P2590A liver-derived secretory protein, selenoprotein P causes pressure overload-induced cardiac hypertrophys

Background

Hepatokine selenoprotein P (SeP) contributes to insulin resistance and hyperglycemia in patients with type 2 diabetes. Inhibition of SeP protects the heart from ischemia reperfusion injury and serum levels of SeP are elevated in patients with heart failure with reduced ejection fraction.

Objective

We investigated the role of SeP in the regulation of cardiac remodeling in response to pressure overload.

Methods and results

To examine the role of SeP in cardiac remodeling, transverse aortic constriction (TAC) was subjected to SeP knockout (KO) and wild-type (WT) mice for 2 weeks. Hepatic expression of SeP in WT was significantly increased by TAC. LV weight/tibial length (TL) was significantly smaller in SeP KO mice than in WT mice (6.75±0.24 vs 8.33±0.32, p<0.01). Lung weight/TL was significantly smaller in SeP KO than in WT mice (10.46±0.44 vs 16.38±1.12, p<0.05). TAC-induced cardiac upregulation of the fetal type genes, including atrial and brain natriuretic factors, was significantly attenuated in SeP KO compared to WT. Furthermore, azan staining revealed that there was significantly less interstitial fibrosis in hearts after TAC in SeP KO than in WT mice. To determine whether hepatic overexpression of SeP affects TAC-induced cardiac hypertrophy, a hydrodynamic injection method was used to generate mice that overexpress SeP mRNA in the liver. Hepatic overexpression of SeP in SeP KO mice lead to a significant increase in LV weight/TL and Lung weight/TL after TAC compared to that in other SeP KO mice.

Conclusions

These results suggest that cardiac pressure overload induced hepatic expression of SeP and the absence of endogenous SeP attenuated cardiac hypertrophy, dysfunction and fibrosis in response to pressure overload in mice. SeP possibly plays a maladaptive role against progression of heart failure through the liver-heart axis.

Abstract 31: Organoid derived from human operative sample of NET shows NET characteristics

Background: Neuroendocrine tumor is a rare neoplasm, then, it was difficult to examine using in vitro or animal models. Recently, patient-derived tumor organoid (PDTO) is considered as a promising method to analyze natural characteristics of human tumor, because PDTO is cultured in near-natural circumstances compared with cell lines. We established PDTO of neuroendocrine tumor (NET) utilizing operative samples from a pancreatic NET patient. Aim: Aim of this study is to establish organoid derived from an operative sample of pancreatic NET patient and to compare its characteristics with original tumor using immuno-histochemistry. Material and Method: A pancreatic NET tissue derived from operative sample was cut into small pieces and was treated by collagenase. Prepared tissues were 3-dimensionally cultured on the Matrigel in a serum-free medium (Advanced MEM/F12) with 4 growth factors (Respondin, EGF, Rock inhibitor, Noggin), then PDTO was established. To evaluate growth rate of PDTO, Major axis of the organoid was measured on the day 1, 2, 3, and 6. One week after primary culture of the organoid, subculture was performed. Then major axis of the 2nd, 6th and 7th filial organoid was also measured and compared with each filial. To evaluate characteristics of PDTO as neuroendocrine tumor, immunohistochemistry was performed for the 1st, 2nd and 3rd filial PDTO using anti-chromogranin-A antibody (Dako, mouse IgG), anti-synaptophysin antibody (Abcam, rabbit IgG), anti-NCAM antibody (Abcam mouse IgG) and Neuro-specific enolase (Dako, rabbit IgG). Results: Growth rate of the 2nd and 3rd filial on the day 6 did not show significant difference compared with that of the 1st filial. On the other hand, Growth rate of the 2nd and 3rd filial was significantly lower than that of the 1st filial. Expression of the 4 factors in the 1st, 2nd and 3rd filial PDTO was kept as much as the primary tumor. Conclusion: PDTO derived from neuroendocrine tumor showed the same characteristics as the primary tumor. The 6th and 7th filial PDTO might show cellular aging.

Citation Format: Yasushi Ichikawa, Yukihiko Hiroshima, Noritoshi Kobayashi, Yusaku Masuda, Ayumu Goto, Motohiko Tokuhisa, Yuma Takeda, Takashi Ishikawa, Itaru Endo. Organoid derived from human operative sample of NET shows NET characteristics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 31.

Emerging investigator series: investigation of mercury emission sources using Hg isotopic compositions of atmospheric mercury at the Cape Hedo Atmosphere and Aerosol Monitoring Station (CHAAMS), Japan

This study conducted mercury (Hg) isotopic analysis, which has been expected as a new indicator for understanding the behavior of atmospheric Hg. The dominant atmospheric Hg species, namely gaseous elemental mercury (GEM, Hg0), were collected at the Cape Hedo Atmosphere and Aerosol Monitoring Station (CHAAMS) in Okinawa, Japan, for evaluating possible source(s) and transformation process(es) of Hg. The Hg isotopic compositions of GEM samples showed that the mass-dependent fractionation (MDF) of δ202Hg and the mass-independent fractionation (MIF) of Δ199Hg ranged from -2.15‰ to 0.79‰ and from -0.32‰ to 0.00‰, respectively. The results were classified into two groups: (1) negative δ202Hg and near-zero Δ199Hg in summer and (2) near-zero δ202Hg and negative Δ199Hg in the other season. According to the NOAA Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model, the dominant air masses traveled from East Asia during winter and South and East Asia during summer. However, the air masses also traveled from mainland Japan and rotated around Okinawa before reaching CHAAMS. In contrast, clear positive correlations between δ202Hg values and CO and PM2.5 concentrations were observed during summer. A small peak of Ox concentration was observed at three atmospheric monitoring stations, namely Nago, Naha, and Miyako Island during summer. Since Miyako Island is located ∼370 km southwest of CHAAMS, the main emission source of GEM transported to CHAAMS was not from mainland Okinawa but traveled from the southwest during summer.

[A Case of Malignant Ameloblastoma Associated with Uncontrollable Hypercalcemia]

Approximately 20-30% of cancers are associated with hypercalcemia, and this is a complication often encountered in cancer care. Hypercalcemia causes disorders such as disturbance of consciousness and, in severe cases, kidney failure and even death. In this report, we present a case of malignant ameloblastoma associated with uncontrollable hypercalcemia followed by a life-threatening disease course. In this case, hypercalcemia shortened the period of home care, and the medical staff could have extended this period by acquiring knowledge that leads to early detection and better control of hypercalcemia. In addition, the choice of the place for end-of-life care may have been expanded by considering the treatment of not only the malignant tumor but also hypercalcemia as its complication.

[Differences in Concepts between Hospital Oncologists and Home Physicians]

Although many patients with terminal cancers desire to be cared for at home, frequently, such patients cannot be shifted to home care due to their unstable symptoms. In severe cases, emergency hospitalizations may be frequently required after introducinghome medical care. We report a case of makinghome medical care difficult due to repeated emergency hospitalizations despite of the patient's deep desire. Interviews were conducted with both the oncologist in charge of the case and a home physician, and their viewpoints were compared. For patients and their families to achieve desired livingconditions, it was considered necessary to give supportive medical care that meet their desires until the end of their lives as mutual viewpoints are taken in a good balance.

[Retrospective Observational Study on Chemical Coping]

Chemical coping also has an idea that it is an early stage of abuse and dependence of opioids, it is important to grasp the frequency, complaints, and risk factors of chemical coping. In this study, observational research was performed backwardly with 549 people using opioids who were newly requested to the palliative care team. Results revealed that 13 of 549 patients (2.4%)were diagnosed with chemical coping. In terms of a breakdown of the complaint, and it was following rate and reasons, 6 people(46%)felt easy, 2 people(15%)were anxious, 2 people(15%)could sleep, 2 people(15%)had unknown reasons, and 1(8%)was calm. Characteristics of each patient diagnosed with chemical coping included frequent psychiatric symptoms such as life expectancy of 3 months, opioid oral administration period of 1 year or more, disease incidence period of 1 year or more, anxiety, delirium, and depression. One benign disease also confirmed the transition to opioid dependence.

Medication-related osteonecrosis of the jaw after tooth extraction in cancer patients: a multicenter retrospective study

Root amputation, immunosuppressive therapy, mandibular tooth extraction, pre-existing inflammation, and longer duration of treatment with bone-modifying agents were significantly associated with an increased risk of medication-related osteonecrosis of the jaw. Hopeless teeth should be extracted without drug holiday before the development of inflammation in cancer patients receiving high-dose bone-modifying agents.

INTRODUCTION

No studies have comprehensively analyzed the influence of pre-existing inflammation, surgical procedure-related factors such as primary wound closure, demographic factors, and drug holiday on the incidence of medication-related osteonecrosis of the jaw (MRONJ). The purpose of this study was to retrospectively investigate the relationships between these various factors and the development of MRONJ after tooth extraction in cancer patients receiving high-dose bone-modifying agents (BMAs) such as bisphosphonates or denosumab.

METHODS

Risk factors for MRONJ after tooth extraction were evaluated with univariate and multivariate analyses. The following parameters were investigated in all patients: demographics, type and duration of BMA use, whether BMA use was discontinued before tooth extraction (drug holiday), the duration of such discontinuation, the presence of pre-existing inflammation, and whether additional surgical procedures (e.g., incision, removal of bone edges, root amputation) were performed.

RESULTS

We found that root amputation (OR = 22.62), immunosuppressive therapy (OR = 16.61), extraction of mandibular teeth (OR = 12.14), extraction of teeth with pre-existing inflammation, and longer duration (≥ 8 months) of high-dose BMA (OR = 7.85) were all significantly associated with MRONJ.

CONCLUSIONS

Tooth extraction should not necessarily be postponed in cancer patients receiving high-dose BMA. The effectiveness of a short-term drug holiday was not confirmed, as drug holidays had no significant impact on MRONJ incidence. Tooth extraction may be acceptable during high-dose BMA therapy until 8 months after initiation.

Studies of Fibrinogen Metabolism in Healthy and Hypertensive Female Subjects with the Use of Autologous I-125-Fibrinogen

10 healthy female subjects and 15 female patients with essential hypertension were studied with respect to fibrinogen metabolism in a steady state. Autologous I-125-labeled fibrinogen (I-125-fibrinogen) was used as a tracer. Comparison of the results showed that plasma volume, t½ of plasma I-125-fibrinogen and fractional catabolic rate (j3p) of plasma fibrinogen were not appreciably different in both groups of subjects, but plasma fibrinogen concentration, and catabolic flux of (synthesis rate) were significantly higher in hypertensive subjects, whereas extravascular fibrinogen and fractional transcapillary transfer rate (j1) of were significantly decreased in the patients. Further analyses of the data in both groups showed that there were significant correlations between diastolic blood pressure (P) and j1 with a regression equation of j1 = e−0.0285P, between 1 and between and j1 with a regression equation of 1. These results indicate that the observed decrease of j1 triggered the transition from normal to pathological steady state and is responsible for the altered metabolism and distribution of fibrinogen in hypertensive subjects.

Effects of Heparin, Typhoid Vaccine and Thrombophlebitis on Factor X Metabolism in the Dog

Studies were made of the effects of heparin, typhoid vaccine and thrombophlebitis on factor X (F.X) metabolism in dogs, using 125-labelled F.X (125I-F.X) as a tracer. 10 healthy male dogs were used for control study and 5 male dogs were used for each of other studies. Plasma F.X concentration was measured by a solid-phase radioimmunoassay. In the control dogs, the plasma F.X concentration was 2.4 ± 0.2 (SD) mg per dl, the plasma F.X (x) was 1.2 ± 0.1(SD) mg per kg, the halflife of plasma 125I-F.X(t½) was 0.5 ± 0.01 (SD) days, the fractional catabolic rate (j3p) was 2.4 ± 0.1 (SD) per day and the catabolic flur (J3pX) (synthesis rate) was 2.9 ± 0.7 (SD) mg per kg per day. These results were not appreciably altered in heparinized dogs. However, a single intravenous injection of 2 ml typhoid vaccine caused a shortened t½ of 0.38 ± 0.01 (SD) days and a decrease of plasma F.X concentration to 1.3 ± 0.13 (SD) mg per dl. Studies in heparinized dogs showed similar effects of typhoid vaccine. Next, thrombophlebitis was produced by a previous method and its effects on F.X metabolism were studied. No detectable alterations of F.X metabolism were found. These results indicate that in health most F. X is directly catabolized without the formation of activated F.X (F.Xa), that the observed effects of typhoid vaccine are mostly due to an acceleration of the direct catabolism of F.X without F.Xa formation and finally that localized thrombophlebitis has no appreciable effects on F.X metabolism.

Studies of Heparin Affinity to Antithrombin III and Other Proteins in Vitro and in Vivo

Properties of human, canine, and porcine heparin and S-35-heparin were first studied. Their electrophoretic mobility through 10 g % polyacrylamide gels, specific activity and their filtration patterns through Sephadex G-200 columns were closely similar. Then, S-35-heparin (0.5 mg) and cold heparin (27 mg) were simultaneously injected intravenously into 5 dogs and their plasma behavior was compared. The plasma half-lives of S-35-heparin averaged 1.18 ± 0. 13 (SD) hr and was identical with that of cold heparin, but the half-lives were much shorter and averaged 0.46 ± 0.08 (SD) hr in 5 dogs when S-35-heparin alone was injected. Studies were next made of heparin affinity to proteins including canine antithrombin III (AT) by the use of Sephadex G-200 chromatography, polyacrylamide gel electrophoresis, and S-35-heparin as a tracer. It was found that S-35-heparin-binding to alpha1, beta, and gammaglobulins and fibrinogen was readily separable upon addition of 5 mg cold heparin, but that the binding to AT was inseparable by addition of cold heparin or by electrophoresis. However, in canine plasma, both S-35-heparin and cold heparin were mostly bound to proteins other than AT, suggesting that this might be the case in vivo. To further substantiate this, studies were made of the comparative behavior of I-125-labeled AT (I-125-AT) and S-35-heparin in dogs with the idea that the plasma half-lives of both should be equal if they were irreversibly bound to each other. The plasma half-lives of I-125-AT averaged 2.10 ± 0.05 (SD) days in 5 male dogs and 1.99 ± 0.04 (SD) days in 5 female dogs, and were much different from the half-life values of S-35-heparin as given above. These results indicate that heparin in vitro is more tightly bound to AT than to other proteins, that heparin in vivo is not irreversibly bound to AT and suggest that it is mostly bound to proteins other than AT in vivo.

Studies of the Effects of Estradiol, Progesterone, Cortisol, Thrombophlebitis, and Typhoid Vaccine on Synthesis and Catabolism of Antithrombin III in the Dog

Effects of estradiol, progesterone, Cortisol, thrombophlebitis and typhoid vaccine on the synthesis and catabolism of antithrombin III (AT) in dogs were studied, using I-125-labeled AT (I-125-AT) as a tracer. Five dogs were used for each study. A single intramuscular injection of 20 mg estradiol caused a 20% decrease of plasma AT concentration in 6 days without appreciable changes in the plasma half-lives of I-125-AT but with a significant decrease in the fractional catabolic rate of I-125-AT (j3u). A single intramuscular injection of 250 mg progesterone did not produce any appreciable changes of plasma AT concentration, the plasma half-lives of I-125-AT or j3u. On the other hand, intravenous and intramuscular injections of a total of 750 mg Cortisol caused a 17 % increase of plasma AT concentration in a day after the injections without alterations of the plasma half-lives of I-125-AT or j3u. Next, thrombophlebitis was produced in dogs by a single intravenous injection of 1 ml 90% phenol into a leg vein occluded for 1 min by a gauze tourniquet and the effects of thrombophlebitis were studied. The results indicated that it did not cause appreciable changes of plasma AT concentration, the plasma half-lives of I-125-AT or j3u. However, studies of the effects of a single intravenous injection of 3 ml typhoid vaccine showed a 25 % decrease of plasma AT concentration in a day after the injection with a moderate acceleration of the decline rate of plasma I-125-AT and a 14% increase in j3u values. Further studies in heparinized dogs showed similar effects with typhoid vaccine. These results indicate that estradiol causes a decreased rate of AT synthesis, that progesterone has no appreciable effects on AT metabolism, that Cortisol increases the rate of AT synthesis, that localized thrombophlebitis has no appreciable effects on AT metabolism and that typhoid vaccine causes an increased j3u by unknown mechanisms which is not an accelerated coagulation process.

Properties of Human Tissue Thromboplastins from Brain, Lung, Arteries, and Placenta

Properties of purified and delipidated human tissue thromboplastins (TTPs) from brain (BTTP), lung (LTTP), arteries (ATTP) and placenta (PTTP) were studied. The extinction coefficients were closely similar with a mean value of 8.3 ± 0.01 (SD). The molecular weights were 200,000 ± 3,000 (SD) (BTTP), 90,000 ± 2,000 (SD) (LTTP), 110,000 ± 3,000 (SD) (ATTP) and 250,000 ± 4,000 (SD) (PTTP). The maximum activity of each delipidated TTP after relipidation was obtained when phospholipid-delipidated TTP ratio was 2.0, and the maximum specific activity was 440 units per mg BTTP, 270 units per mg LTTP, 80 units per mg ATTP and 600 units per mg PTTP. Ouchterlony analysis with anti-delipidated PTTP antibody showed the reaction of partial identity between delipidated TTPs and the antibody. Studies of the reactivity of I-125-delipidated TTPs with the antibody gave the following average values for % bound I-125-TTPs in 2 hours: 3.6± 0.2 (SD) % (I-125-BTTP), 11.0± 0.3 (SD) % (I-125-LTTP), 4.4±0.2 (SD) % (I-125-ATTP) and 13.7±0.3 (SD) % (I-125-PTTP). It was also found that the antibody markedly neutralized the coagulant activity of saline extracts of brain, lung and placenta. These results indicate that delipidated BTTP, LTTP, ATTP and PTTP are different while being similar in some aspects and that complete TTPs are not coated with lipids in a manner inaccessible to anti-delipidated PTTP antibody.

Studies of the Metabolism and Distribution of Prothrombin in Healthy Men with Homologous 125I-Prothrombin

A method was described for preparation of purified human prothrombin using repeated barium citrate adsorption and citrate elution, (NH4)2S04 fractionation, Sephadex chromatography and isoelectric precipitation. The produced prothrombins were then physicochemically analyzed. The extinction coefficient was 12.7 ± 0.82 (SD) and the specific activity, 2,563 ± 420 (SD) Iowa units per mg prothrombin. The amino acid composition in g% was as follows: aspartic acid, 8.64; threonine, 5.87; serine, 4.16; glutamic acid, 11.15; proline, 3.91; glycine, 3.96; alanine, 4.65; half cystine, 4.68; valine, 4.46; methionine, 1.14; isoleucine, 2.93; leucine, 6.18; tyrosine, 4.52; phenylalanin, 4.19; lysine, 4.78; histidine, 1.73; ammonia, 1.85; arginine, 6.91. The tryptophan and carbohydrate contents were not determined. The prothrombins were then labeled with 125I in a ratio of about 0.25 atom iodine per molecule of prothrombin and were used for studies of the metabolism and distribution of prothrombin in thirteen healthy men. A model was proposed for the human prothrombin system based on the assumptions that prothrombin is catabolized intravascularly without the formation of thrombin, and was tested against the observed behavior of injected 125I- prothrombin. The model closely predicted the observed behavior of 125I-prothrombin. The analytical results of the tracer data in thirteen healthy men by the methods derived from the model were as follows: The plasma prothrombin, 6.65 ± 1.10 (SD) mg per kg; the interstitial prothrombin, 6.0 ^ 1.9 (SD) mg per kg; the half-life of plasma 125I-prothrombin, 2.29 ± 0.14 (SD) days ; the transcapillary transfer rate of prothrombin, 10.2 ± 3.9 (SD) mg per kg per day; and the catabolic (synthetic) rate of prothrombin, 4.3 J: 1.0 (SD) mg per kg per day. These results support the concept that in healthy men prothrombin is degraded in plasma or spaces in rapid exchange with it generation of appreciable amounts of thrombin.

Relationship between arthroscopic findings of synovitis and levels of tumour necrosis factor-alpha and matrix metalloproteinases in synovial lavage fluid from patients with unilateral high mandibular condyle fractures

Arthrocentesis has an effect of washing out inflammatory products that accumulate in the joint compartment of a dysfunctional temporomandibular joint (TMJ). The procedure removes inflammatory cytokines, which are pain-causing substances, for early reduction of TMJ pain and quick recovery of jaw function, thus increasing the possibility of a successful rehabilitation. The aim of this study was to investigate the relationship between arthroscopy synovitis grade in patients with unilateral high condylar fractures and concentrations of the pro-inflammatory cytokines tumour necrosis factor (TNF)-alpha as well as of matrix metalloproteinases (MMPs) in washed-out synovial fluid (SF) samples obtained from those patients. A total of 26 patients with unilateral high condylar fractures who underwent arthrocentesis for a therapeutic purpose were examined. SF samples were collected before performing arthroscopy to determine synovitis grade. The detection rates and concentrations of TNF-alpha and MMPs were determined, and their association with synovitis grade was analysed. TNF-alpha was detected in 23 and MMP-3 in 22 of the TMJs. There was a correlation between synovitis grade and concentration of TNF-alpha in the fracture group. Furthermore, the concentrations of TNF-alpha and MMP-3 were significantly higher as compared to the control group, comprised of TMJs on the non-fracture side of the same patients, while a correlation was also noted between TNF-alpha concentration and synovitis grade in the fracture group. The present findings may provide a biological/biochemical rationale for arthrocentesis as a reasonable treatment modality for high condylar fractures.