report in the literature.

Attenuation of lung inflammation and pro-inflammatory cytokine production by resveratrol following trauma-hemorrhage

Although studies have demonstrated that resveratrol administration following adverse circulatory conditions is known to be protective, the mechanism by which resveratrol produces the salutary effects remains unknown. We hypothesized that resveratrol administration in males following trauma-hemorrhage decreases cytokine production and protects against lung injury. Male Sprague-Dawley rats underwent trauma-hemorrhage (mean blood pressure 40 mmHg for 90 min, then resuscitation). A single dose of resveratrol (30 mg/kg of body weight) or vehicle was administered intravenously during resuscitation. Twenty-four hours thereafter, tissue myeloperoxidase activity (a marker of neutrophil sequestration), cytokine-induced neutrophil chemoattractant (CINC)-1, CINC-3, intercellular adhesion molecule (ICAM)-1, and interleukin (IL)-6 levels in the lung and protein concentrations in bronchoalveolar lavage fluid were measured (n = 6 rats/group). One-way ANOVA and Tukey's test were used for statistical analysis. Trauma-hemorrhage increased lung myeloperoxidase activity, CINC-1, CINC-3, ICAM-1, and IL-6 levels and protein concentrations in bronchoalveolar lavage fluid. These parameters were significantly improved in the resveratrol-treated rats subjected to trauma-hemorrhage. The salutary effects of resveratrol administration on attenuation of lung injury following trauma-hemorrhage are likely due to reduction of pro-inflammatory mediators.

Glucose-regulated protein 78 regulates multiple malignant phenotypes in head and neck cancer and may serve as a molecular target of therapeutic intervention

Glucose-regulated protein 78 (Grp78) is an endoplasmic reticulum chaperone protein and is overexpressed in various cancers. However, it is unclear how significance of this molecule play an active role contributing to the oncogenic effect of head and neck cancer (HNC). To investigate the potential function of Grp78, six HNC cell lines were used. We found that Grp78 is highly expressed in all six cell lines and many of the proteins were localized in the periphery regions, implying other function of this molecule aside from endoplasmic reticulum stress response. Knockdown of Grp78 by small interfering RNA significantly reduced cell growth and colony formation to 53% to 12% compared with that of controls in all six HNC cell lines. Using in vitro wound healing and Matrigel invasion assays, we found that cell migration and invasive ability were also inhibited to 23% to 2% in all these cell lines tested. In vivo xenograft studies showed that administration of Grp78-small interfering RNA plasmid into HNC xenografts significantly inhibited both tumor growth in situ (>60% inhibition at day 34) and liver metastasis (>90% inhibition at day 20). Our study showed that Grp78 actively regulates multiple malignant phenotypes, including cell growth, migration, and invasion. Because knockdown Grp78 expression succeeds in the reduction of tumor growth and metastatic potential, this molecule may serve as a molecular target of therapeutic intervention for HNC.

Total HLA class I loss in a sarcomatoid renal carcinoma cell line caused by the coexistence of distinct mutations in the two encoding beta2-microglobulin genes

In renal cell carcinoma (RCC), HLA class I downregulation has been found in about 40% of the lesions examined. Since only scanty information is available about the molecular basis of these defects, we have investigated the mechanism(s) underlying HLA class I antigen downregulation or loss in six RCC cell lines. Five of them express HLA class I antigens although at various levels; on the other hand, HLA class I antigens are not detectable on the remaining cell line, the RCC52 cell line, belonging to a sarcomatoid subtype, even following incubation with IFN-gamma. beta(2)-microglobulin (beta(2) m) was not detected in RCC52 cells. Surprisingly, RCC52 cells harbor two mutations in the beta ( 2 ) m genes in exon 1: a single G deletion (delG) in codon 6, which introduces a premature stop at codon 7, and a CT dinucleotide deletion (delCT), which leads to a premature stop at codon 55. Analysis of eight clonal sublines isolated from the RCC52 cell line showed that the two beta ( 2 ) m gene mutations are carried separately by RCC52 cell subpopulations. The delG/delCT double mutations were detected in two sublines with a fibroblast-like morphology, while the delCT mutation was detected in the remaining six sublines with an epithelial cell morphology. Furthermore, loss of heterozygosity (LOH) of the beta ( 2 ) m gene at STR D15S-209 was found only in the epithelioid subpopulation, indicating loss of one copy of chromosome 15. Immunostaining results of the tumor lesion from which the cell line RCC52 was originated were consistent with the phenotyping/molecular findings of the cultured cells. This is the first example of the coexistence of distinct beta ( 2 ) m defects in two different tumor subpopulations of a RCC, where loss of one copy of chromosome 15 occurs in one of the subpopulations with total HLA class I antigen loss.

Serine/threonine kinase-protein kinase B and extracellular signal-regulated kinase regulate ventilator-induced pulmonary fibrosis after bleomycin-induced acute lung injury: a prospective, controlled animal experiment

Introduction

Lung fibrosis, reduced lung compliance, and severe hypoxemia found in patients with acute lung injury often result in a need for the support of mechanical ventilation. High-tidal-volume mechanical ventilation can increase lung damage and fibrogeneic activity but the mechanisms regulating the interaction between high tidal volume and lung fibrosis are unclear. We hypothesized that high-tidal-volume ventilation increased pulmonary fibrosis in acute lung injury via the serine/threonine kinase-protein kinase B (Akt) and mitogen-activated protein kinase pathways.

Methods

After 5 days of bleomycin administration to simulate acute lung injury, male C57BL/6 mice, weighing 20 to 25 g, were exposed to either high-tidal-volume mechanical ventilation (30 ml/kg) or low-tidal-volume mechanical ventilation (6 ml/kg) with room air for 1 to 5 hours.

Results

High-tidal-volume ventilation induced type I and type III procollagen mRNA expression, microvascular permeability, hydroxyproline content, Masson's trichrome staining, S100A4/fibroblast specific protein-1 staining, activation of Akt and extracellular signal-regulated kinase (ERK) 1/2, and production of macrophage inflammatory protein-2 and 10 kDa IFNγ-inducible protein in a dose-dependent manner. High-tidal-volume ventilation-induced lung fibrosis was attenuated in Akt-deficient mice and in mice with pharmacologic inhibition of ERK1/2 activity by PD98059.

Conclusion

We conclude that high-tidal-volume ventilation-induced microvascular permeability, lung fibrosis, and chemokine production were dependent, in part, on activation of the Akt and ERK1/2 pathways.

Involvement of Akt and endothelial nitric oxide synthase in ventilation-induced neutrophil infiltration: a prospective, controlled animal experiment

Introduction

Positive pressure ventilation with large tidal volumes has been shown to cause release of cytokines, including macrophage inflammatory protein-2 (MIP-2), a functional equivalent of human IL-8, and neutrophil infiltration. Hyperoxia has been shown to increase ventilator-induced lung injury, but the mechanisms regulating interaction between a large tidal volume and hyperoxia are unclear. We hypothesized that large tidal volume ventilation using hyperoxia would increase MIP-2 production and neutrophil infiltration via the serine/threonine kinase/protein kinase B (Akt) pathway and the endothelial nitric oxide synthase (eNOS) pathway.

Methods

C57BL/6 mice were exposed to large tidal volume (30 ml/kg) mechanical ventilation with room air or hyperoxia for 1–5 hours.

Results

Large tidal volume ventilation using hyperoxia induced neutrophil migration into the lung, MIP-2 production, and Akt and eNOS activation in a time-dependent manner. Both the large tidal volume ventilation of Akt mutant mice and the pharmacological inhibition of Akt with LY294002 attenuated neutrophil sequestration, MIP-2 protein production, and Akt and eNOS activation.

Conclusion

We conclude that hyperoxia increased large tidal volume-induced MIP-2 production and neutrophil influx through activation of the Akt and eNOS pathways.