Biased signalling and proteinase-activated receptors (PARs): targeting inflammatory disease

Although it has been known since the 1960s that trypsin and chymotrypsin can mimic hormone action in tissues, it took until the 1990s to discover that serine proteinases can regulate cells by cleaving and activating a unique four-member family of GPCRs known as proteinase-activated receptors (PARs). PAR activation involves the proteolytic exposure of its N-terminal receptor sequence that folds back to function as a 'tethered' receptor-activating ligand (TL). A key N-terminal arginine in each of PARs 1 to 4 has been singled out as a target for cleavage by thrombin (PARs 1, 3 and 4), trypsin (PARs 2 and 4) or other proteases to unmask the TL that activates signalling via Gq , Gi or G12 /13 . Similarly, synthetic receptor-activating peptides, corresponding to the exposed 'TL sequences' (e.g. SFLLRN-, for PAR1 or SLIGRL- for PAR2) can, like proteinase activation, also drive signalling via Gq , Gi and G12 /13 , without requiring receptor cleavage. Recent data show, however, that distinct proteinase-revealed 'non-canonical' PAR tethered-ligand sequences and PAR-activating agonist and antagonist peptide analogues can induce 'biased' PAR signalling, for example, via G12 /13 -MAPKinase instead of Gq -calcium. This overview summarizes implications of this 'biased' signalling by PAR agonists and antagonists for the recognized roles the PARs play in inflammatory settings.

Pathway-selective antagonism of proteinase activated receptor 2

BACKGROUND AND PURPOSE

Proteinase activated receptor 2 (PAR2) is a GPCR associated with inflammation, metabolism and disease. Clues to understanding how to block PAR2 signalling associated with disease without inhibiting PAR2 activation in normal physiology could be provided by studies of biased signalling.

EXPERIMENTAL APPROACH

PAR2 ligand GB88 was profiled for PAR2 agonist and antagonist properties by several functional assays associated with intracellular G-protein-coupled signalling in vitro in three cell types and with PAR2-induced rat paw oedema in vivo.

KEY RESULTS

In HT29 cells, GB88 was a PAR2 antagonist in terms of Ca(2+) mobilization and PKC phosphorylation, but a PAR2 agonist in attenuating forskolin-induced cAMP accumulation, increasing ERK1/2 phosphorylation, RhoA activation, myosin phosphatase phosphorylation and actin filament rearrangement. In CHO-hPAR2 cells, GB88 inhibited Ca(2+) release, but activated G(i/o) and increased ERK1/2 phosphorylation. In human kidney tubule cells, GB88 inhibited cytokine secretion (IL6, IL8, GM-CSF, TNF-α) mediated by PAR2. A rat paw oedema induced by PAR2 agonists was also inhibited by orally administered GB88 and compared with effects of locally administered inhibitors of G-protein coupled pathways.

CONCLUSIONS AND IMPLICATIONS

GB88 is a biased antagonist of PAR2 that selectively inhibits PAR2/G(q/11)/Ca(2+)/PKC signalling, leading to anti-inflammatory activity in vivo, while being an agonist in activating three other PAR2-activated pathways (cAMP, ERK, Rho) in human cells. These findings highlight opportunities to design drugs to block specific PAR2-linked signalling pathways in disease, without blocking beneficial PAR2 signalling in normal physiology, and to dissect PAR2-associated mechanisms of disease in vivo.

Abstract P6-06-25: Usefulness of pretreatment NLR as prognostic factor of late recurrence, 5-year after primary treatment

Background

Prognostic factor and predictive factors are well established in early-stage breast cancer, but less is known about recurrence, especially 5-year after primary treatment. While mortality of breast cancer is from organic dysfunction with metastatic disease, not from the diseased breast itself, still we do not have adequate information about metastatic disease as we do about primary breast cancer itself.

The aim of this study is to investigate of usefulness of pretreatment NLR(neutrophil to lymphocyte ratio) as prognostic factor that can tell risk of recurrence 5- year after primary treatment.

Patients and methods

A retrospective review of invasive breast cancer patients surgically resected between January 2001 and December 2007. Exclusion criteria were as followings: patients with recurrence or death within 5yrs.

Results

A total of 301 patients were included and 13 patients experienced with recurrence after 5 years.

Table 1. Patients' characteristics Total (n = 301) N (%)Age*48.8(±11.4)Age ≤3525(8.3)35< ≤50165(54.8)50<111(36.9)Histology Ductal270(89.7)Lobular7(2.3)Others24(8.0)Tumor size (cm)*2.73(±1.64)T stage T1126(41.9)T2158(52.5)T317(5.6)N stage N0199(66.1)N167(22.3)N220(6.6)N311(3.7)unknown4(1.3)Histologic grade I72(23.9)II110(36.5)III70 (23.3)unknown49(16.3)Estrogen receptor Negative111(36.9)Positive185(61.5)unknown5(1.6)Progesterone receptor Negative129(42.9)Positive167(55.5)Unknown5(1.6)HER-2 Negative196(65.1)Positive98(32.6)unknown7(2.3)Molecular subtype Luminal A136(45.2)Luminal B66(21.9)HER-2 enriched32(10.6)Triple negative60(20.0)unknown7(2.3)Late recur Yes13(4.3)No288(95.7)*mean±SD

Overall average of NLR value was 2.16, median value was 1.83. The average NLR were 2.80±1.68 in patients with recurrences occurred after 5 years and 2.13±1.15 in patients without recurrence. The NLR cutoff value of 1.83 was determined by median value.

In 1.83≤NLR group has a higher incidence of recurrence after 5 years compared with NLR<1.83 group (8yr DFS 99.2% vs. 93.3%, p = 0.021). Especially in luminal A(ER (+) or PR (+), HER-2(-)), 1.83≤NLR group has a higher incidence of recurrence after 5 years compared with NLR<1.83 group (8yr DFS 100% vs. 87.0%, p = 0.015).

Conclusion

We found that pretreatment NLR is associated with late recurrence that occurs after five years. And we suggest that NLR could be used as one of the prognostic factor that can tell about late recurrence, 5-year after primary treatment.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-25.

Effects of maltitol and xylitol chewing-gums on parameters involved in dental caries development

AIM

The effects on plaque parameters of sugar free chewing-gums (CG) sweetened with either maltitol or xylitol were assessed to better understand the role polyols can play in dental caries prevention.

MATERIALS AND METHODS

A double-blind, parallel, randomised, controlled study was conducted in China. Subjects (N = 258, age = 13 to 15 years-old) were divided into 4 groups: 2 receiving polyols CG, containing respectively maltitol or xylitol, a group receiving gum base (placebo) and a negative control group not receiving any gum. CG were chewed for 30 days. This corresponds to a 10 g consumption of polyol per day. Plaque parameters (growth, pH, bacteria and insoluble glucans) were evaluated throughout the experimental period.

RESULTS

All parameters studied were significantly modified with gum base compared to no-gum: plaque pH increased; plaque growth, bacteria (S. mutans, S. sobrinus, A. viscosus and Lactobacillus) and insoluble glucans decreased. Maltitol and xylitol CG led similarly to a higher plaque pH (AUC, p⋜0.05) on short (at baseline after the first CG consumption) and long term (after 4 weeks of daily CG consumption), with or without saliva stimulation compared to both control and placebo groups. They led to a decrease in plaque growth (p=0.02) over the experimental period compared to controls. Moreover, they significantly reduced the concentration of 4 cariogenic bacteria species (p⋜0.05) in dental plaque compared to gum base.

CONCLUSION

Sugar free CG sweetened with either maltitol or xylitol can similarly reduce plaque acidogenicity compared to gum base through a decrease in oral bacteria presence. The use of a gum base placebo allowed to isolate effects on parameters involved in dental caries development specific to maltitol and xylitol, and to show these effects were similar.

Abstract P6-07-40: Initial Neutrophil-to-Lymphocyte ratio in primary breast cancer patients: a simple and useful biomarker as prognostic factor

Background: Increasing neutrophil/lymphocyte ratios (NLR) on preoperative blood tests have been associated with worse survival of patients with colorectal, gastric, hepatocellular, pancreatic and lung cancer. However the utility of NLR to predict mortality in breast cancer patients has not been studied. The aim of our study was to determine whether the NLR is predictive of disease specific mortality in breast cancer and subtype-adjusted prognostic effect in breast cancer patients.

Methods: We retrospectively identified all the patients with primary breast cancer diagnosed at Yonsei University Wonju Medical School between January 2000 and June 2011 who underwent primary surgery and completed all phase of their treatment. Breast cancer with infiltrating ductal histology was included and divided into 4 subtypes: Luminal A, Luminal B, Her2-enriched, and basal type. Each immunohistochemical characteristics are as followings: Luminal A: ER and/or PgR positive and negative Her2, Luminal B: ER and/or PgR positive with positive HER2, Her2-enriched: negative ER and PR with positive Her2, and triple negative as basal.

Results: Patients with NLR≥2.5 showed significantly lower 5-year, 10-year breast cancer specific survival than patients with NLR<2.5. (5-year survival; 88.6% vs. 96.4%, p = 0.009, 10-year survival; 84.3% vs. 92.2%, p = 0.006). Cox proportional multivariate hazard model for cancer-specific mortality showed that patients with NLR≥2.5 has hazard ratio 4.71 with 95% confidence interval 1.77–12.53. Further analysis was done according to stratified patients' subgroup with intrinsic subtype. In Luminal A subtype, patients with NLR≥2.5 showed higher mortality rate(p = 0.014), while NLR≥2.5 failed to show statistical significance in the other subtype such as Luminal B, Her2 enriched, and triple negative subtype.

Conclusion: Increased preoperative NLR is a significant prognostic factor in breast cancer specific survival and relevant in Luminal A subtype. This study shows that NLR could be a useful prognostic factor for breast cancer specific survival. And this study suggests that different factors could contribute as prognostic factor to each subtype, such as NLR was significant prognostic factor in Luminal A, while we couldn't find increased NLR is significant in other subtypes.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-07-40.

Effects of the addition of electrolyte on liquid infiltration in a hydrophobic nanoporous silica gel

In this letter, we report the experimental results of pressure induced infiltration in the hydrophobic nanopores of a silica gel. The infiltration pressure increases with the prolonged surface treatment time, whereas the infiltration volume is not dependent on the surface coverage. When temperature increases, if the liquid phase is pure water, the infiltration pressure would decrease, which is in agreement with the classic contact angle measurement results at large solid surfaces. As an electrolyte is added, however, the variation in infiltration pressure is negligible over a broad temperature range.