Sustained expression of hepatocyte nuclear factor-6 leads to loss of pancreatic beta-cells by apoptosis

Hepatocyte nuclear factor-6 (HNF-6) is the ONECUT-homeodomain transcription factor that is enriched in liver and also present in pancreas and central nervous system. It is expressed in the pancreatic bud at E10.5. In adult pancreas, its expression is restricted to the exocrine pancreas and duct cells. Since duct cells are thought to be precursors of endocrine cells and HNF-6 is involved in the regulation of the expression of HNF-4alpha and -1beta, genes that cause maturity onset diabetes of the young (MODY), we hypothesized that the sustained expression of HNF-6 would affect beta-cell function. We generated transgenic mice over-expressing human HNF-6 using the mouse insulin I promoter (MIP). We obtained one female founder in which the transgene had been incorporated into two sites; the chromosome (Ch) 14 and the X chromosome. The integration site of the latter was within centromeric heterochromatin and the transgene was inactivated. Studies on mice in which the transgene was integrated into Ch14 showed beta-cell specific defects functionally and pathologically. The insulin secretory response to glucose and arginine in the in situ-perfused pancreas was also significantly impaired in these mice. Immunohistochemical analysis revealed that the islets were smaller and had an abnormal architecture with an inverted ratio of alpha- and beta-cells resulting from beta-cell loss to 30% by 6-wk of age. The decreased number of beta-cells was quantified first time by fluorescent activated cell sorting using entire pancreata from the transgenic mice crossed with MIP-green fluorescent protein (GFP) mice. This severe loss of beta-cells involved programmed cell death.

No association of the POLI Thr706Ala polymorphism with the risk of cervical carcinoma

OBJECTIVE

To investigate the association of repair gene POLI genetic polymorphisms with cervical carcinoma.

MATERIALS AND METHODS

Four hundred sixty one cervical carcinoma patients and 628 normal women were randomly selected for this study. Single nucleotide polymorphisms (SNPs) (POLI Thr706Ala) were genotyped, and the epidemiological risk factor was assessed.

RESULTS

Compared with the POLI Thr706Thr genotype, neither POLI Thr706Ala nor POLI Ala706Ala elevated or decreased the risk of cervical carcinoma or cervical squamous cell carcinoma [ORs and 95% CIs 1.25(0.97-1.61), 1.11(0.67-1.83), 1.22(0.94-1.58), 1.06(0.63-1.78), respectively]. When analyzing the risk of the POLI Thr706Ala variant genotype for cervical carcinoma in different histological types or HPV infection status, very similar risk factors were observed for the squamous cell carcinoma group or the HPV positive group to the overall carcinoma. Regardless of sexual or reproductive histories, patients with the POLI Thr706Ala or POLI Ala706Ala genotype showed a significantly increased risk of cervical carcinoma.

CONCLUSION

The POLI Thr706Ala genotype was not associated with cervical carcinoma in a Chinese population, but we cannot exclude the possibility that the POLI polymorphism might be associated with sexual and reproductive history.

Expression of complement regulatory proteins in accommodated xenografts induced by anti-alpha-Gal IgG1 in a rat-to-mouse model

Anti-graft antibodies are often associated with graft rejection. Under special conditions, grafts continue to function normally even in the presence of anti-graft antibodies and complement. This condition is termed accommodation. We developed a xenograft accommodation model in which baby Lewis rat hearts are transplanted into Rag/GT-deficient mice, and accommodation is induced by repeated i.v. injections of low-dose anti-alpha-Gal IgG(1). The accommodated grafts survived a bolus dose of anti-alpha-Gal IgG(1), while freshly transplanted second grafts were rejected. To study the mechanism of anti-alpha-Gal IgG(1)-mediated accommodation, both real-time PCR and immunohistochemical staining revealed elevated expression of DAF, Crry and CD59 in the accommodated grafts. In vitro exposure of rat endothelial cells to anti-alpha-Gal IgG(1) also induced the up-regulation of DAF, Crry and CD59, as revealed by Western blot analyses, and was associated with an acquired resistance to antibody and complement-mediated lysis in vitro. Collectively, these studies suggest that the up-regulation of complement regulatory proteins may abrogate complement-mediated rejection and permit the development of xenograft accommodation.

A comparison of cardiovascular disease risk factor biomarkers in African Americans and Yoruba Nigerians

OBJECTIVE

Classical risk factors for coronary artery disease are changing in the developing world while rates of cardiovascular disease are increasing in these populations. Newer risk factors have been identified for cardiovascular disease, but these have been rarely examined in elderly populations and not those of developing countries.

METHODS

This study was a cross-sectional comparison from a longitudinal, observational, epidemiologic study in which participants are interviewed at three-year intervals. The sample included 1510 African Americans from Indianapolis, Indiana, and 1254 Yoruba from Ibadan, Nigeria. We compared anthropomorphic measurements; biomarkers of endothelial dysfunction (plasminogen activator inhibitor type 1 [PAI-1 and E-selectin), inflammation (C-reactive protein), and lipid oxidation (8-isoprostane); and levels of lipids, homocysteine, folate, and vitamin B12.

RESULTS

Cholesterol, triglycerides, and low-density lipoprotein cholesterol levels were higher in African Americans. For markers of endothelial dysfunction, E-selectin and homocysteine differed between men, and PAI-1 was higher in the Yoruba. C-reactive protein differed only in women, but 8-isoprostane was higher in the Yoruba.

CONCLUSION

Higher lipid levels in African Americans are consistent with their Western diet and lifestyle. Oxidative stress appears to be higher in the Yoruba than in African Americans, which may be secondary to dietary differences. Whether these differences in classical and emerging risk factors account for the different rates of cardiovascular disease, dementia, or other morbidities in these two populations remains to be determined.

Interleukin-18 gene polymorphisms and haplotypes in patients with oral lichen planus: a study in an ethnic Chinese cohort

Interleukin (IL)-18, a proinflammatory cytokine, induces T-helper 1 differentiation and cytotoxic T-lymphocyte functions, both of which have been proposed in the pathogenesis of oral lichen planus (OLP) - an oral disease resembles oral mucosal graft-versus-host disease (GVHD) both clinically and histologically. The aim of this study was to evaluate the association of single nucleotide polymorphisms (SNPs) in the IL18 gene on the chromosome 11q22 in patients with OLP. Four SNPs of the IL18 gene at positions -137G/C (rs187238), -607C/A (rs1946518), -656G/T (rs1946519), and 1248A/G (rs189667) were analyzed in 151 patients with OLP and 143 normal controls using polymerase chain reaction-sequence-specific primers method, and the serum level of IL-18 protein was determined by enzyme-linked immunosorbent assay (ELISA). The data revealed that there is a significant difference in IL18-607 genotype distributions between the patient group and the control group (P < 0.001), and the polymorphism -137G/C also appears to be statistically associated with the more severe erosive subtype (eOLP) (P = 0.023). The identified polymorphisms at the IL-18 promoter region (i.e. -137GG) are likely to exert positive effect on the production of IL-18 protein in OLP, as detected by ELISA. Using phase software, four haplotypes were deduced from the two polymorphisms -607C/A and -137G/C, named haplotypes I to IV, and the haplotypes I, II, and IV are significantly associated with OLP (P < 0.001). Our data suggest that the identified IL18 polymorphisms may be associated with the pathogenesis of OLP in this Chinese cohort by upregulation of IL-18 production in vivo.

Meta-analysis: The utility and safety of heparin in the treatment of active ulcerative colitis

BACKGROUND

The use of heparin for the treatment of ulcerative colitis has been evaluated in several open and controlled trials, with varying outcomes.

AIM

To evaluate the efficacy and safety of heparin as supplemental therapy compared with conventional therapy in patients with ulcerative colitis.

METHODS

All randomized trials comparing heparin supplementation to conventional therapy were included from electronic databases. Statistical analysis was performed with review manager 4.2.8 (The Cochrane Collaboration, Oxford, UK). Sub-analysis and sensitivity analysis were also performed.

RESULTS

Eight randomized-controlled trials, investigating a total of 454 participants, met the inclusion criteria. The odds ratio (OR) for the efficacy of heparin supplementation vs. conventional therapy was 0.78 (95% CI = 0.50-1.21). Few serious adverse events were observed. The OR for the efficacy of unfractionated heparin and low-molecular-weight heparin vs. conventional therapy was 0.26 (95% CI = 0.07-0.93) and 0.92 (95% CI = 0.57-1.47), respectively. The OR for the efficacy of heparin vs. conventional therapy with placebo was 0.87 (95% CI = 0.53-1.44).

CONCLUSIONS

Our meta-analysis suggests that administration of heparin in patients with ulcerative colitis is safe, but no additive benefit over conventional therapy is indicated.

Forced expression of a constitutively active form of Stat3 in mouse epidermis enhances malignant progression of skin tumors induced by two-stage carcinogenesis

Recently, our laboratory demonstrated that Stat3 is required for the de novo development of chemically-induced skin tumors. We have further investigated the role of Stat3 in epithelial carcinogenesis using mice in which the expression of a constitutively active/dimerized form of Stat3 (Stat3C) is targeted to the proliferative compartment of epidermis (referred to as K5.Stat3C transgenic mice). Keratinocytes from K5.Stat3C mice showed increased survival following exposure to 7,12-dimethylbenz[a]anthracene (DMBA) and enhanced proliferation following exposure to 12-O-tetradecanoylphorbol-13-acetate (TPA). In two-stage chemical carcinogenesis experiments using DMBA as the tumor initiator and TPA as the promoter, K5.Stat3C mice developed skin tumors with a shorter latency and in much greater number compared to non-transgenic littermates. Remarkably, 100% of the skin tumors that developed in K5.Stat3C transgenic mice bypassed the premalignant stage and were initially diagnosed as carcinoma in situ which rapidly progressed to squamous cell carcinoma (SCC). These tumors were highly vascularized, poorly differentiated and invasive and loss of expression of K10, filaggrin and E-cadherin was observed by 20 weeks. Finally, overexpression of Stat3C in a papilloma cell line led to enhanced cell migration and enhanced invasion through Matrigel in both the absence and presence of growth factors. In addition to its critical role in early stages of epithelial carcinogenesis, the current study reveals a novel role for Stat3 in driving malignant progression of skin tumors in vivo.

The cell cycle regulation of anti-cancer bioactive peptide (ACBP) on gastric cancer cell lines

15087

Background: Anti-cancer bioactive peptide (ACBP) was extracted from the spleen of the goat suffered immune inducement by immunoreaction, supercentrifuge and ultra-filtration. Our previous studies have identified ACBP had significantly inhibited the growth of the human gastric cancer cell lines BGC-823 and MGC-803, the human rhinopharyngocele cell line CNE and the leukemic cell line. The in vivo experiments showed ACBP could dramatically repress the growth of tumor, and had few side-effects in the long-term toxic experiments. In clinical trials, ACBP could enhance the survival and life quality of the patients with advanced gastric cancer. In this study, we will explore the influence and mechanism of the effect of ACBP on cell cycle using human gastric cancer cell lines BGC-823 and MGC-803. Methods: Human gastric cancer cell lines BGC-823 and MGC-803 were cultured with different concentrations (10–25 ug/ml) of ACBP. The MTT method was employed to measure the growth inhibition rates of the cells with different concentrations of ACBP; the morphological changes were observed under the light microscope; the semi-quantitative RT-PCR was used to assay the changes of mRNA for p16,p21,p27,c-myc,cyclin D1,bax,bcl-2 gene. Results: Different concentrations of ACBP in the range of 10.0–25.0 μg/ml could inhibit the growth of BGC-823 and MGC-803 cell and such effect was both concentration and time dependent. 25.0 μg/ml ACBP had an inhibition rate (IR) of 84.4%, 72.3% and a median concentration (IC50) of 17.86 μg/ml, 13.16 ug/ml. After ACBP treatment, the cells showed typical apoptotic changes under the light microscope. On RT-PCR, the expressions of p16,p21,p27,bax mRNA in the two cell lines were markedly increased after ACBP treatment. On the contrary, the expression of c-myc,cyclin D1,bcl-2 mRNA in the two cell lines were obviously decreased after ACBP treatment. Conclusion: ACBP had markedly repressed the growth of BGC-823 and MGC-803 cell lines through inducing the cellular apoptosis. The possible mechanism is ACBP affects the cell cycle molecules expression including p16,p21,p27,cyclin D1 and regulate c-myc,bcl-2 and bax to induce apoptosis.

No significant financial relationships to disclose.

Pemetrexed plus cetuximab in patients (pts) with recurrent non-small cell lung cancer (NSCLC): A phase I-IIa dose-ranging study from the Hoosier Oncology Group

7698

Background: Both pemetrexed (P) and cetuximab (C) have single agent activity in NSCLC, non-overlapping toxicities and different mechanisms of action, making the combination of P and C an attractive option to evaluate. This study evaluates the feasibility of combining these agents, and tests the activity and toxicity of this regimen in pts with recurrent NSCLC. Methods: Eligible pts had stage IIIB/IV NSCLC, previously treated ≥ 1 prior platinum containing regimen, PS 0–1. Prior use of EGFR tyrosine kinase inhibitors was permitted. The phase I portion determined the MTD (Bedano Proc ASCO et al., 2006). The primary endpoint of the phase II portion was to estimate TTP using Kaplan-Meier analysis (5% alpha, 80% beta), requiring 25 pts to demonstrate a TTP of ≥ 24 weeks vs. historical control of 12 weeks. Following a loading dose of C at 400 mg/m2 on week 1, pts received P at 750 mg/m2 iv q3wks and C at 250 mg/m2 iv weekly. Cycles were repeated every 21 days. After completing at least 4 cycles, pts with non-progressive disease (PD) were allowed to continue C alone until PD. Results: Eligible and treated phase II pts (n=23) received a median of 4 cycles (range 1–12). Pt characteristics: M:F 57%:43%; median age 64 (range 43–80), stage IIIB: IV 17%:83%; adeno:squamous cell 61%:30%; smoking status: current/former/never: 29%/62%/10%. Prior regimens, median 2 (range 1–6). G3/4/5 toxicities included: 4.3% neutropenia, 13% infection, 4.3% hemorrhage, 22% skin. There were no G3/4 episodes of anemia, TCP, febrile neutropenia, liver toxicity or diarrhea. Response data was available for 18 patients. Partial responses were seen in 2 pts (8.7 %), SD in 8 patients (34.8%). Median TTP was 25 weeks. Conclusion: It is feasible and safe to combine P at 750 mg/m2 every 21 days and C at 400 mg/m2 week 1 and 250 mg/m2 weekly thereafter. This combination resulted in longer TTP when compared with historical controls of P at 500 mg/m2 alone.

No significant financial relationships to disclose.

Paeoniflorin inhibits TGF-beta1-mediated collagen production by Schistosoma japonicum soluble egg antigen in vitro

The main pathological characteristics of hepatic fibrosis in schistosomiasis are the proliferation of hepatic stellate cells (HSCs) and the deposition of collagen type I (Col I) and collagen type III (Col III). Transforming growth factor beta-1 (TGF-beta1) plays an important role in hepatic fibrosis. Paeoniflorin (PAE) has been reported to have immunoregulatory effects; however, the mechanism of its anti-hepatic fibrosis in S. japonicum has not been elucidated. In the present study, we found that mouse peritoneal macrophages (PMphis) stimulated by soluble egg antigen (SEA) of S. japonicum could secrete TGF-beta1, and the TGF-beta1 in the peritoneal macrophage-conditioned medium (PMCM) could induce proliferation of HSCs and secretion of Col I and III. We selected PMCM at 1 : 2 dilution as the optimum PMCM (OPMCM). Then we treated HSCs pre-incubated with OPMCM with PAE, and found that the inhibition of HSC proliferation or Col I and III production were closely correlated with the concentration of PAE. Further investigation found that PAE significantly decreased the Smad3 transcription and phosphorylation in HSCs stimulated by OPMCM. In conclusion, SEA plays a key role in hepatic fibrosis by inducing TGF-beta1 from PMphis. PAE can exert anti-fibrogenic effects by inhibiting HSCs proliferation and down-regulating Smad3 expression and phosphorylation through TGF-beta1 signalling.

Thyroid arterial embolization to treat Graves' disease

PURPOSE

To prospectively investigate the effect of thyroid arterial embolization on hyperthyroid Graves' disease in selected patients.

MATERIAL AND METHODS

Twenty-eight patients with hyperthyroidism caused by Graves' disease were enrolled to undergo thyroid arterial embolization and followed up for 12-22 months. Twenty-two patients had three thyroid arteries embolized and six patients two arteries. Serum thyroid hormone, thyroid-stimulating hormone (TSH), and autoimmune function were tested before and after embolization in all patients.

RESULTS

Of 28 patients, 22 (78.6%) became euthyroid, five improved (17.8%), and one had temporary improvement followed by recurrence (3.6%). No serious complications occurred. Compared with the pre-embolization values, serum concentrations of thyroid hormone increased temporarily on day 3 post-embolization, dropped substantially after 1 and 2 months, and returned to nearly normal at 6 and 12 months post-embolization. TSH dropped on day 3, increased after 1 and 2 months, and returned to normal after 6 and 12 months. Thyroid antibodies TGAb and TMAb declined on day 3 to normal range, rose after 1 month, dropped to normal again after 2 months, and were slightly increased at 6 and 12 months follow-up.

CONCLUSION

Thyroid arterial embolization may be an effective approach for patients with hyperthyroidism caused by Graves' disease.

Confirmation of four nitroimidazoles in porcine liver by liquid chromatography–tandem mass spectrometry

A sensitive and reliable multiresidue method is described for analysis of ronidazole, metronidazole, dimetridazole and the common metabolite of ronidazole and dimetridazole, 2-hydroxymethyl-1-methyl-5-nitroimidazole in swine liver. The sample preparation procedure was based on liquid-liquid extraction and mixed mode cation exchange/reverse phase solid-phase extraction. The compounds of interest were determined by reverse phase gradient liquid chromatography separation and tandem mass spectrometry (MS/MS) in the multiple reaction monitoring (MRM) mode. The limits of confirmation were 0.1-0.5 microg kg(-1) for the analytes.

FDG-PET study of the bilateral subthalamic nucleus stimulation effects on the regional cerebral metabolism in advanced Parkinson disease

The aim of the study was to evaluate the changes in regional cerebral metabolic rate of glucose (rCMRGlu) induced by bilateral subthalamic nucleurs (STN) stimulation in advanced Parkinson's disease (PD). 18F-Fluorodeoxyglucose (FDG) PET data obtained before and one month after stimulation were analyzed with statistical parametric mapping (SPM). As a result of clinically effective bilateral STN stimulation, rCMRGlu increased in lateral globus pallidus (GP), upper brain stem, dorsolateral prefrontal cortex (DLPFC) and posterior parietal-occipital cortex, and decreased in the orbital frontal cortex and parahippocampus gyrus (p < 0.001). We conclude that the alleviation of clinical symptoms in advanced PD by bilateral STN stimulation may be the result of activation of both ascending and descending pathways from STN and of restoration of the impaired higher-order cortex functions.

Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy

BACKGROUND

Recent evidence found probiotics could inhibit Helicobacter pylori colonization from both in vitro and in vivo studies.

AIM

To systematically evaluate whether adding probiotics to anti-H. pylori regimens could improve eradication rates and reduce side effects during anti-H. pylori treatment.

METHODS

Eligible articles were identified by searches of electronic databases. We included all randomized trials comparing probiotics supplementation to placebo or no treatment during anti-H. pylori regimens. Statistical analysis was performed with Review Manager 4.2.8. Subanalysis/Sensitivity analysis was also performed.

RESULTS

We identified 14 randomized trials (n = 1671). Pooled H. pylori eradication rates were 83.6% (95% CI = 80.5-86.7%) and 74.8% (95% CI = 71.1-78.5%) for patients with or without probiotics by intention-to-treat analysis, respectively, the odds ratio (OR) was 1.84 (95% CI = 1.34-2.54); the occurrence of total side effects were 24.7% (95% CI = 20.0-29.4%) and 38.5% (95% CI = 33.0-44.1%) for groups with or without probiotics, especially for diarrhoea, the summary OR was 0.44 (95% CI = 0.30-0.66).

CONCLUSIONS

Our review suggests that supplementation with probiotics could be effective in increasing eradication rates of anti-H. pylori therapy, and could be considered helpful for patients with eradication failure. Furthermore, probiotics show a positive impact on H. pylori therapy-related side effects.

Morphologic analysis of normal human lumbar dorsal root ganglion by 3D MR imaging

BACKGROUND AND PURPOSE

The dorsal root ganglion (DRG) of the spinal nerve has been considered a key structure in the mechanism of low-back pain and radicular symptoms. The purpose of this study was to clarify the normal morphologic features and variations of the lumbar DRGs in a healthy population by using 3D MR imaging.

METHODS

3D fast-field echo (FFE) with water selective excitation coronal MR images of lumbar spine obtained in 115 healthy volunteers were further reconstructed into a radial stack of 15 coronal images by using maximum intensity projection technique. The DRGs from L1 through L5 were assessed for the location, signal intensity, architecture, and dimensions.

RESULTS

Most DGRs were foraminal in location. Only 5.7% of the L5 DGRs were located intraspinally. The sizes of L1, L2, and L5 DRGs in men were larger than those in women (P < .05). The dimensions of the DRGs gradually increased from L1 to L5 (P < .0001). The biganglia (2 ganglial components) frequently occurred in the L4 and L3 DRGs, whereas the singular ganglion (1 ganglial component), in the L5 and L1 DRGs.

CONCLUSION

The normal anatomy and variants of the lumbar DRG could be better demonstrated by 3D MR imaging with water selective excitation technique. The relatively larger and more proximally located DRGs in the lower lumbar region may be more susceptible to compression. An appreciation of normal anatomy and variants of DRGs radiologically is helpful for the diagnosis and proper treatment for radiculopathy.

Giant discrete steps in metal-insulator transition in perovskite manganite wires

Optical lithography is used to fabricate LPCMO wires starting from a single (La(5/8-0.3)Pr(0.3))Ca3/8MnO3 (LPCMO) film epitaxially grown on a LaAlO3(100) substrate. As the width of the wires is decreased, the resistivity of the LPCMO wires exhibits giant and ultrasharp steps upon varying temperature and magnetic field in the vicinity of the metal-insulator transition. The origin of the ultrasharp transitions is attributed to the effect of spatial confinement on the percolative transport in manganites.

TLR engagement prevents transplantation tolerance

In many experimental models, heart, pancreas and kidney allografts are accepted long-term following costimulation-targeting therapies, whereas skin, lung and intestine resist the induction of tolerance under the same regimens. We noted that a common feature of the resistant organs is their constant exposure to commensal microbes and hypothesized that these microorganisms may stimulate Toll-like receptors (TLRs), promote alloresponses and prevent tolerance induction. This hypothesis prompts the predictions that TLR engagement at the time of transplantation should avert tolerance to heart allografts in animals treated with costimulation-targeting therapies, whereas inhibition of TLR signaling should promote tolerance to skin allografts under the same conditions. Indeed, engagement of a single TLR was sufficient to prevent anti-CD154-mediated long-term cardiac allograft acceptance and correlated with abolished intragraft recruitment of CD4+/FoxP3+ regulatory T cells and the development of linked-suppression. Conversely, a lack of donor and recipient MyD88-dependent signaling led to successful skin allograft acceptance in anti-CD154-treated animals. Thus, the status of TLR signaling contributes to the resistance versus susceptibility of organs to transplantation tolerance.

Periodic ZnO nanorod arrays defined by polystyrene microsphere self-assembled monolayers

We demonstrate a low-cost and effective method to fabricate hexagonally patterned, vertically aligned ZnO nanorod arrays. Selective wet-etching is used to develop the catalyzing gold particle hexagonal pattern with the aid of a polystyrene microsphere self-assembled monolayer. The gold particles have tunable sizes independent of the polystyrene microsphere's diameter and are inherently round in shape. Each ZnO rod is grown individually from a catalyzing site via catalyst-initiated epitaxy, and the original hexagonal periodicity is well-preserved. The rods have flat ends, and the diameters of the rods can be controlled well by the amount of source materials. This method provides a promising way to create ZnO one-dimensional nanostructures for applications as two-dimensional photonic crystal, sensor arrays, nanolaser arrays, and optoelectronic devices.

Decoupling of normal CD40/interleukin-4 immunoglobulin heavy chain switch signal leads to genomic instability in SGH-MM5 and RPMI 8226 multiple myeloma cell lines

The processes mediating genomic instability and clonal evolution are obscure in multiple myeloma (MM). Acquisition of new chromosomal translocations into the switch region of the immunoglobulin heavy chain (IgH) gene (chromosome 14q32) in MM, often heralds transformation to more aggressive disease. Since the combined effects of CD40 plus interleukin-4 (IL-4) mediate IgH isotype class switch recombination (CSR), and this process involves DNA double strand break repair (DSBR), we hypothesized that CD40 and/or IL-4 activation of MM cells could induce abnormal DNA DSBR and lead to genomic instability and clonal evolution. In this study, we show that MM cell lines that are optimally triggered via CD40 and/or IL-4 demonstrate abnormal decoupling of IL-4 signal transduction from CD40. Specifically, CD40 alone was sufficient to trigger maximal growth of tumor cells. We further demonstrate that CD40 triggering induced both DNA DSBs as well as newly acquired karyotypic abnormalities in MM cell lines. Importantly, these observations were accompanied by induction of activation induced cytidine deaminase expression, but not gross apoptosis. These data support the role of abnormal CD40 signal transduction in mediating genomic instability, suggesting a role for the CD40 pathway and intermediates in myelomagenesis and clonal evolution in vivo.