Brazilein inhibits survivin protein and mRNA expression and induces apoptosis in hepatocellular carcinoma HepG2 cells

Hepatocellular carcinomas represent the third leading cause of cancer-related deaths worldwide. Survivin, a structurally unique member of the inhibitor of apoptosis protein (IAP) family, is overexpressed in a wide range of malignancies, including hepatocellular carcinoma. Due to its involvement in cancer progression and treatment resistance, survivin is currently undergoing extensive investigation as a novel intervention target to induce apoptosis in cancer cells by phytochemicals or synthetic agents. Brazilein, a compound obtained in a large amount from the dried heartwood of Caesalpinia sappan Linn., which has long been used in traditional medicine in China, has some pharmacological activities. Human hepatocellular carcinoma HepG2 cells were treated with brazilein and analyzed for survivin protein and mRNA levels by Western blotting and real-time RT-PCR, respectively. Brazilein treatment of cells for 48 h at 5 and 10 microg/ml doses resulted in significantly decrease in survivin protein expression. We also observed that brazilein caused a strong decrease in survivin mRNA expression. In other studies, down-regulation of survivin by brazilein was associated with a strong and prominent caspases-9 and -3 activation as well as PARP cleavage. It was also shown that brazilein induced a strong apoptotic cell death, as shown by DNA ladder assay, and growth inhibition of HepG2 cells. Further studies are needed to investigate in vivo effect of brazilein on survivin expression and associated biological effects in hepatocellular carcinoma that could provide useful information for brazilein efficacy in the prevention/intervention of human hepatocellular carcinoma.

Toward the elimination of medical oncology admissions

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Background: While medical oncology is growing in volume, it is increasingly becoming an outpatient enterprise. Issues leading to hospital admissions in the past are commonly either prevented or managed on an outpatient basis. We sought out trends within our practice on the frequency and reasons for hospital admissions. Methods: Computerized office visit and hospital admissions data were obtained on admissions by physician and year, for Pa. Oncology-Hematology Associates from 2000–2007. A retrospective chart review was also done for one physician from 6/08–12/08 to determine the reasons for admission. Results: While the total number of patients seen per year increased by 40% over the review period from 2000–2007, the relative number of admissions has steadily declined. Adjusting the number of admissions per patients in the practice (since the overall increase in volume partially masks the decline in admission frequency), the reduction in admissions is further evident. The frequency of admissions for the 4 senior oncologists showed a 50% reduction in admissions per patient over the past 8 years. Of 56 admissions reviewed from 6/08–12/08, 20 were related to infections (although only a minority were neutropenic), 13 for symptom management of disease progression, 6 for anemia/bleeding, 3 for bowel obstruction, 3 for non-infectious complications of treatment, and only 1 for chemotherapy administration. Conclusions: Trends in our practice indicate a continued decline in the frequency of admissions per patient. Elective admissions for diagnosis, work-up, and chemotherapy are rare. Improved medications for symptoms related to cancer, its complications and treatment-related toxicities and improvements in palliative care (psychosocial support, communication about prognosis and treatment goals, and end-of-life care) have contributed to decreased admissions. Increasingly, even patients with incurable disease are managed from diagnosis to death entirely as outpatients. Optimizing outpatient management and avoiding admissions in medical oncology has major implications for practice quality, patient quality of life, cost and allocation of health care resources.

No significant financial relationships to disclose.

Platelet adhesion to multimerin 1 in vitro: influences of platelet membrane receptors, von Willebrand factor and shear

BACKGROUND

Multimerin 1 (MMRN1) is a large, homopolymeric adhesive protein, stored in platelets and endothelium, that when released, binds to activated platelets, endothelial cells and the extracellular matrix.

OBJECTIVES

The goals of our study were to determine if (i) MMRN1 supports adhesion of resting and/or activated platelets under conditions of blood flow, and (ii) if MMRN1 enhances platelet adhesion to types I and III collagen.

PATIENTS/METHODS

Platelet adhesion was evaluated using protein-coated microcapillaries, with or without added adhesive proteins and receptor antibodies. Platelets from healthy controls, Glanzmann thrombasthenia (GT) and severe von Willebrand factor (VWF)-deficient donors were tested.

RESULTS

MMRN1 supported the adhesion of activated, but not resting, washed platelets over a wide range of shear rates. At low shear (150 s(-1)), this adhesion was supported by integrins alphavbeta3 and glycoprotein (GP) Ibalpha but it did not require integrins alphaIIbbeta3 or VWF. At high shear (1500 s(-1)), adhesion to MMRN1 was supported by beta3 integrin-independent mechanisms, involving GPIbalpha and VWF, that did not require platelet activation when VWF was perfused over MMRN1 prior to platelets. MMRN1 bound to types I and III collagen, independent of VWF, however, its enhancing effects on platelet adhesion to collagen at high shear were VWF dependent.

CONCLUSIONS

MMRN1 supports platelet adhesion by VWF-dependent and -independent mechanisms that vary by flow rate. Additionally, MMRN1 binds to, and enhances, platelet adhesion to collagen. These findings suggest that MMRN1 could function as an adhesive ligand that promotes platelet adhesion at sites of vascular injury.

The tolerance time limits of biliary tracts of liver grafts subjected to warm ischemia and cold preservation: an experimental study in swine

OBJECTIVE

The objective of this study was to investigate the tolerance time limits of liver grafts and biliary tracts with warm ischemia to cold preservation providing experimental data to the prevent primary graft nonfunction and biliary necrosis after orthotopic liver transplantation (OLT).

METHODS

OLTs were performed in Bama miniature swine. Morphological and functional changes in the liver graft and biliary tracts were investigated after 10 minutes of warm ischemia and various durations of cold preservation.

RESULTS

When grafts were subjected to 10 minutes of warm ischemia followed by less than 16 hours of cold preservation, all animals survived 1 week; no animal died of biliary necrosis. However, when the cold preservation time exceeded 16 hours, the incidence of biliary necrosis increased significantly (P < .05) with deaths due to bile leaks. As cold preservation persisted, primary graft nonfunction and intraoperative or early postoperative deaths occurred, and all surviving animals developed biliary necrosis. When compared with the group undergoing less than 16 hours of cold preservation, the morphological scores and apoptosis index of epithelial cells of graft bile ducts were significantly increased among the group subjected to more than 16 hours of cold preservation after reperfusion (P < .05), whereas the activity of Na+-K+-ATPase and Ca2+-ATPase of graft bile ducts were reduced significantly (P < .05). Liver function tests showed the concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase, and alkaline phosphatase (ALP) decreased more slowly among the group undergoing more than 16 hours of cold preservation after operation.

CONCLUSIONS

We concluded that given 10 minutes of warm ischemia, cold preservation should be less than 16 hours to avoid early biliary necrosis; the corresponding tolerance time limit of the liver to cold preservation was less than 20 hours.

Primary Hepatic Carcinoid Tumours: Clinical Features with an Emphasis on Carcinoid Syndrome and Recurrence

This study sought to determine the clinical profiles and optimal management of primary hepatic carcinoid tumours. The clinical features of nine Chinese patients and 64 patients reported in the English-language literature were characterized. Recurrence rate and survival analysis were performed with the Kaplan–Meier method. The impact of surgical resection and post-operative recurrence on survival was determined by means of the log-rank test. Carcinoid syndrome complicated 10 cases (14%). Sixty-two patients (85%) underwent surgical resection. Actuarial 5-and 10-year survival rates for resected patients were 80% and 75%, respectively. Twelve patients experienced recurrences: the recurrence rate at 5 years post-operatively was 26%. All patients with resectable recurrent disease achieved good long-term survival and no significant relationship was found between recurrence and survival. Owing to the high incidence of recurrence, long-term follow-up is necessary and it is recommended that recurrent cases should be managed with judicious surgical resection.

Vaccination with a recombinant chicken FGFR-1 bypasses immunological tolerance against self-FGFR-1 in mice

The possibility that a recombinant protein vaccine based on xenogeneic homologous FGFR-1 of chicken induces production of autoantibodies against self-FGFR-1 in BALB/c mice was examined by using ELISA, Western blot analysis and ELISPOT assay respectively. Autoantibodies against mouse FGFR-1 were identified by Western blot analysis and ELISA. Compared with the two control groups, the number of APBCs, which were detected by ELISPOT assay, was significantly increased in the spleens of mice immunized with cFR1 (P < 0.05). IgG1 and IgG2b, which were detected by ELISA, were the major subclasses and were substantially increased in response to chicken FGFR-1 when compared with control group. The recombinant chicken FGFR-1 protein used as a vaccine can induce autoantibodies against self-FGFR-1 in mice and provide a basis for the active immunotherapy of tumor angiogenesis.

Haemolytic Uraemic Syndrome after Living-donor Liver Transplantation: Is Small-for-size Graft a Potential Risk Factor?

Haemolytic uraemic syndrome (HUS) is a rare complication of solid organ transplantation. Immunosuppressive drugs, including cyclosporin A and tacrolimus, have frequently been incriminated. Here we report a case of tacrolimus-induced HUS in a woman with small-for-size syndrome after living-donor liver transplantation. Hypertension, microangiopathic anaemia and end-stage renal failure occurred in the immediate post-transplant period; all other risk factors that might be implicated in the development of HUS were investigated and excluded if no evidence was found. A possible association between small-for-size syndrome, which frequently results in a high blood concentration of tacrolimus post-operatively, and the occurrence of HUS is discussed.

Analysis of the pathomorphology of the intra- and extrahepatic biliary system in biliary atresia

OBJECTIVE

Aim of the study was to investigate the pathomorphological changes in the liver and triangular cord of the porta hepatis in biliary atresia and assess the relationship between the degree of differentiation of fibroblasts in the triangular cord of the porta hepatis and the liver fibrosis scores.

METHODS

From September 2005 to May 2006, 21 patients with biliary atresia (66+/-20 days old) underwent a Kasai procedure. The liver biopsy and the remnant of the porta hepatis were conserved. Five cases with cholestasis syndrome and 10 cases with choledochal cyst were used as a control group. Liver biopsies were performed in the control group. The micro- and ultrastructure of the liver and the remnant of the porta hepatis were assessed in the biliary atresia and the control group. Ultrastructural features were examined by transmission electron microscopy. The semiquantitative differences in liver fibrosis grading between the biliary atresia and the control group was evaluated with a 3-grade staging system. The degree of differentiation of fibroblasts (FB) in the triangular cord of the porta hepatis was assessed as follows: 1) juvenile type: above 50 % FBs were juvenile, 2) senior type: above 50% FBs were senior, 3) median type: between the former 2 types. The differentiation scores of FB in the porta hepatis were assessed in relation to the liver fibrosis score.

RESULTS

1) The pathological changes with BA are characterized by inflammation and fibrosis in the hepatic portal area. The fibrosis scores in the biliary atresia group (I: 2 cases, II: 12 cases, III: 7 cases) were significantly higher than in the control group (I: 8 cases, II: 5 cases, III: 2 cases; p=0.01. 2) In the biliary atresia group, the extrahepatic biliary system of all cases showed a triangular cord in the porta hepatis. The triangular cord of porta hepatis was characterized by hyperplasia of canaliculi, atresia or stenosis of the bile ducts, inflammation infiltration, cholestasis, and interstitial fibrosis. 3) The ultrastructural features of BA showed active fibroblasts, a loss of microvilli, dense deposits in the hepatocytes and liver sinusoid, and dilatation of canaliculi. 4) The differentiation scores of FB in the porta hepatis were positively related to the liver fibrosis score (p=0.04).

CONCLUSION

The main pathological changes of biliary atresia are inflammation and fibrosis in the hepatic portal area. The ultrastructural features of biliary atresia suggested that the differentiation scores of FB in the triangular cord of the porta hepatis were positively related to the liver fibrosis score.

Suprahepatic vena cava manipulative bleeding alleviates hepatic ischemia-reperfusion injury in rats

BACKGROUND

Little is known about time course and peak level of reactive oxygen species in suprahepatic vena cava after liver ischemia-reperfusion.

OBJECTIVE

To determine time course and peak level of reactive oxygen species in suprahepatic vena cava after liver ischemia-reperfusion. To focus on the effects of suprahepatic vena cava manipulative bleeding on the hepatic ischemia-reperfusion injury in rat model.

METHODS

In experiment Part I, blood was taken from suprahepatic vena cava and infrahepatic vena cava for malondialdehyde detection at different time points after reperfusion. Furthermore, we treated the experimental rats in Part II by suprahepatic vena cava manipulative bleeding or infrahepatic vena cava manipulative bleeding at 10 min after reperfusion.

RESULTS

In experiment Part I, malondialdehyde concentration in suprahepatic vena cava elevated obviously with time and peaked at 10 min after reperfusion. The numbers of accumulated polymorphonuclear neutrophils was significantly increased in ischemia-reperfusion group from 10 min after reperfusion, compared with sham-operated group. In Part II, 2% of body weight suprahepatic vena cava manipulative bleeding with blood transfusion at 10 min after reperfusion significantly decreased circulating malondialdehyde, tumour necrosis factor-alpha, endothelin-1, hyaluronic acid, alanine aminotransferase, aspartate aminotransferase levels and polymorphonuclear neutrophil infiltrations in the liver. The 7-day survival rate of this group was 68.75% (11/16) which was significantly higher than other groups.

CONCLUSIONS

We provided the first evidence that 2% of body weight suprahepatic vena cava manipulative bleeding with blood transfusion at 10 min after reperfusion significantly prevented liver ischemia-reperfusion injury.

An animal model of human cytomegalovirus infection

To develop a rat model that allowed in vivo progressive human cytomegalovirus (HCMV) infection, allogeneic liver transplantation was performed across a rat combination of Dark Agouti (DA) to Brown Norway (BN). AD169, a well-characterized laboratory strain of HCMV, was used to establish a rat model of HCMV infection by injection of 0.4 mL (30.0 logTCID50) supernate into the rat peritoneum. Histological and blood specimens were obtained from animals sacrificed at predetermined timepoints. We performed immunohistochemical staining in liver, heart, kidney, spleen, and lung for HCMV immediate-early antigen (IE), lower matrix protein (pp65) detection in peripheral blood leukocytes, and HCMV early antigen (EA) and late antigen (LA). We compared survival rates. Our results showed positive HCMV IE and pp65 antigenemia detected in peripheral blood leukocytes in transplanted recipients from day 1 to day 30. Positive HCMV EA and LA staining cells were only detected in sections 10 days after liver transplantation, namely, in hepatocytes, mononuclear cells, bile duct epithelial cells, and endothelial cells. Successful HCMV replication was due to the combination of liver transplantation and cyclosporine (CsA) immunosuppression. Survival analysis showed no significant differences between the HCMV-infected group and HCMV-uninfected group. This new rat model of HCMV infection may be helpful to understand immune system modulation of HCMV infection.

Discovery of altered protein profiles in epithelial ovarian carcinogenesis by SELDI mass spectrometry

OBJECTIVE

Identification of proteomic alterations in epithelial ovarian tumorigenesis may facilitate the understanding of progression of this disease.

METHODS

Specific protein peak patterns were identified in 20 microdissected epithelial ovarian tumors (13 epithelial ovarian cancers (EOCs) and 7 low malignant potential (LMP) tumors), as well as in the matched normal cells. Protein profiles were generated by surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) from all the different types of cells.

RESULTS

Among seven protein peaks from EOC cells, six were significantly increased while one was decreased compared with normal cells, and three peaks from LMP cells were markedly increased while one was decreased compared with normal cells.

CONCLUSIONS

The combination of SELDI and laser capture microdissection (LCM) is effective in finding the key molecules in ovarian tumorigenesis. Further identification of these protein peaks is important and these malignant protein signatures lend themselves to identification of populations at high-risk for EOC and for monitoring response to EOC chemopreventive agents.

Molecular genetic evidence supporting the neoplastic nature of stromal cells in 'fibrosis' after chemotherapy for testicular germ cell tumours

A residual retroperitoneal mass containing only fibrosis and necrosis is present in 40-52% of patients with advanced testicular germ cell tumours after chemotherapy. The biological nature and genetic characteristics of the stromal cells in these residual masses have not been adequately investigated. Laser-microdissected stromal cells from 27 patients who underwent retroperitoneal lymph node dissection after chemotherapy for metastatic testicular germ cell tumour were analysed. Allelic loss in the stromal cells of fibrosis was present at one or more of the ten microsatellite DNA loci examined in 23 (85%) of the cases. Chromosome arm 12p anomalies, the hallmark of germ cell neoplasia, were present in nine (33%) cases. The high frequency of allelic losses and chromosome arm 12p anomalies in the stromal cells from residual retroperitoneal fibrous masses after chemotherapy for testicular germ cell tumours suggests that the stromal cells are derived from the same tumour progenitor cells as the pre-existing metastatic germ cell tumour.

Primary hepatic malignant fibrous histiocytoma: a case report and review of the literature

Primary malignant fibrous histiocytoma (MFH) of the liver remains extremely rare with only several cases having been reported in literature. We report a case of hepatic MFH in a 53-year-old man who presented with upper abdominal pain, and weight loss for one month. Ultrasound and computed tomography (CT) scan showed a large mass with fine tumor vessels over the left lobe of the liver. Histopathological findings indicated a mesenchymal tumor consisting of spindle cells in storiform pattern intermingled with histiocyte-like cells and giant cells. Immunohistochemically, most tumor cells expressed vimentin, alpha-1 anti-chymotrypsin, alpha-1 antitrypsin and CD68. Morphological and immunohistochemical findings support that the tumor should be classified as a primary malignant fibrous histiocytoma. The literatures is briefly reviewed.

Effect of coronary heart disease (CHD) risk factors and medications on invasive breast cancer risk in the Raloxifene Use for The Heart (RUTH) trial

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Background: RUTH enrolled 10,101 postmenopausal women at increased risk for major coronary events. Women were not enrolled based on their risk for breast cancer. The incidence of invasive breast cancer in the placebo group was low for this older population of women (mean age 67.5 years). The aim of this analysis was to determine whether CHD risk factors and selected cardiac medications were protective against invasive breast cancer in this population at increased risk for coronary events. Methods: Covariates assessed were baseline factors that are known CHD risk factors and selected medications ( Table ). Univariate analyses were performed for all covariates using placebo data. Results: The effect of baseline CHD risk factors and selected cardiac medications on the incidence of invasive breast cancer in women receiving placebo in RUTH (N=5057) Conclusions: In these postmenopausal women at increased risk for major coronary events, baseline CHD risk factors and selected cardiac medications assessed individually did not protect against invasive breast cancer. The low incidence of invasive breast cancer in the RUTH population does not appear to be due to the presence of CHD risk factors or use of cardiac medications.

[Table: see text]

[Table: see text]

Role of Reactive Oxygen Species in Mediating Hepatic Ischemia-Reperfusion Injury and Its Therapeutic Applications in Liver Transplantation

Increasing evidence has shown that reactive oxygen species (ROS) are important mediators in liver ischemia/reperfusion injury(IRI). ROS include hydrogen peroxide (H(2)O(2)), superoxide anion (O(-2)), and hydroxyl radical (HO(-)), which may be generated by activated Kupffer cells in the liver, contributing to reperfusion injury. Hepatic IRI is a multistep process that damages liver graft function. To establish a series of therapeutic strategies to improve the outcome of liver transplantation, a good understanding of the mechanisms of IRI is essential. However, the detail mechanisms of how ROS lead to hepatocyte damage in IRI remains unclear. The aim of this review was to describe recent developments in the field of oxidative stress research. The first part of this review focused on the key roles and possible mechanisms of ROS in hepatic IRI. The second part of this review summarizes some findings including novel and classic antioxidant methods to ameliorate the hepatocyte damage during IRI.

Automated sample preparation and purification of homogenized brain tissues

A robotic homogenized tissue sample transferring method has been developed by using a Packard MultiProbe II 8-tip system. It enables robotically transferring homogenized tissue samples from individual test tubes into a 96-well format plate for further sample purification and analysis. Extensive validation has been made to establish the accuracy and variability of this method. This automatic tissue sample transferring approach combined with automatic tissue homogenization, has significantly increased the throughput of tissue sample preparation in screening of drug candidates using liquid chromatography coupled with highly sensitive and selective tandem mass spectrometry (LC-MS/MS).

A genetic mouse model for metastatic lung cancer with gender differences in survival

Lung cancer is a devastating disease with poor prognosis. The design of better therapies for lung cancer patients would be greatly aided by good mouse models that closely resemble the human disease. Unfortunately, current models for lung adenocarcinoma are inadequate due to the absence of metastases. In this study, we incorporated both K-ras and p53 missense mutations into the mouse genome and established a more faithful genetic model for human lung adenocarcinoma, the most common type of lung cancer. Mice with both mutations developed advanced lung adenocarcinomas that were highly aggressive and metastasized to multiple intrathoracic and extrathoracic sites in a pattern similar to that of human lung cancer. These mice also showed a gender difference in cancer-related death. Additionally, the presence of both mutations induced pleural mesotheliomas in 23% of these mice. This mouse model recapitulates the metastatic nature of human lung cancer and will be invaluable to further probe the molecular basis of metastatic lung cancer and for translational studies.