1
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Ullman JC, Arguello A, Getz JA, Bhalla A, Mahon CS, Wang J, Giese T, Bedard C, Kim DJ, Blumenfeld JR, Liang N, Ravi R, Nugent AA, Davis SS, Ha C, Duque J, Tran HL, Wells RC, Lianoglou S, Daryani VM, Kwan W, Solanoy H, Nguyen H, Earr T, Dugas JC, Tuck MD, Harvey JL, Reyzer ML, Caprioli RM, Hall S, Poda S, Sanchez PE, Dennis MS, Gunasekaran K, Srivastava A, Sandmann T, Henne KR, Thorne RG, Di Paolo G, Astarita G, Diaz D, Silverman AP, Watts RJ, Sweeney ZK, Kariolis MS, Henry AG. Brain delivery and activity of a lysosomal enzyme using a blood-brain barrier transport vehicle in mice. Sci Transl Med 2021; 12:12/545/eaay1163. [PMID: 32461331 DOI: 10.1126/scitranslmed.aay1163] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/10/2020] [Accepted: 04/02/2020] [Indexed: 12/20/2022]
Abstract
Most lysosomal storage diseases (LSDs) involve progressive central nervous system (CNS) impairment, resulting from deficiency of a lysosomal enzyme. Treatment of neuronopathic LSDs remains a considerable challenge, as approved intravenously administered enzyme therapies are ineffective in modifying CNS disease because they do not effectively cross the blood-brain barrier (BBB). We describe a therapeutic platform for increasing the brain exposure of enzyme replacement therapies. The enzyme transport vehicle (ETV) is a lysosomal enzyme fused to an Fc domain that has been engineered to bind to the transferrin receptor, which facilitates receptor-mediated transcytosis across the BBB. We demonstrate that ETV fusions containing iduronate 2-sulfatase (ETV:IDS), the lysosomal enzyme deficient in mucopolysaccharidosis type II, exhibited high intrinsic activity and degraded accumulated substrates in both IDS-deficient cell and in vivo models. ETV substantially improved brain delivery of IDS in a preclinical model of disease, enabling enhanced cellular distribution to neurons, astrocytes, and microglia throughout the brain. Improved brain exposure for ETV:IDS translated to a reduction in accumulated substrates in these CNS cell types and peripheral tissues and resulted in a complete correction of downstream disease-relevant pathologies in the brain, including secondary accumulation of lysosomal lipids, perturbed gene expression, neuroinflammation, and neuroaxonal damage. These data highlight the therapeutic potential of the ETV platform for LSDs and provide preclinical proof of concept for TV-enabled therapeutics to treat CNS diseases more broadly.
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Affiliation(s)
- Julie C Ullman
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Annie Arguello
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Jennifer A Getz
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Akhil Bhalla
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Cathal S Mahon
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Junhua Wang
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Tina Giese
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Catherine Bedard
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Do Jin Kim
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Jessica R Blumenfeld
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Nicholas Liang
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Ritesh Ravi
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Alicia A Nugent
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Sonnet S Davis
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Connie Ha
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Joseph Duque
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Hai L Tran
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Robert C Wells
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Steve Lianoglou
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Vinay M Daryani
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Wanda Kwan
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Hilda Solanoy
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Hoang Nguyen
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Timothy Earr
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Jason C Dugas
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Michael D Tuck
- Mass Spectrometry Research Center, Vanderbilt University, 9160 MRB III, 465 21 Avenue South, Nashville, TN 37240, USA
| | - Jennifer L Harvey
- Mass Spectrometry Research Center, Vanderbilt University, 9160 MRB III, 465 21 Avenue South, Nashville, TN 37240, USA
| | - Michelle L Reyzer
- Mass Spectrometry Research Center, Vanderbilt University, 9160 MRB III, 465 21 Avenue South, Nashville, TN 37240, USA
| | - Richard M Caprioli
- Mass Spectrometry Research Center, Vanderbilt University, 9160 MRB III, 465 21 Avenue South, Nashville, TN 37240, USA
| | - Sejal Hall
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Suresh Poda
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Pascal E Sanchez
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Mark S Dennis
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Kannan Gunasekaran
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Ankita Srivastava
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Thomas Sandmann
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Kirk R Henne
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Robert G Thorne
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Gilbert Di Paolo
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Giuseppe Astarita
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Dolores Diaz
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Adam P Silverman
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Ryan J Watts
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Zachary K Sweeney
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Mihalis S Kariolis
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA.
| | - Anastasia G Henry
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA.
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2
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Kariolis MS, Wells RC, Getz JA, Kwan W, Mahon CS, Tong R, Kim DJ, Srivastava A, Bedard C, Henne KR, Giese T, Assimon VA, Chen X, Zhang Y, Solanoy H, Jenkins K, Sanchez PE, Kane L, Miyamoto T, Chew KS, Pizzo ME, Liang N, Calvert MEK, DeVos SL, Baskaran S, Hall S, Sweeney ZK, Thorne RG, Watts RJ, Dennis MS, Silverman AP, Zuchero YJY. Brain delivery of therapeutic proteins using an Fc fragment blood-brain barrier transport vehicle in mice and monkeys. Sci Transl Med 2021; 12:12/545/eaay1359. [PMID: 32461332 DOI: 10.1126/scitranslmed.aay1359] [Citation(s) in RCA: 146] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/10/2020] [Accepted: 04/02/2020] [Indexed: 12/14/2022]
Abstract
Effective delivery of protein therapeutics to the central nervous system (CNS) has been greatly restricted by the blood-brain barrier (BBB). We describe the development of a BBB transport vehicle (TV) comprising an engineered Fc fragment that exploits receptor-mediated transcytosis for CNS delivery of biotherapeutics by binding a highly expressed brain endothelial cell target. TVs were engineered using directed evolution to bind the apical domain of the human transferrin receptor (hTfR) without the use of amino acid insertions, deletions, or unnatural appendages. A crystal structure of the TV-TfR complex revealed the TV binding site to be away from transferrin and FcRn binding sites, which was further confirmed experimentally in vitro and in vivo. Recombinant expression of TVs fused to anti-β-secretase (BACE1) Fabs yielded antibody transport vehicle (ATV) molecules with native immunoglobulin G (IgG) structure and stability. Peripheral administration of anti-BACE1 ATVs to hTfR-engineered mice and cynomolgus monkeys resulted in substantially improved CNS uptake and sustained pharmacodynamic responses. The TV platform readily accommodates numerous additional configurations, including bispecific antibodies and protein fusions, yielding a highly modular CNS delivery platform.
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Affiliation(s)
- Mihalis S Kariolis
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA.
| | - Robert C Wells
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Jennifer A Getz
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Wanda Kwan
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Cathal S Mahon
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Raymond Tong
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Do Jin Kim
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Ankita Srivastava
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Catherine Bedard
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Kirk R Henne
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Tina Giese
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Victoria A Assimon
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Xiaocheng Chen
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Yin Zhang
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Hilda Solanoy
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Katherine Jenkins
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Pascal E Sanchez
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Lesley Kane
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Takashi Miyamoto
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Kylie S Chew
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Michelle E Pizzo
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Nicholas Liang
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Meredith E K Calvert
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Sarah L DeVos
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | | | - Sejal Hall
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Zachary K Sweeney
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Robert G Thorne
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Ryan J Watts
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Mark S Dennis
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Adam P Silverman
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA
| | - Y Joy Yu Zuchero
- Denali Therapeutics Inc., 161 Oyster Point Blvd., South San Francisco, CA 94080, USA.
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Raziee H, Gulstene S, Lohrisch C, Lovedeep G, Speers C, Kwan W, Balkwill S, Cheung A, Casey S, Nichol A. Resection Margin Status and Radiation Boost to Surgical Cavity after Breast Conserving Surgery, a Pattern-of-Practice Study in British Columbia, Canada. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kohli K, Corns R, Vinnakota K, Steiner P, Elith C, Schellenberg D, Kwan W, Karvat A. A bioimpedance analysis of head-and-neck cancer patients undergoing radiotherapy. ACTA ACUST UNITED AC 2018; 25:e193-e199. [PMID: 29962845 DOI: 10.3747/co.25.3920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Malnutrition is a frequent manifestation in patients with head-and-neck cancer undergoing radiation therapy and a major contributor to morbidity and mortality. Thus, body composition is an important component of an overall evaluation of nutrition in cancer patients. Malnutrition is characterized by weight loss, loss of muscle mass, changes in cell membrane integrity, and alterations in fluid balance. Bioelectrical impedance analysis is a method to analyze body composition and includes parameters such as intracellular water content, extracellular water content, and cell membrane integrity in the form of a phase angle (Φ). Bioelectrical impedance analysis has consistently been shown to have prognostic value with respect to mortality and morbidity in patients undergoing chemotherapy. The goal of the present study was to evaluate the relationship between Φ, time, intracellular water content, and weight for head-and-neck cancer patients undergoing radiotherapy. The results demonstrate that Φ decreases with time and increases with intracellular water content and weight.
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Affiliation(s)
- K Kohli
- BC Cancer-Fraser Valley Centre, Surrey, BC
| | - R Corns
- Brody School of Medicine, East Carolina University, Greenville, North Carolina, U.S.A
| | - K Vinnakota
- University College Dublin, School of Medicine and Medical Science, Dublin, Ireland
| | - P Steiner
- BC Cancer-Fraser Valley Centre, Surrey, BC
| | - C Elith
- BC Cancer-Fraser Valley Centre, Surrey, BC
| | | | - W Kwan
- BC Cancer-Fraser Valley Centre, Surrey, BC
| | - A Karvat
- BC Cancer-Fraser Valley Centre, Surrey, BC
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Oo ZM, Illendula A, Grembecka J, Schmidt C, Zhou Y, Esain V, Kwan W, Frost I, North TE, Rajewski RA, Speck NA, Bushweller JH. A tool compound targeting the core binding factor Runt domain to disrupt binding to CBFβ in leukemic cells. Leuk Lymphoma 2017; 59:2188-2200. [PMID: 29249175 DOI: 10.1080/10428194.2017.1410882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The core binding factor (CBF) gene RUNX1 is a target of chromosomal translocations in leukemia, including t(8;21) in acute myeloid leukemia (AML). Normal CBF function is essential for activity of AML1-ETO, product of the t(8;21), and for survival of several leukemias lacking RUNX1 mutations. Using virtual screening and optimization, we developed Runt domain inhibitors which bind to the Runt domain and disrupt its interaction with CBFβ. On-target activity was demonstrated by the Runt domain inhibitors' ability to depress hematopoietic cell formation in zebrafish embryos, reduce growth and induce apoptosis of t(8;21) AML cell lines, and reduce progenitor activity of mouse and human leukemia cells harboring the t(8;21), but not normal bone marrow cells. Runt domain inhibitors had similar effects on murine and human T cell acute lymphocytic leukemia (T-ALL) cell lines. Our results confirmed that Runt domain inhibitors might prove efficacious in various AMLs and in T-ALL.
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Affiliation(s)
- Zaw Min Oo
- a Abramson Family Cancer Research Institute , Philadelphia , PA , USA.,b Department of Cell and Molecular Biology , University of Pennsylvania , Philadelphia , PA , USA
| | - Anuradha Illendula
- c Department of Molecular Physiology and Biological Physics , University of Virginia , Charlottesville , VA , USA
| | - Jolanta Grembecka
- d Department of Pathology , University of Michigan , Ann Arbor , MI , USA
| | - Charles Schmidt
- c Department of Molecular Physiology and Biological Physics , University of Virginia , Charlottesville , VA , USA
| | - Yunpeng Zhou
- c Department of Molecular Physiology and Biological Physics , University of Virginia , Charlottesville , VA , USA
| | - Virginie Esain
- e Department of Pathology , Beth Israel Deaconess Medical Center, Harvard Medical School , Boston , MA , USA
| | - Wanda Kwan
- e Department of Pathology , Beth Israel Deaconess Medical Center, Harvard Medical School , Boston , MA , USA
| | - Isaura Frost
- e Department of Pathology , Beth Israel Deaconess Medical Center, Harvard Medical School , Boston , MA , USA
| | - Trista E North
- e Department of Pathology , Beth Israel Deaconess Medical Center, Harvard Medical School , Boston , MA , USA
| | - Roger A Rajewski
- f Department of Pharmaceutical Chemistry , University of Kansas , Lawrence , KS , USA
| | - Nancy A Speck
- a Abramson Family Cancer Research Institute , Philadelphia , PA , USA.,b Department of Cell and Molecular Biology , University of Pennsylvania , Philadelphia , PA , USA
| | - John H Bushweller
- c Department of Molecular Physiology and Biological Physics , University of Virginia , Charlottesville , VA , USA
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Cortes M, Chen MJ, Stachura DL, Liu SY, Kwan W, Wright F, Vo LT, Theodore LN, Esain V, Frost IM, Schlaeger TM, Goessling W, Daley GQ, North TE. Developmental Vitamin D Availability Impacts Hematopoietic Stem Cell Production. Cell Rep 2017; 17:458-468. [PMID: 27705794 PMCID: PMC5338633 DOI: 10.1016/j.celrep.2016.09.012] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/18/2016] [Accepted: 09/02/2016] [Indexed: 01/01/2023] Open
Abstract
Vitamin D insufficiency is a worldwide epidemic affecting billions of individuals, including pregnant women and children. Despite its high incidence, the impact of active vitamin D3 (1,25(OH)D3) on embryonic development beyond osteo-regulation remains largely undefined. Here, we demonstrate that 1,25(OH)D3 availability modulates zebrafish hematopoietic stem and progenitor cell (HSPC) production. Loss of Cyp27b1-mediated biosynthesis or vitamin D receptor (VDR) function by gene knockdown resulted in significantly reduced runx1 expression and Flk1+cMyb+ HSPC numbers. Selective modulation in vivo and in vitro in zebrafish indicated that vitamin D3 acts directly on HSPCs, independent of calcium regulation, to increase proliferation. Notably, ex vivo treatment of human HSPCs with 1,25(OH)D3 also enhanced hematopoietic colony numbers, illustrating conservation across species. Finally, gene expression and epistasis analysis indicated that CXCL8 (IL-8) was a functional target of vitamin D3-mediated HSPC regulation. Together, these findings highlight the relevance of developmental 1,25(OH)D3 availability for definitive hematopoiesis and suggest potential therapeutic utility in HSPC expansion.
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Affiliation(s)
- Mauricio Cortes
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | | - David L Stachura
- Department of Biological Sciences, California State University, Chico, Chico, CA 95929, USA
| | - Sarah Y Liu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Wanda Kwan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Francis Wright
- Department of Biological Sciences, California State University, Chico, Chico, CA 95929, USA
| | - Linda T Vo
- Boston Children's Hospital, Boston, MA 02115, USA
| | - Lindsay N Theodore
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Virginie Esain
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Isaura M Frost
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | | - Wolfram Goessling
- Brigham and Women's Hospital, Boston, MA 02115, USA; Harvard Stem Cell Institute, Cambridge, MA 02138, USA
| | - George Q Daley
- Boston Children's Hospital, Boston, MA 02115, USA; Harvard Stem Cell Institute, Cambridge, MA 02138, USA
| | - Trista E North
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; Harvard Stem Cell Institute, Cambridge, MA 02138, USA.
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Leong N, Truong P, Tankel K, Kwan W, Weir L, Olivotto I. Abstract P1-10-06: Hypofractionated nodal radiotherapy (RT) did not increase arm morbidity compared to conventional fractionated nodal RT. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-10-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Regional nodal radiation therapy (RT) can cause adverse arm symptoms and lymphedema. Hypofractionation (HF), defined as >2 Gy/fraction, improves convenience but whether it increases arm morbidity is unclear. This study evaluates patient-reported arm symptoms in women treated with HF compared to conventional fractionation (CF) RT (defined as ≤2Gy/fraction).
Materials / Methods: Provincial cancer registries were used to identify subjects who received 3D, CT-planned nodal RT for pT1-3 pN0-2 M0 breast cancer from 2007-2009 in British Columbia and 2008 – 2010 in Alberta, Canada. Treatment eras were selected to enable sufficient follow-up time to develop late arm symptoms. Following research ethics approval, eligible patients were mailed an explanation letter and an externally validated, Self-reported Arm Symptom Scale (SASS) survey. The SASS included 8 questions about arm symptoms, with responses on a 5-point Likert scale regarding arm/hand problems (numbness, pain, stiffness, immobility and swelling), and 5 questions related to activities of daily living (ADL). Clinicopathologic characteristics and SASS scores were compared between HF vs. CF nodal RT cohorts using non-parametric analysis (on ordinal and scale responses) and binned chi-squared analysis (comparison for responses of 1 vs. > 1).
Results: 800/1759 eligible patients returned a completed survey (45.5%). Upon detailed chart review of responders, 92 cases with recurrence or metastasis were excluded. The remaining 708 cases formed the study cohort. Of these, 406 (57%) patients received HF RT (modal dose/fractionation 40 Gy/15 fractions (fx) and 45 Gy/20 fx), and 302 (43%) received CF RT (45 Gy/25 fx, 48-50 Gy/25 fx, and 50.4 Gy/28 fx). A boost was delivered to the breast in 22% of subjects, equally by fractionation group (p=0.31).
Median time interval since RT completion was 5.67 years. The mean age at diagnosis was 59.0 in HF vs 53.8 years in CF-treated cohorts (p<0.001). The mean # positive (n=3) and excised (n=12) nodes were similar between fractionation cohorts (p=0.44). Primary tumor size was marginally larger in the CF group (2.8 vs. 2.7 cm, p=0.03). 42.9% of patients were treated with partial mastectomy with no significant difference in fractionation (p=0.54). Overall, 602 (75.3%) patients received chemotherapy. A trend toward increased use of CF after chemotherapy was observed (78.8% vs. 72.7%, p=0.07).
The mean sums of responses for the arm symptoms / ADL components of the SASS were 12.5 / 7.6 vs. 13.3 / 7.9 for the HF and CF groups respectively (p=0.17 / 0.85). On analysis of individual questions, the CF group had a higher prevalence of self-reported symptoms, including shoulder stiffness (p=0.04), trouble moving the arm (p=0.02), and ability to reach overhead (p<0.01). There was no difference in self-reported arm swelling between the two groups (p=0.57).
Conclusion: Hypofractionated nodal RT was not associated with an increase in patient-reported arm symptoms or disability compared to conventional fractionated nodal RT. Subjects treated with CF RT reported more disability in certain aspects of arm and shoulder function. These data support the use of shorter fractionation when the regional lymph nodes are part of the therapeutic target.
Citation Format: Leong N, Truong P, Tankel K, Kwan W, Weir L, Olivotto I. Hypofractionated nodal radiotherapy (RT) did not increase arm morbidity compared to conventional fractionated nodal RT [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-10-06.
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Affiliation(s)
- N Leong
- Saskatchewan Cancer Agency Allan Blair Cancer Centre, Regina, SK, Canada; BC Cancer Agency Vancouver Island Centre, Victoria, BC, Canada; Alberta Health Services Tom Baker Cancer Centre, Calgary, AB, Canada; BC Cancer Agency Fraser Valley Centre, Surrey, BC, Canada; BC Cancer Agency Vancouver Centre, Vancouver, BC, Canada; Alberta Health Services Cross Cancer Institute, Edmonton, AB, Canada
| | - P Truong
- Saskatchewan Cancer Agency Allan Blair Cancer Centre, Regina, SK, Canada; BC Cancer Agency Vancouver Island Centre, Victoria, BC, Canada; Alberta Health Services Tom Baker Cancer Centre, Calgary, AB, Canada; BC Cancer Agency Fraser Valley Centre, Surrey, BC, Canada; BC Cancer Agency Vancouver Centre, Vancouver, BC, Canada; Alberta Health Services Cross Cancer Institute, Edmonton, AB, Canada
| | - K Tankel
- Saskatchewan Cancer Agency Allan Blair Cancer Centre, Regina, SK, Canada; BC Cancer Agency Vancouver Island Centre, Victoria, BC, Canada; Alberta Health Services Tom Baker Cancer Centre, Calgary, AB, Canada; BC Cancer Agency Fraser Valley Centre, Surrey, BC, Canada; BC Cancer Agency Vancouver Centre, Vancouver, BC, Canada; Alberta Health Services Cross Cancer Institute, Edmonton, AB, Canada
| | - W Kwan
- Saskatchewan Cancer Agency Allan Blair Cancer Centre, Regina, SK, Canada; BC Cancer Agency Vancouver Island Centre, Victoria, BC, Canada; Alberta Health Services Tom Baker Cancer Centre, Calgary, AB, Canada; BC Cancer Agency Fraser Valley Centre, Surrey, BC, Canada; BC Cancer Agency Vancouver Centre, Vancouver, BC, Canada; Alberta Health Services Cross Cancer Institute, Edmonton, AB, Canada
| | - L Weir
- Saskatchewan Cancer Agency Allan Blair Cancer Centre, Regina, SK, Canada; BC Cancer Agency Vancouver Island Centre, Victoria, BC, Canada; Alberta Health Services Tom Baker Cancer Centre, Calgary, AB, Canada; BC Cancer Agency Fraser Valley Centre, Surrey, BC, Canada; BC Cancer Agency Vancouver Centre, Vancouver, BC, Canada; Alberta Health Services Cross Cancer Institute, Edmonton, AB, Canada
| | - I Olivotto
- Saskatchewan Cancer Agency Allan Blair Cancer Centre, Regina, SK, Canada; BC Cancer Agency Vancouver Island Centre, Victoria, BC, Canada; Alberta Health Services Tom Baker Cancer Centre, Calgary, AB, Canada; BC Cancer Agency Fraser Valley Centre, Surrey, BC, Canada; BC Cancer Agency Vancouver Centre, Vancouver, BC, Canada; Alberta Health Services Cross Cancer Institute, Edmonton, AB, Canada
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8
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9
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Lim SE, Esain V, Kwan W, Theodore LN, Cortes M, Frost IM, Liu SY, North TE. HIF1α-induced PDGFRβ signaling promotes developmental HSC production via IL-6 activation. Exp Hematol 2016; 46:83-95.e6. [PMID: 27751871 DOI: 10.1016/j.exphem.2016.10.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/01/2016] [Indexed: 12/15/2022]
Abstract
Hematopoietic stem cells (HSCs) have the ability to both self-renew and differentiate each of the mature blood cell lineages and thereby reconstitute the entire blood system. Therefore, HSCs are therapeutically valuable for treatment of hematological malignances and bone marrow failure. We showed recently that transient glucose elevation elicited dose-dependent effects on HSCs through elevated metabolic activity and subsequent reactive oxygen species-mediated induction of Hypoxia-Inducible Factor 1α (Hif1α). Platelet-Derived Growth Factor B (pdgfb), a Hif1α-target, and its receptor, pdgfrb, were significantly upregulated in response to metabolic stimulation. Although the function of PDGF signaling is well established in vascular development, its role in hematopoiesis is less understood. Exposure to either a pan-PDGF inhibitor or a PDGFRβ-selective antagonist in the context of Hif1α stimulation blocked elevations in hematopoietic stem and progenitor cell (HSPC) formation as determined by runx1;cmyb whole-mount in situ hybridization (WISH) and HSPC-reporter flow cytometry analysis. Similar results were observed for morpholino (MO) knockdown of pdgfrb or dominant-negative pdgfrb expression, indicating that PDGFRβ signaling is a key downstream mediator of Hif1α-mediated induction of HSPCs. Notably, overexpression of Pdgfb ligand enhanced HSPC numbers in the aorta-gonado-mesonephros (AGM) at 36 hours postfertilization (hpf) and in the caudal hematopoietic tissue at 48 hpf. A survey of known PDGF-B/PDGFRβ regulatory targets by expression analysis revealed a significant increase in inflammatory intermediates, including Interleukin 6 (IL-6) and its receptor (IL-6R). MO-mediated knockdown of il6 or chemical inhibition of IL-6R antagonized the effect of Pdgfb overexpression. Furthermore, epistatic analysis of IL-6/IL-6R function confirmed activity downstream of Hif1α. Together, these findings define a Hif1α-regulated signaling axis mediated through PBFGB/PDGFRβ and IL-6/IL-6R that acts to control embryonic HSPC production.
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Affiliation(s)
- Sung-Eun Lim
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Virginie Esain
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Wanda Kwan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsay N Theodore
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mauricio Cortes
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Isaura M Frost
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sarah Y Liu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Trista E North
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA; Harvard Stem Cell Institute, Cambridge, Massachusetts, USA.
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10
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Kwan W, Cortes M, Frost I, Esain V, Theodore LN, Liu SY, Budrow N, Goessling W, North TE. The Central Nervous System Regulates Embryonic HSPC Production via Stress-Responsive Glucocorticoid Receptor Signaling. Cell Stem Cell 2016; 19:370-82. [PMID: 27424782 DOI: 10.1016/j.stem.2016.06.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/04/2016] [Accepted: 06/10/2016] [Indexed: 01/08/2023]
Abstract
Hematopoietic stem and progenitor cell (HSPC) specification is regulated by numerous defined factors acting locally within the hemogenic niche; however, it is unclear whether production can adapt to fluctuating systemic needs. Here we show that the CNS controls embryonic HSPC numbers via the hypothalamic-pituitary-adrenal/interrenal (HPA/I) stress response axis. Exposure to serotonin or the reuptake inhibitor fluoxetine increased runx1 expression and Flk1(+)/cMyb(+) HSPCs independent of peripheral innervation. Inhibition of neuronal, but not peripheral, tryptophan hydroxlyase (Tph) persistently reduced HSPC number. Consistent with central HPA/I axis induction and glucocorticoid receptor (GR) activation, GR agonists enhanced, whereas GR loss diminished, HSPC formation. Significantly, developmental hypoxia, as indicated by Hif1α function, induced the HPA/I axis and cortisol production. Furthermore, Hif1α-stimulated HSPC enhancement was attenuated by neuronal tph or GR loss. Our data establish that embryonic HSC production responds to physiologic stress via CNS-derived serotonin synthesis and central feedback regulation to control HSC numbers.
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Affiliation(s)
- Wanda Kwan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Mauricio Cortes
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Isaura Frost
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Virginie Esain
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Lindsay N Theodore
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Sarah Y Liu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Nadine Budrow
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Wolfram Goessling
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA
| | - Trista E North
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA.
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11
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Whittle AK, Kalsi T, Babic-Illman G, Wang Y, Fields P, Ross PJ, Maisey NR, Hughes S, Kwan W, Harari D. A comprehensive geriatric assessment screening questionnaire (CGA-GOLD) for older people undergoing treatment for cancer. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27132979 DOI: 10.1111/ecc.12509] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 12/12/2022]
Abstract
Oncology services do not routinely assess broader needs of older people with cancer. This study evaluates a comprehensive geriatric assessment and comorbidity screening questionnaire (CGA-GOLD) covering evidence-based domains and quality of life (EORTC-QLQ-C30). Patients aged 65+ attending oncology services were recruited into (1) Observational cohort (completed CGA-GOLD, received standard oncology care), (2) Intervention cohort (responses categorised 'low-risk', 'high-risk', 'possible need' by geriatricians). N = 417 observational patients (1002 invited by post, 418 consented, age 73.9 ± 5.4) completed CGA-GOLD in 11.7 ± 7.9 min, 86.3% required no assistance, 3.1% overall missing responses. Multiple problems reported: hypertension (18.1%), diabetes (16.9%), dyspnoea on flat surfaces (27.6%), polypharmacy (46%), difficulty walking (14.9%), fatigue (40.5%), living alone (30.9%), social isolation (11.2%), recent functional dependence (27.8%), urinary incontinence (21.4%), falls (13.3%). 237/239 intervention patients completed CGA-GOLD and consecutive subsets examined. The doctor and nurse specialist independently identified same need level in 87.3% (high inter-rater reliability kappa = 0.80), taking 1-2 min per questionnaire. Need level remained unchanged following hospital notes review against responses in 90% (75/83). 'Possible need' patients were telephoned with change in 29% (16/55) to low-risk and none to high-risk, confirming high need was not being missed. CGA-GOLD screening questionnaire was acceptable to older patients, feasibly administered in NHS cancer services, described comorbidities, CGA and QOL needs, and reliably identified higher risk patients requiring further input for optimal cancer treatment.
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Affiliation(s)
- A K Whittle
- Department of Ageing & Health, Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - T Kalsi
- Department of Ageing & Health, Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.,Division of Health and Social Care Research, King's College London, London, UK
| | - G Babic-Illman
- Department of Ageing & Health, Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
| | - Y Wang
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - P Fields
- Department of Haematology, Guys & St Thomas' NHS Trust, Guys Hospital, London, UK
| | - P J Ross
- Department of Medical Oncology, Guys & St Thomas' NHS Trust, Guys Hospital, London, UK
| | - N R Maisey
- Department of Medical Oncology, Guys & St Thomas' NHS Trust, Guys Hospital, London, UK
| | - S Hughes
- Department of Clinical Oncology, Guys & St Thomas' NHS Trust, London, UK
| | - W Kwan
- Bexley Clinical Commissioning Group/Macmillan GP, Crook Log General Practice Surgery, Bexleyheath, Kent, UK
| | - D Harari
- Department of Ageing & Health, Guys & St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.,Division of Health and Social Care Research, King's College London, London, UK
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12
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Cortes M, Liu SY, Kwan W, Alexa K, Goessling W, North TE. Accumulation of the Vitamin D Precursor Cholecalciferol Antagonizes Hedgehog Signaling to Impair Hemogenic Endothelium Formation. Stem Cell Reports 2015; 5:471-9. [PMID: 26365513 PMCID: PMC4624955 DOI: 10.1016/j.stemcr.2015.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/08/2015] [Accepted: 08/08/2015] [Indexed: 01/25/2023] Open
Abstract
Hematopoietic stem and progenitor cells (HSPCs) are born from hemogenic endothelium in the dorsal aorta. Specification of this hematopoietic niche is regulated by a signaling axis using Hedgehog (Hh) and Notch, which culminates in expression of Runx1 in the ventral wall of the artery. Here, we demonstrate that the vitamin D precursor cholecalciferol (D3) modulates HSPC production by impairing hemogenic vascular niche formation. Accumulation of D3 through exogenous treatment or inhibition of Cyp2r1, the enzyme required for D3 25-hydroxylation, results in Hh pathway antagonism marked by loss of Gli-reporter activation, defects in vascular niche identity, and reduced HSPCs. Mechanistic studies indicated the effect was specific to D3, and not active 1,25-dihydroxy vitamin D3, acting on the extracellular sterol-binding domain of Smoothened. These findings highlight a direct impact of inefficient vitamin D synthesis on cell fate commitment and maturation in Hh-regulated tissues, which may have implications beyond hemogenic endothelium specification.
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Affiliation(s)
- Mauricio Cortes
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Sarah Y Liu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Wanda Kwan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Kristen Alexa
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Wolfram Goessling
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA
| | - Trista E North
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA.
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13
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Kwan W, Cortes M, Liu SY, Goessling W, North TE. Serotonin regulates HSC formation via glucocorticoid production from the hypothalamic-pituitary-interrenal axis. Exp Hematol 2015. [DOI: 10.1016/j.exphem.2015.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Esain V, Kwan W, Carroll KJ, Cortes M, Liu SY, Frechette GM, Sheward LMV, Nissim S, Goessling W, North TE. Cannabinoid Receptor-2 Regulates Embryonic Hematopoietic Stem Cell Development via Prostaglandin E2 and P-Selectin Activity. Stem Cells 2015; 33:2596-612. [PMID: 25931248 DOI: 10.1002/stem.2044] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 03/11/2015] [Accepted: 03/30/2015] [Indexed: 12/30/2022]
Abstract
Cannabinoids (CB) modulate adult hematopoietic stem and progenitor cell (HSPCs) function, however, impact on the production, expansion, or migration of embryonic HSCs is currently uncharacterized. Here, using chemical and genetic approaches targeting CB-signaling in zebrafish, we show that CB receptor (CNR) 2, but not CNR1, regulates embryonic HSC development. During HSC specification in the aorta-gonad-mesonephros (AGM) region, CNR2 stimulation by AM1241 increased runx1;cmyb(+) HSPCs, through heightened proliferation, whereas CNR2 antagonism decreased HSPC number; FACS analysis and absolute HSC counts confirmed and quantified these effects. Epistatic investigations showed AM1241 significantly upregulated PGE2 synthesis in a Ptgs2-dependent manner to increase AGM HSCs. During the phases of HSC production and colonization of secondary niches, AM1241 accelerated migration to the caudal hematopoietic tissue (CHT), the site of embryonic HSC expansion, and the thymus; however these effects occurred independently of PGE2. Using a candidate approach for HSC migration and retention factors, P-selectin was identified as the functional target of CNR2 regulation. Epistatic analyses confirmed migration of HSCs into the CHT and thymus was dependent on CNR2-regulated P-selectin activity. Together, these data suggest CNR2-signaling optimizes the production, expansion, and migration of embryonic HSCs by modulating multiple downstream signaling pathways.
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Affiliation(s)
- Virginie Esain
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Wanda Kwan
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kelli J Carroll
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Mauricio Cortes
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Sarah Y Liu
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Gregory M Frechette
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Lea M V Sheward
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Sahar Nissim
- Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Wolfram Goessling
- Division of Genetics, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Stem Cell Institute, Cambridge, Massachusetts, USA
| | - Trista E North
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Stem Cell Institute, Cambridge, Massachusetts, USA
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15
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Lee T, Handy A, Wassersug R, Brotto L, Kwan W, Oliffe J, Dowsett G. EP-1245: The impact of prostate cancer on the sex lives of menwho- have-sex-with-men (MSM): a qualitative study. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Li Y, Esain V, Teng L, Xu J, Kwan W, Frost IM, Yzaguirre AD, Cai X, Cortes M, Maijenburg MW, Tober J, Dzierzak E, Orkin SH, Tan K, North TE, Speck NA. Inflammatory signaling regulates embryonic hematopoietic stem and progenitor cell production. Genes Dev 2014; 28:2597-612. [PMID: 25395663 PMCID: PMC4248291 DOI: 10.1101/gad.253302.114] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Here, Li et al. show that inflammatory signaling regulates embryonic hematopoietic stem and progenitor cell (HSPC) formation. HSCs from aorta/gonad/mesonephros (AGM) regions of midgestation mouse embryos expressed a robust innate immune/inflammatory signature. Mouse embryos lacking interferon γ (IFN-γ )or IFN-α signaling and zebrafish lacking IFN-γ and IFN-ϕ activity had fewer AGM HSPCs. IRF2-occupied genes identified in human fetal liver CD34+ HSPCs were actively transcribed in human and mouse HSPCs. Identifying signaling pathways that regulate hematopoietic stem and progenitor cell (HSPC) formation in the embryo will guide efforts to produce and expand HSPCs ex vivo. Here we show that sterile tonic inflammatory signaling regulates embryonic HSPC formation. Expression profiling of progenitors with lymphoid potential and hematopoietic stem cells (HSCs) from aorta/gonad/mesonephros (AGM) regions of midgestation mouse embryos revealed a robust innate immune/inflammatory signature. Mouse embryos lacking interferon γ (IFN-γ) or IFN-α signaling and zebrafish morphants lacking IFN-γ and IFN-ϕ activity had significantly fewer AGM HSPCs. Conversely, knockdown of IFN regulatory factor 2 (IRF2), a negative regulator of IFN signaling, increased expression of IFN target genes and HSPC production in zebrafish. Chromatin immunoprecipitation (ChIP) combined with sequencing (ChIP-seq) and expression analyses demonstrated that IRF2-occupied genes identified in human fetal liver CD34+ HSPCs are actively transcribed in human and mouse HSPCs. Furthermore, we demonstrate that the primitive myeloid population contributes to the local inflammatory response to impact the scale of HSPC production in the AGM region. Thus, sterile inflammatory signaling is an evolutionarily conserved pathway regulating the production of HSPCs during embryonic development.
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Affiliation(s)
- Yan Li
- Abramson Family Cancer Research Institute, Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19014, USA
| | - Virginie Esain
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Li Teng
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa 52242, USA
| | - Jian Xu
- Howard Hughes Medical Institute, Division of Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts 02115, USA
| | - Wanda Kwan
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Isaura M Frost
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Amanda D Yzaguirre
- Abramson Family Cancer Research Institute, Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19014, USA
| | - Xiongwei Cai
- Abramson Family Cancer Research Institute, Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19014, USA
| | - Mauricio Cortes
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Marijke W Maijenburg
- Abramson Family Cancer Research Institute, Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19014, USA
| | - Joanna Tober
- Abramson Family Cancer Research Institute, Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19014, USA
| | - Elaine Dzierzak
- The University of Edinburgh, Edinburgh EH8 9YL, United Kingdom
| | - Stuart H Orkin
- Howard Hughes Medical Institute, Division of Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts 02115, USA; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA
| | - Kai Tan
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa 52242, USA; Department of Bioengineering, University of Iowa, Iowa City, Iowa 52242, USA
| | - Trista E North
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02115, USA;
| | - Nancy A Speck
- Abramson Family Cancer Research Institute, Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, Pennsylvania 19014, USA
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Kwan W, Cortes M, Goessling W, North T. Serotonergic regulation of hematopoietic stem cell production in the AGM. Exp Hematol 2014. [DOI: 10.1016/j.exphem.2014.07.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Carroll KJ, Esain V, Garnaas MK, Cortes M, Dovey MC, Nissim S, Frechette GM, Liu SY, Kwan W, Cutting CC, Harris JM, Gorelick DA, Halpern ME, Lawson ND, Goessling W, North TE. Estrogen defines the dorsal-ventral limit of VEGF regulation to specify the location of the hemogenic endothelial niche. Dev Cell 2014; 29:437-53. [PMID: 24871948 DOI: 10.1016/j.devcel.2014.04.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 01/26/2014] [Accepted: 04/10/2014] [Indexed: 11/30/2022]
Abstract
Genetic control of hematopoietic stem and progenitor cell (HSPC) function is increasingly understood; however, less is known about the interactions specifying the embryonic hematopoietic niche. Here, we report that 17β-estradiol (E2) influences production of runx1+ HSPCs in the AGM region by antagonizing VEGF signaling and subsequent assignment of hemogenic endothelial (HE) identity. Exposure to exogenous E2 during vascular niche development significantly disrupted flk1+ vessel maturation, ephrinB2+ arterial identity, and specification of scl+ HE by decreasing expression of VEGFAa and downstream arterial Notch-pathway components; heat shock induction of VEGFAa/Notch rescued E2-mediated hematovascular defects. Conversely, repression of endogenous E2 activity increased somitic VEGF expression and vascular target regulation, shifting assignment of arterial/venous fate and HE localization; blocking E2 signaling allowed venous production of scl+/runx1+ cells, independent of arterial identity acquisition. Together, these data suggest that yolk-derived E2 sets the ventral boundary of hemogenic vascular niche specification by antagonizing the dorsal-ventral regulatory limits of VEGF.
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Affiliation(s)
- Kelli J Carroll
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Virginie Esain
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Maija K Garnaas
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Mauricio Cortes
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Michael C Dovey
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Sahar Nissim
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Gregory M Frechette
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Sarah Y Liu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Wanda Kwan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Claire C Cutting
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - James M Harris
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | | | | | - Nathan D Lawson
- University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Wolfram Goessling
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; Harvard Stem Cell Institute, Cambridge, MA 02138, USA.
| | - Trista E North
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA; Harvard Stem Cell Institute, Cambridge, MA 02138, USA.
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19
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Lee T, Singh-Carlson S, Oshan G, Kwan W. Problems Encountered During Cultural Adaptation of the EPIC Questionnaire for Prostate Cancer Into Punjabi and Chinese. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Nguyen SKA, Oxley P, Rastegar R, Joffres M, Kwan W. Abstract P4-17-08: Tissue Expander/Implant Breast Reconstruction with and without Postmastectomy Radiation: Predictive Factors for Complications. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p4-17-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: 1) Review our complication rates with implant/expander reconstruction for breast cancer 2) Determine factors for complications, especially with postmastectomy radiation (PMRT)
Materials and Methods: Data were collected through chart review of all patients (2004–2008) from an academic hospital undergoing implant/expander reconstruction. SAS was used for two or multi-variable analyses (logistic regression) to determine predictive factors for complications. Among PMRT patients, we evaluated complications rates by risk factors.
Results: 237 patients underwent implant/expander reconstruction. Median time from implant placement until last follow-up was 173 days. 21.5% developed major complications (needing operative time or infection needing intravenous treatment). Diabetes was the most consistent factor associated with major complications (46.7 vs 20.1%, p = 0.02 and p = 0.009 in multivariable analysis). Radiation was linked to capsular contractures (18.6 vs 10.1%, p = 0.02). Chemotherapy (25.0 vs 19.0%, p = 0.26) or radiation (26.3 vs 19.1%, p = 0.21) did not predict major complications. Among patients receiving PMRT (80 patients), 26.2% had major complications, 34 had immediate PMRT on the expander and 44 had PMRT to the chest wall, followed by delayed reconstruction with expander/implant placement. In these, delayed reconstruction increased dehiscence (0 vs 18.2%, p = 0.009) compared to immediate reconstruction, with a trend for higher incidence of major complications in the delayed reconstruction group (14.7 vs 34.1%, p = 0.05). 40 Gy/16 versus 50–50.4 Gy/25-28 (28 vs 24%, p = 0.78) was not associated with major complications. Diabetes and smoking were associated with several complications.
Conclusions: Diabetes is associated with a higher rate of major complications after expander/implant reconstruction while radiation increases capsular contractures. If PMRT is indicated, putting in an expander before radiation results in less morbidity than delayed reconstruction. Also, 40 Gy/16 versus 50–50.4 Gy/25-28 do not differ much in terms of complication rates.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-08.
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Affiliation(s)
- SKA Nguyen
- British Columbia Cancer Agency, Fraser Valley Cancer Centre; University of British Columbia; Simon Fraser University
| | - P Oxley
- British Columbia Cancer Agency, Fraser Valley Cancer Centre; University of British Columbia; Simon Fraser University
| | - R Rastegar
- British Columbia Cancer Agency, Fraser Valley Cancer Centre; University of British Columbia; Simon Fraser University
| | - M Joffres
- British Columbia Cancer Agency, Fraser Valley Cancer Centre; University of British Columbia; Simon Fraser University
| | - W Kwan
- British Columbia Cancer Agency, Fraser Valley Cancer Centre; University of British Columbia; Simon Fraser University
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Kwan W, Träger U, Davalos D, Chou A, Bouchard J, Andre R, Miller A, Weiss A, Giorgini F, Cheah C, Möller T, Stella N, Akassoglou K, Tabrizi SJ, Muchowski PJ. Mutant huntingtin impairs immune cell migration in Huntington disease. J Clin Invest 2012; 122:4737-47. [PMID: 23160193 DOI: 10.1172/jci64484] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 09/27/2012] [Indexed: 11/17/2022] Open
Abstract
In Huntington disease (HD), immune cells are activated before symptoms arise; however, it is unclear how the expression of mutant huntingtin (htt) compromises the normal functions of immune cells. Here we report that primary microglia from early postnatal HD mice were profoundly impaired in their migration to chemotactic stimuli, and expression of a mutant htt fragment in microglial cell lines was sufficient to reproduce these deficits. Microglia expressing mutant htt had a retarded response to a laser-induced brain injury in vivo. Leukocyte recruitment was defective upon induction of peritonitis in HD mice at early disease stages and was normalized upon genetic deletion of mutant htt in immune cells. Migration was also strongly impaired in peripheral immune cells from pre-manifest human HD patients. Defective actin remodeling in immune cells expressing mutant htt likely contributed to their migration deficit. Our results suggest that these functional changes may contribute to immune dysfunction and neurodegeneration in HD, and may have implications for other polyglutamine expansion diseases in which mutant proteins are ubiquitously expressed.
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Affiliation(s)
- Wanda Kwan
- Biomedical Sciences Program, UCSF, San Francisco, California, USA
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Tran E, Tyldesley S, Paquette M, Hamm J, Liu M, Lim J, Keyes M, Kwan W, Pickles T. Population-based Validation of the Bolla Study in T3-4 Prostate Cancer in British Columbia. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Raedler H, Vieyra MB, Leisman S, Lakhani P, Kwan W, Yang M, Johnson K, Faas SJ, Tamburini P, Heeger PS. Anti-complement component C5 mAb synergizes with CTLA4Ig to inhibit alloreactive T cells and prolong cardiac allograft survival in mice. Am J Transplant 2011; 11:1397-406. [PMID: 21668627 PMCID: PMC3128644 DOI: 10.1111/j.1600-6143.2011.03561.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
While activation of serum complement mediates antibody-initiated vascular allograft injury, increasing evidence indicates that complement also functions as a modulator of alloreactive T cells. We tested whether blockade of complement activation at the C5 convertase step affects T cell-mediated cardiac allograft rejection in mice. The anti-C5 mAb BB5.1, which prevents the formation of C5a and C5b, synergized with subtherapeutic doses of CTLA4Ig to significantly prolong the survival of C57BL/6 heart grafts that were transplanted into naive BALB/c recipients. Anti-C5 mAb treatment limited the induction of donor-specific IFNγ-producing T cell alloimmunity without inducing Th2 or Th17 immunity in vivo and inhibited primed T cells from responding to donor antigens in secondary mixed lymphocyte responses. Additional administration of anti-C5 mAb to the donor prior to graft recovery further prolonged graft survival and concomitantly reduced both the in vivo trafficking of primed T cells into the transplanted allograft and decreased expression of T cell chemoattractant chemokines within the graft. Together these results support the novel concept that C5 blockade can inhibit T cell-mediated allograft rejection through multiple mechanisms, and suggest that C5 blockade may constitute a viable strategy to prevent and/or treat T cell-mediated allograft rejection in humans.
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Affiliation(s)
- H Raedler
- Division of Nephrology, Mount Sinai School of Medicine, New York, NY, USA
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24
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Khaira M, Huang V, Liu M, Cheung A, Laberge T, Kwan W. The Use of Cone Beam CT for Treatment Verification in Prostate Radiotherapy. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Tauber E, Miller-Fleming L, Mason RP, Kwan W, Clapp J, Butler NJ, Outeiro TF, Muchowski PJ, Giorgini F. Functional gene expression profiling in yeast implicates translational dysfunction in mutant huntingtin toxicity. J Biol Chem 2010; 286:410-9. [PMID: 21044956 PMCID: PMC3012999 DOI: 10.1074/jbc.m110.101527] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Huntington disease (HD) is a neurodegenerative disorder caused by the expansion of a polyglutamine tract in the huntingtin (htt) protein. To uncover candidate therapeutic targets and networks involved in pathogenesis, we integrated gene expression profiling and functional genetic screening to identify genes critical for mutant htt toxicity in yeast. Using mRNA profiling, we have identified genes differentially expressed in wild-type yeast in response to mutant htt toxicity as well as in three toxicity suppressor strains: bna4Δ, mbf1Δ, and ume1Δ. BNA4 encodes the yeast homolog of kynurenine 3-monooxygenase, a promising drug target for HD. Intriguingly, despite playing diverse cellular roles, these three suppressors share common differentially expressed genes involved in stress response, translation elongation, and mitochondrial transport. We then systematically tested the ability of the differentially expressed genes to suppress mutant htt toxicity when overexpressed and have thereby identified 12 novel suppressors, including genes that play a role in stress response, Golgi to endosome transport, and rRNA processing. Integrating the mRNA profiling data and the genetic screening data, we have generated a robust network that shows enrichment in genes involved in rRNA processing and ribosome biogenesis. Strikingly, these observations implicate dysfunction of translation in the pathology of HD. Recent work has shown that regulation of translation is critical for life span extension in Drosophila and that manipulation of this process is protective in Parkinson disease models. In total, these observations suggest that pharmacological manipulation of translation may have therapeutic value in HD.
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Affiliation(s)
- Eran Tauber
- Department of Genetics, University of Leicester, Leicester LE1 7RH, United Kingdom
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26
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Liu M, Moiseenko V, Agranovich A, Karvat A, Kwan W, Saleh Z, Apte A, Deasy J. Normal Tissue Complication Probability (NTCP) Modeling of Late Rectal Bleeding following External Beam Radiotherapy for Prostate Cancer: A Test of the QUANTEC-favored Model. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Kwan W, Al-Tourah AJ, Speers C, Woods R, Kennecke H, Olivotto IA. Does HER2 status influence locoregional failure rates in breast cancer patients treated with mastectomy for pT1-2pN0 disease? Ann Oncol 2009; 21:988-93. [PMID: 19825881 DOI: 10.1093/annonc/mdp396] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The impact of HER2 overexpression on the locoregional control of breast cancer is controversial. PATIENTS AND METHODS Data on 906 women diagnosed with pT(1-2)pN(0) breast cancer from 1986 to 1992 with known HER2 status and treated with a modified radical mastectomy without adjuvant radiotherapy or adjuvant trastuzumab were analyzed with respect to local relapse-free survival (LRFS), regional relapse-free survival (RRFS) and distant relapse-free survival (DRFS). Log-rank statistics were used to compare 10-year Kaplan-Meier curves of LRFS, RRFS and DRFS in HER2+ and HER2- patients. RESULTS Median follow-up was 12.8 years. HER2+ patients had a worse DRFS (P = 0.028) but there was no statistically significant difference in LRFS or RRFS between HER2+ and HER2- patients (P = 0.32 and 0.24 for LRFS and RRFS, respectively). Ten-year LRFS estimates among HER2+ patients was 91.3% and 86.9% for HER2- patients. Ten-year RRFS estimates for HER2+ and HER2- patients were 88.0% and 93.0%, respectively. CONCLUSION HER2 overexpression was not associated with higher local or regional recurrence risk in subjects with pT(1-2)pN(0) breast cancer following mastectomy and nodal dissection after a median follow-up of >12 years.
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Affiliation(s)
- W Kwan
- Radiation Therapy Program, Fraser Valley Centre, British Columbia, Canada.
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28
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Olson R, Kosztyla R, Moiseenko V, Carolan H, Balkwill S, Karvat A, Kwan W. 119 CUTANEOUS MARKERS USED FOR TARGET LOCALIZATION IN ACCELERATED PARTIAL BREAST IRRADIATION (APBI) ARE STRONGLY CORRELATED WITH THE UNDERLYING SURGICAL CAVITY. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72506-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Kosztyla R, Olson R, Carolan H, Balkwill S, Moiseenko V, Kwan W. Sci-Thurs AM: YIS-07: Dosimetric Consequences of Surgical Cavity Contour Variability in Accelerated Partial Breast Irradiation. Med Phys 2009. [DOI: 10.1118/1.3244167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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30
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Kosztyla R, Olson R, Carolan H, Balkwill S, Moiseenko V, Kwan W. TU-D-BRC-03: Assessment of Interobserver and Intraobserver Surgical Cavity Contour Variability in Accelerated Partial Breast Irradiation Through the Use of a Representative Surgical Cavity Contour. Med Phys 2009. [DOI: 10.1118/1.3182378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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31
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Kohli K, Harrop S, Kwan W, Thomas S, Ramaseshan R. SU-FF-I-14: Investigation of Metallic Filters On the Detectability of Soft Tissues in Cone Beam Computed Tomography Using Flat Panel Detector of Acuity Simulator. Med Phys 2009. [DOI: 10.1118/1.3181133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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32
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Thomas-Maclean R, Towers A, Quinlan E, Hack TF, Kwan W, Miedema B, Tilley A, Graham P. "This is a kind of betrayal": a qualitative study of disability after breast cancer. Curr Oncol 2009; 16:26-32. [PMID: 19526082 PMCID: PMC2695715 DOI: 10.3747/co.v16i3.389] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We proposed to document the effect of arm morbidity and disability in 40 Canadian women who were 12-24 months post breast cancer surgery. METHODS We completed 40 qualitative interviews as one component of a multidisciplinary national longitudinal study of arm morbidity after breast cancer (n = 745) involving four research sites (Fredericton/Saint John, Montreal, Winnipeg, Surrey). During semi-structured interviews, participants who had reported arm morbidity and disability in earlier surveys were asked to discuss the effects of these conditions on everyday life. RESULTS The interviewees reported making major adjustments to paid and unpaid work, which often involved the assistance of family members, thus demonstrating the effect of disability. Interview data resulted in the creation of a model that addresses arm morbidity and disability, and that holds implications for health care professionals. CONCLUSIONS Based on the interview findings, we conclude that a robust measure of disability after breast cancer should be developed. In the absence of a validated measure of the effect of disability, evaluating qualitative responses to questions about everyday activities could provide the impetus for provision of physical therapy and emotional support.
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Affiliation(s)
- R Thomas-Maclean
- Department of Sociology, University of Saskatchewan, Saskatoon, SK.
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33
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Morris WJ, Keyes M, Palma D, Spadinger I, McKenzie MR, Agranovich A, Pickles T, Liu M, Kwan W, Wu J, Berthelet E, Pai H. Population-based study of biochemical and survival outcomes after permanent 125I brachytherapy for low- and intermediate-risk prostate cancer. Urology 2009; 73:860-5; discussion 865-7. [PMID: 19168203 DOI: 10.1016/j.urology.2008.07.064] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 07/01/2008] [Accepted: 07/07/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To analyze the biochemical and survival outcomes after permanent low-dose-rate prostate brachytherapy in a large, consecutive, population-based cohort of patients. METHODS A total of 1006 consecutive implants were performed from July 20, 1998 to October 23, 2003 for men with low-risk and "low-tier" intermediate-risk prostate cancer. The prescribed minimal peripheral dose was 144 Gy, using 0.33 mCi (125)I sources and a preplan technique with a strong posterior-peripheral dose bias. Most patients (65%) had received 6 months of androgen deprivation therapy. Supplemental external beam radiotherapy was not used. The prognostic features, dose metrics, and follow-up data were prospectively collected. Kaplan-Meier and Cox regression analyses were used to assess the factors associated with freedom from biochemical recurrence and survival. RESULTS The median patient age at treatment was 66 years. The median follow-up was 54 months for biochemical outcomes and 66 months for survival. The actuarial freedom from biochemical recurrence rate was 95.6% +/- 1.6% at 5 years and 94.0% +/- 2.2% at 7 years. On multivariate analysis, the pretreatment prostate-specific antigen level (P = .03) and androgen deprivation therapy use (P = .04) were predictive of the freedom from biochemical recurrence. The actuarial rates of distant metastasis and disease-specific death at 5 years were both <1%. The overall survival rate at 5 years was 95.2% +/- 1.4% and was 93.4% +/- 1.8% at 7 years. On multivariate analysis, only age was predictive of overall survival (P = .011). CONCLUSIONS When consistently planned and delivered, low-dose-rate brachytherapy, without supplemental external beam radiotherapy or intraoperative planning, can produce cancer-specific outcomes for men with low- and "low-tier" intermediate-risk prostate cancer at least equal to that produced by dose-escalated external beam radiotherapy or surgical prostatectomy.
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Affiliation(s)
- W J Morris
- British Columbia Cancer Centre, Vancouver, British Columbia, Canada.
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34
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Cheng A, Tang K, Yip H, Kwan W, Lee Y, Lee A, Lee K, Wong K, Gomersall C. Portable chest radiography in mechanically ventilated ICU patients: does synchronizing with end-inspiration improve the quality of films? Crit Care 2009. [PMCID: PMC4083891 DOI: 10.1186/cc7169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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35
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Liu S, Cheng H, Kwan W, Lubieniecka JM, Nielsen TO. Histone deacetylase inhibitors induce growth arrest, apoptosis, and differentiation in clear cell sarcoma models. Mol Cancer Ther 2008; 7:1751-61. [PMID: 18566246 DOI: 10.1158/1535-7163.mct-07-0560] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clear cell sarcoma is an aggressive malignancy occurring most commonly in the distal extremities of young adults, characterized by t(12;22)(q13;q12) creating the chimeric fusion oncoprotein EWS-ATF1. We assessed growth inhibition and differentiation effects of histone deacetylase inhibitors MS-275 and romidepsin (depsipeptide, FK228) on clear cell sarcoma cells and evaluated drug sensitivity among related translocation-associated sarcomas and other cell models. Three clear cell sarcoma cell lines, seven other sarcomas, six nonsarcoma malignant cell lines, and two nonneoplastic mesenchymal cell models were treated with MS-275 or romidepsin. Growth inhibition was assayed by monolayer 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Induction of cell cycle arrest and apoptosis were assessed by propidium iodide/Annexin V flow cytometry in monolayer and spheroid cultures and by immunoblotting analysis. Expression levels of key genes involved in mesenchymal differentiation and of EWS-ATF1 were measured by quantitative real-time PCR in clear cell sarcoma cells treated with histone deacetylase inhibitors. MS-275 and romidepsin inhibited growth in clear cell sarcoma cells by inducing cell cycle arrest and apoptosis in a time- and dose-dependent manner. Sarcomas showed greater sensitivity than other tumor types, with clear cell sarcomas most sensitive of all, whereas nonmalignant mesenchymal cells were highly resistant. MS-275 at 1 micromol/L and romidepsin at 1 nmol/L induced histone H3 acetylation, cell cycle arrest, apoptosis, and differentiation in clear cell sarcoma cells within 24 hours. Histone deacetylase inhibitors increased expression of SOX9, MYOD1, and PPARG and decreased EWS-ATF1 expression in clear cell sarcoma cells. Histone deacetylase inhibitors show promising preclinical activity in multiple clear cell sarcoma models.
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Affiliation(s)
- Shuzhen Liu
- Genetic Pathology Evaluation Centre, University of British Columbia, Vancouver, British Columbia, Canada
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36
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Giorgini F, Möller T, Kwan W, Zwilling D, Wacker JL, Hong S, Tsai LCL, Cheah CS, Schwarcz R, Guidetti P, Muchowski PJ. Histone deacetylase inhibition modulates kynurenine pathway activation in yeast, microglia, and mice expressing a mutant huntingtin fragment. J Biol Chem 2007; 283:7390-400. [PMID: 18079112 DOI: 10.1074/jbc.m708192200] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The kynurenine pathway of tryptophan degradation is hypothesized to play an important role in Huntington disease, a neurodegenerative disorder caused by a polyglutamine expansion in the protein huntingtin. Neurotoxic metabolites of the kynurenine pathway, generated in microglia and macrophages, are present at increased levels in the brains of patients and mouse models during early stages of disease, but the mechanism by which kynurenine pathway up-regulation occurs in Huntington disease is unknown. Here we report that expression of a mutant huntingtin fragment was sufficient to induce transcription of the kynurenine pathway in yeast and that this induction was abrogated by impairing the activity of the histone deacetylase Rpd3. Moreover, numerous genetic suppressors of mutant huntingtin toxicity that are functionally unrelated converged unexpectedly on the kynurenine pathway, supporting a critical role for the kynurenine pathway in mediating mutant huntingtin toxicity in yeast. Histone deacetylase-dependent regulation of the kynurenine pathway was also observed in a mouse model of Huntington disease, in which treatment with a neuroprotective histone deacetylase inhibitor blocked activation of the kynurenine pathway in microglia expressing a mutant huntingtin fragment in vitro and in vivo. These findings suggest that a mutant huntingtin fragment can perturb transcriptional programs in microglia, and thus implicate these cells as potential modulators of neurodegeneration in Huntington disease that are worthy of further investigation.
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Affiliation(s)
- Flaviano Giorgini
- Department of Pharmacology, University of Washington, Seattle, Washington 98195, USA
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37
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Chau M, Leung S, Kam K, Cheung K, Kwan W, Yu K, Chiu K, Cheung L, Chan T. A Broadly-Adaptive Array of Dose Constraint Templates for Planning of Intensity-Modulated Radiation Therapy for Advanced T-Stage Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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38
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Kwan W, Duncan G, Van Patten C, Liu M, Lima J. 204 A phase II trial of a soy beverage for subjects without clinical disease with rising psa after radical radiation for prostate cancer. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80945-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Miller S, Keyes M, Moravan V, Kwan W, Liu M, Morris J, Halperin R, Pai H, Pickles T. 133 Late urinary symptom flare following prostate brachytherapy. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80874-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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40
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Chau M, Leung S, Kam K, Cheung K, Kwan W, Yu K, Chiu K, Chan T. SU-FF-T-191: Dosimetric Improvement in Treatment of Advanced-Stage Nasopharyngeal Carcinoma Using Split Organ Delineation Approach and Multiple Virtual Organs Generation Approach in Intensity-Modulated Radiation Therapy Dose Optimization. Med Phys 2006. [DOI: 10.1118/1.2241115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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41
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Chung C, Berthelet E, Truong P, Wong F, Currie T, Kwan W, Patterson K. 207 The effect of vitamin E cream on acute skin toxicity during adjuvant radiotherapy for breast cancer. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80368-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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42
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Terry J, Lubieniecka JM, Kwan W, Liu S, Nielsen TO. Hsp90 Inhibitor 17-Allylamino-17-Demethoxygeldanamycin Prevents Synovial Sarcoma Proliferation via Apoptosis in In vitro Models. Clin Cancer Res 2005; 11:5631-8. [PMID: 16061882 DOI: 10.1158/1078-0432.ccr-05-0398] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Synovial sarcoma is a soft tissue malignancy with a poor prognosis; many patients will die from this disease within 10 years of diagnosis, despite treatment. Gene expression profiling and immunohistochemistry studies have identified oncogenes that are highly expressed in synovial sarcoma. Included in this group are receptor tyrosine kinases such as epidermal growth factor receptor, insulin-like growth factor receptor 1, fibroblast growth factor receptor 3, KIT, and HER2. Inhibitors of these growth-promoting receptors are likely to inhibit proliferation of synovial sarcoma; however, the effect of receptor tyrosine kinase inhibitors on synovial sarcoma is largely unknown. We assessed the ability of the following receptor tyrosine kinase inhibitors to halt proliferation and induce apoptosis in synovial sarcoma monolayer and three dimensional spheroid in vitro models: gefitinib (Iressa), NVP-AEW541, imatinib mesylate (Gleevec), SU5402, PRO-001, trastuzumab (Herceptin), and 17-allylamino-17-demethoxygeldanamycin (17-AAG). Gefitinib, NVP-AEW541, and imatinib inhibited proliferation only at relatively high concentrations, which are not clinically applicable. 17-AAG, which destabilizes multiple receptor tyrosine kinases and other oncoproteins through heat shock protein 90 inhibition, prevented proliferation and induced apoptosis in synovial sarcoma monolayer models at concentrations achievable in human serum. 17-AAG treatment was also associated with receptor tyrosine kinase degradation and induction of apoptosis in synovial sarcoma spheroid models. 17-AAG was more effective than doxorubicin, particularly in the spheroid models. Here we provide in vitro evidence that 17-AAG, a clinically applicable drug with known pharmacology and limited toxicity, inhibits synovial sarcoma proliferation by inducing apoptosis, and thus has potential as a systemic therapy for this disease.
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Affiliation(s)
- Jefferson Terry
- Genetic Pathology Evaluation Centre, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Kwan W, Terry J, Liu S, Knowling MA, Nielsen T. Effect of depsipeptide (NSC 630176), a histone deacetylase inhibitor, on human synovial sarcoma in vitro. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- W. Kwan
- Univ of British Columbia, Vancouver, BC, Canada; British Columbia Cancer Agency, Vancouver, BC, Canada
| | - J. Terry
- Univ of British Columbia, Vancouver, BC, Canada; British Columbia Cancer Agency, Vancouver, BC, Canada
| | - S. Liu
- Univ of British Columbia, Vancouver, BC, Canada; British Columbia Cancer Agency, Vancouver, BC, Canada
| | - M. A. Knowling
- Univ of British Columbia, Vancouver, BC, Canada; British Columbia Cancer Agency, Vancouver, BC, Canada
| | - T. Nielsen
- Univ of British Columbia, Vancouver, BC, Canada; British Columbia Cancer Agency, Vancouver, BC, Canada
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Liu H, Hsu Y, Huang J, Kwan W, Wu C, Mahankali S. SU-FF-I-32: Detectability of Vasodilatation During Breath Holding by Dynamic CBV-Based MRI: Comparison with BOLD-Based MRI. Med Phys 2005. [DOI: 10.1118/1.1997512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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45
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Chan AT, Ngan R, Teo P, Leung SF, Yiu HY, Yeo W, Mok T, Cheung FY, Kwan W, Zee B. Final results of a phase III randomized study of concurrent weekly cisplatin-RT versus RT alone in locoregionally advanced nasopharyngeal carcinoma (NPC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. T. Chan
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - R. Ngan
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - P. Teo
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - S. F. Leung
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - H. Y. Yiu
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - W. Yeo
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - T. Mok
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - F. Y. Cheung
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - W. Kwan
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
| | - B. Zee
- Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region of China; Queen Elizabeth Hospital, Hong Kong, Hong Kong Special Administrative Region of China
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Pickles T, Liu M, Berthelet E, Kim-Sing C, Kwan W, Tyldesley S. The effect of smoking on outcome following external radiation for localized prostate cancer. J Urol 2004; 171:1543-6. [PMID: 15017216 DOI: 10.1097/01.ju.0000118292.25214.a4] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE We investigated whether a smoking habit affects biochemical and survival outcome after curative external beam radiation therapy (EBRT) for localized prostate cancer. MATERIALS AND METHODS The study population comprised 601 men treated with curative EBRT between 1994 and 1997 who had a smoking history available. Pretreatment prognostic factors were examined and high risk was defined as any of prostate specific antigen greater than 20, Gleason greater than 7 or stages T3-4. Biochemical outcome (bNED) was assessed by American Society for Therapeutic Radiology and Oncology, and Houston criteria. Biochemical, clinical, prostate cancer and nonprostate cancer death rates were examined by univariate and multivariate statistics. RESULTS Of the men 15% were current smokers, 55% were former smokers and 31% were nonsmokers. Current smokers were younger than former smokers or nonsmokers by a mean of 2.5 years (p <0.001). Current smokers had higher risk cancers than former smokers or nonsmokers (high risk 60%, 40% and 43%, respectively, p = 0.017). Five-year bNED rates for smokers were significantly worse than for former smokers or nonsmokers (55%, 69% and 73%, p = 0.01 and 0.0019, respectively). Median followup was 59 months. Multivariate analysis confirmed smoking as an independent adverse factor for bNED (p = 0.013) even when controlling for prostate specific antigen (p <0.0001), Gleason score (p <0.0001), stage (not significant), radiation dose (not significant) and neoadjuvant hormone use (p = 0.0014). Local and metastatic failure did not differ among the groups. Prostate cancer specific mortality was nonsignificantly worse in smokers but overall mortality was much greater. CONCLUSIONS Smokers present with higher risk prostate cancers. Outcomes following EBRT are poorer, even when accounting for differences in known pretreatment factors.
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Affiliation(s)
- T Pickles
- Radiation Program, Columbia Cancer Agency, Vancouver Clinic, British Columbia, Canada.
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Berthelet E, Liu M, Truong P, Czaykowski P, Kalach N, Yu C, Patterson K, Currie T, Kristensen S, Kwan W, Moravan V. CT slice index and thickness: impact on organ contouring in radiation treatment planning for prostate cancer. J Appl Clin Med Phys 2004; 4:365-73. [PMID: 14604426 PMCID: PMC5724462 DOI: 10.1120/jacmp.v4i4.2511] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: To assess the impact of CT slice index and thickness (3 mm versus 5 mm) on (i) prostate volume, dimensions, and isocenter coordinates, (ii) bladder and rectal volumes, and (iii) DRR quality, in the treatment of prostate cancer. Methods: 16 patients with prostate cancer underwent two planning CT‐scans using 3 and 5 mm slice index/thickness. Prostate, bladder, and rectum were outlined on all scans. Prostate isocenter coordinates, maximum dimensions, and volumes were compared along with bladder and rectal volumes. Bladder volumes and maximum diameters were further investigated using a second observer. A comparative analysis of DRR quality was conducted as well as a dosimetric analysis using DVH. Results: The differences in measurements of prostate volume, isocenter coordinates and maximum dimensions between the 3 and 5 mm scans, were small and not statistically significant. Similar finding was seen for rectal volume. However, bladder volume was always larger on the 3 mm scan (mean difference=27.9 cc; SE=4.8 cc; 95% CI: 17.7−38.2 cc; p<0.001) and the findings were reproduced with the second observer (mean difference=31.9 cc; SE=4.7 cc; 95% CI: 21.9−41.9 cc; p<0.001). The differences in volume are caused by a slight increase in (1) the measurement of the longitudinal dimensions on the 3 mm scans, and (2) the slice by slice measured bladder area on the 3 mm scans. The latter is due to partial volume effect. The 3 mm DRR were slightly better than the 5 mm DRR. The bladder DVH differed significantly in some patients. Conclusion: Bladder volume is significantly larger on the 3 mm scans. Differences in contoured areas may be accounted for, in part, by the partial volume effect. PACS number(s): 87.57.–s, 87.53.–j
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Affiliation(s)
- E. Berthelet
- Department of Radiation OncologyBCCA‐Vancouver Island Centre2410 Lee AvenueVictoriaBCV8R 6V5Canada
| | - M. Liu
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - P. Truong
- Department of Radiation OncologyBCCA‐Vancouver Island Centre2410 Lee AvenueVictoriaBCV8R 6V5Canada
| | - P. Czaykowski
- Division of Hematology/Oncology, Department of Medical OncologyUniversity of Manitoba, CancerCare Manitoba675 McDermot AvenueWinnipegMBR3E 0V9Canada
| | - N. Kalach
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - C. Yu
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - K. Patterson
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - T. Currie
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - S. Kristensen
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - W. Kwan
- Department of Radiation OncologyBCCA‐Fraser Valley Centre13750 96th AvenueSurreyBCV3V 1Z2Canada
| | - V. Moravan
- Population and Preventative OncologyBCCA‐Vancouver Centre600 W 10th AvenueVancouverBOV5Z 4E6Canada
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Liu M, Pickles T, Berthelet E, Agranovich A, Kwan W, Tyldesley S, McKenzie M, Keyes M, Morris J, Pai H. 858 Urinary incontinence in prostate cancer patients treated with external beam radiotherapy. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Agranovich A, Czaykowski P, Hui D, Pickles T, Kwan W. Radiotherapy for muscle-invasive urinary bladder cancer in elderly patients. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03519-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liu M, Pickles T, Agranovich A, Berthelet E, Duncan G, Keyes M, Kwan W, McKenzie M, Morris J, Pai H, Tyldesley S, Wu J. Impact of neoadjuvant androgen ablation and other factors on late toxicity following external beam prostate radiation. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03513-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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