Differential effect of specific gr/gr deletion subtypes on spermatogenesis in the Chinese Han population

As a common variation in the azoospermia factor c (AZFc) region of Y chromosome, the gr/gr deletion is regarded as a significant risk factor for spermatogenic impairment, whereas the association of the deletion's phenotypic expression with Y-chromosomal background is still a subject of debate. To further investigate the contribution of the deletion to spermatogenic impairment in different Y-chromosomal haplogroups, the partial AZFc deletion was detected with AZFc-specific sequence tagged sites, gene dosage and gene copy analyses of deleted in azoospermia (DAZ), chromodomain Y1 (CDY1) and basic protein Y2 (BPY2) in 1426 azoo/oligozoospermic and 672 normozoospermic men from a Chinese population. The haplogrouping was performed in 231 deletion carriers with 12 polymorphic loci of Y chromosome. As a result, five gr/gr rearrangement types in eight Y haplogroups were observed, in which the simple gr/gr deletion was the most common type, and its frequency was significantly higher in men with azoo/oligozoospermia relative to normozoospermia. Also the distribution of gr/gr-rearranged Y haplogroups was significantly different between the two groups, in which gr/gr-deleted haplogroups C and DE were more common in men with azoo/oligozoospermia. In the 6 gr/gr copy deletion haplotypes, the frequencies of DAZ1/DAZ2+CDY1a or CDY1b deletion were significantly higher in men with azoo/oligozoospermia, while all DAZ3/DAZ4+CDY1b+BPY2.2 or 2.3 deletions were found only in haplogroup Q1 without any distribution difference between the azoo/oligozoospermic and normozoospermic groups. This study provided further evidence for the existence of multiple subtypes of gr/gr deletion and indicates that gr/gr-DAZ1/DAZ2 deletion is a significant risk factor. However, the association of the phenotypic variation of gr/gr deletion with Y-chromosomal haplogroups is not definite yet, because of the limited amounts of the deletions observed in each of the haplogroups and the lack of the quantitative trait analyses such as sperm density analysis. The fact that a common gr/gr copy deletion haplotype was found exclusively in the Y hgr Q1, without pathogenic consequences, implies the importance of haplogrouping and of copy deletion typing prior to genetic counselling of deletion carriers of Chinese descent.

Treatment of whole blood (WB) and red blood cells (RBC) with S-303 inactivates pathogens and retains in vitro quality of stored RBC

A pathogen inactivation (PI) process has been developed using the frangible anchor linker effector (FRALE) compound S-303. A series of experiments were performed in whole blood (WB) to measure the level of viral and bacterial inactivation. The results showed that 0.2mM S-303 and 2mM glutathione (GSH) inactivated >6.5 logs of HIV, >5.7 logs of Bluetongue virus, >7.0 logs of Yersinia enterocolitica, 4.2 logs of Serratia marcescens, and 7.5 logs of Staphylococcus epidermidis. Recent development for S-303 is focused on optimization of the PI process for red blood cell concentrates (RBC). A series of studies in RBC showed that 0.2mM S-303 and 20mM GSH inactivated approximately 5 logs or greater of Y. enterocolitica, E. coli, S. marcescens, S. aureus, HIV, bovine viral diarrhoea virus, bluetongue virus and human adenovirus 5. In both applications of the S-303 process, in vitro parameters of RBC function and physiology were retained compared to conventional RBC. Results from these studies indicate that S-303 can be applicable for PI of RBC and WB.

Could changes in arterioles impede the perivascular drainage of interstitial fluid from the cerebral white matter in leukoaraiosis?

AIMS

Leukoaraiosis (LA) is the increase in fluid in cerebral white matter with hyperintensity on T2-weighted MR imaging that occurs in 25% of individuals over 65 years of age and in Alzheimer's disease. Age, hypertension, diabetes mellitus and cardiac disease are the major risk factors for LA. Ischaemia is considered to be the cause of LA, but the aim of the present study is to assess whether changes in arterioles in LA could impede perivascular lymphatic drainage of interstitial fluid from the cerebral white matter.

METHODS

We quantified arteriolosclerosis and immunohistochemical changes in the extracellular matrix in arterioles of cerebral white matter in 20 hypertension autopsy cases with LA and in 10 controls.

RESULTS

The ratio of the area immunoreactive for collagen types I, III, V and VI to the cross-sectional area of arterioles was significantly higher in LA patients compared with controls (P < 0.001). Changes were observed in collagen IV and laminin. The walls of white matter arterioles in LA were significantly thicker (P < 0.01), and lumina were significantly smaller (P < 0.01). Arterioles had a significantly higher sclerotic index [1 - (internal/external diameter)] in LA than in adjacent cortex or control white matter (P < 0.01).

CONCLUSIONS

Our results show that thickening and sclerosis of the walls of arterioles in cerebral white matter in LA are associated with the accumulation of extracellular matrix components. Although these changes may result in decreased perfusion, they could also impede perivascular lymphatic drainage of interstitial fluid from white matter in LA.

Brucellosis in a Singaporean with prolonged fever

Brucellosis, a zoonotic disease of worldwide distribution, is common in many developing countries as well as in countries of the Mediterranean basin. We report brucellosis in a 52-year-old man, who had a recent travel history to Saudi Arabia, and who presented with prolonged fever and deranged liver enzymes. In view of the rarity of brucellosis and its potential life-threatening complications, patients returning from an endemic country need to be questioned for possible Brucella exposure, to ensure that diagnostic tests and treatment are carried out in a timely fashion. In addition to notifying the authorities, the clinician should also warn the laboratory early as cultures of brucellosis are highly transmissible and are one of the most common laboratory-acquired infections.

Effect of the psoralen-based photochemical pathogen inactivation on mitochondrial DNA in platelets

Photochemical treatment (PCT) of platelet concentrates, using amotosalen HCl and UVA-light, inactivates pathogens by forming adducts between amotosalen and nucleic acids. The impact of the photochemical treatment on pathogens and leukocytes has been studied extensively. Yet little is known about the effect of PCT on nucleic acids in platelets. Platelets contain viable mitochondria and mitochondrial DNA (mtDNA) and this study aimed at evaluating the amotosalen modifications on platelet mtDNA. We applied two independent but complementary molecular assays to investigate qualitative as well as quantitative aspects of the psoralen-mediated DNA modifications in platelet mtDNA. The amotosalen-DNA modification density was measured using (14)C-labeled amotosalen. Amotosalen (150 microM) yielded 4.0 +/- 1.2 psoralen adducts per 1,000 bp in mtDNA after irradiation with 3 J/cm(2) UVA. Furthermore, we tested if the PCT-induced DNA modifications could be detected by a PCR assay. On the basis of PCR inhibition due to amotosalen-DNA adducts, mtDNA-specific PCR assays were developed and tested for their specificity and sensitivity. Our data revealed that mtDNA in platelets is substantially modified by PCT and that these modifications can be documented by a PCR inhibition system.

Diabetes, pre-diabetes and associated risks on Minnesota code-indicated major electrocardiogram abnormality among Chinese: a cross-sectional diabetic study in Fujian province, southeast China

The goal of this study was to determine the prevalence of diabetes mellitus (DM), impaired glucose regulation (IGR) and related metabolic disorders (overweight, obesity and hypertension) in a Chinese population (20-74 years old). An additional goal was to investigate the relationship between glucose metabolism and the Minnesota code-indicated major abnormal electrocardiogram (MA-ECG). There were 3960 individuals selected from urban and rural areas of Fujian, China from July 2007 to May 2008 by multistage-stratified sampling. Ultimately, data from 3208 subjects (20-74 years old) were analysed (including physical measurements, blood biochemical analysis, oral glucose tolerance test and 12-lead resting ECG). According to World Health Organization diagnostic criteria, the prevalence rates of DM and IGR were 9.51% (male, 10.08%; female, 9.14%) and 14.40% (male, 14.48%; female, 14.35%) respectively. Newly diagnosed DM was found in 53.44% of the diabetic subjects. Based on the 2000 China census, the age-standardized prevalence rates of DM and IGR were 7.19% (male, 7.74%; female, 6.61%) and 11.96 % (male, 12.35%; female, 11.56%) respectively. The age-standardized prevalence rates of DM and IGR in urban areas (7.74% and 12.97% respectively) were slightly but no significantly higher than in rural areas (6.67%, 10.86%). The prevalence rates of overweight, obesity and hypertension were 25.50%, 3.52% and 28.52% respectively (age- and sex- standardized rates: 23.69%, 3.02 % and 22.45 %). After adjusting for other confounding risk factors, multiple logistic regression analysis showed that DM and impaired glucose tolerance were independent risk factors for MA-ECG. Non-diabetic subjects with increased 30-min plasma glucose (PG) after an oral glucose load had a higher risk of MA-ECG after adjusting for other risk factors, especially in those with normal glucose tolerance but with 30-min PG >or= 7.8 mmol L(-1) (odds ratio = 1.371 [1.055-1.780]). The prevalence rates of DM and IGR as well as other metabolic disorders have increased dramatically in the last decade in China, especially in rural areas, with many undiagnosed cases of DM. Even slightly elevated PG levels may predict early cardiovascular events.

Discharge of pharmaceutical products (PPs) through a conventional biological sewage treatment plant: MECs vs PECs?

Pharmaceuticals for human use are consumed in significant quantities and their occurrence in aquatic systems has been reported by a number of authors. In the context of environmental risk assessment, there is an increasing interest in evaluating the discharge of pharmaceutical products to surface waters through sewage treatment plants (STP). This case study was carried out on a conventional biological treatment plant (Alès, France) and focused on a set of eleven drugs representing the main therapeutic classes. Measured environmental concentrations (MECs) range from the low ng L(-1) to 1.5 microg L(-1) in effluent and up to few hundred ng L(-1) in receiving surface waters. There is a good agreement between MEC and predicted environmental concentration (PEC) values for seven of the eleven investigated drugs in STP effluent. There is not such a good match between PEC and MEC values in surface waters, and this highlights the limits of this approach, at the local scale.

PIK3CA mutation analysis in recurrent breast cancer

11041

Background: Mutations in PIK3CA (encoding p110α catalytic subunit of phosphatidylinositol-3-kinase) are among the most common genetic events identified in breast cancer but the role of these mutations in determining the clinical course of the disease is uncertain. Furthermore the frequency of PIK3CA mutation in metastatic breast cancer samples has not been adequately studied but is an important concern in the design of studies with novel agents designed to inhibit mutant PIK3CA. Methods: We have established a tumor banking protocol for patients (pts) with metastatic breast cancer. In this study, we performed a mutational analysis of exons 9 (HD) and 20 (KD) of the PIK3CA using tumor DNA obtained from pts with recurrent disease and correlated mutational status with clinicopathological features and prognosis. Results: Biopsies were obtained from sites of recurrence in 51 pts with stage 4 disease. The median F/U was 44 (range: 0.9–239) months and death has occurred in 66%. Mutations in PIK3CA were identified in 24.5% (11.3% in HD and 13.2% in KD). PIK3CA mutation was significantly correlated with lower tumor grade (47% in grade 1/2 vs 8% in grade 3, p=0.004), positive ER (35% in ER+ vs 5% in ER-, p=0.017), and PR (37% in PR+ vs 5% in PR-, p=0.011). Overall survival (OS) was 139.5 and 53.7 months for mutation- and non-mutation- carriers respectively (p=0.014). Conclusions: About one quarter of pts with recurrent/advanced breast cancer carry PIK3CA mutations in samples of recurrent disease, which correlated with positive ER/PR status and a more indolent clinical course. These patients are good candidates for experimental protocols that combine endocrine agents with PI3 kinase inhibitors but the slower kinetics of disease progression in PIK3CA mutation carriers may have to be taken into account for statistical designs and power size calculations.

No significant financial relationships to disclose.

Clinical outcomes of elective nodal irradiation (ENI) compared with involved field radiotherapy (IFRT) in NSCLC

7541

Background: Local failure rates in patients treated with definitive radiotherapy for non-small cell lung cancer (NSCLC) remain high. IFRT allows higher radiation doses to the primary tumor with the goal of reducing local failure rates while minimizing toxicity. This approach, however, raises concern for increased nodal failures. Our retrospective analysis evaluates clinical outcomes of patients treated at our institution with ENI or IFRT. Methods: We assessed all patients (pts) with stage III locally advanced or stage IV oligometastatic NSCLC treated with definitive radiotherapy (RT) from January 1, 2003 to August 21, 2008. The decision to treat with ENI vs. IFRT was based on physician treatment philosophy. We compared baseline demographics in each group as well as toxicities and therapeutic outcomes. Involved nodal failures (INF) were defined as radiographic progression in lymph nodes that were initially involved at the time of treatment. Elective nodal failures (ENF) were defined as progression in initially uninvolved lymph nodes. Results: A total of 104 consecutive pts (56 ENI vs. 48 IFRT) were assessed. Pts in both groups had similar characteristics with respect to age, baseline KPS, and percentage receiving chemotherapy. The average RT dose was 6,345 cGy in the ENI group and 6988 cGy in the IFRT group. The median follow-up time was 8.4 mos (0.3–43.4) for all pts and 9.7 mos (1.5–40.1) for survivors. The results follow in the table below. Conclusions: Our data suggest that IFRT does not result in increased nodal failures or decreased survival compared to ENI, and may result in increased local control. The majority of patients who experienced a local failure also experienced nodal failure, suggesting that local relapse may be linked to subsequent nodal failure. This may explain the increased nodal failure rates in patients treated with ENI. Decreased esophagitis rates in patients treated with IFRT may allow the integration of concurrent, full dose systemic therapy in a greater proportion of patients, as well as higher RT doses.

[Table: see text]

No significant financial relationships to disclose.

Observation of reversed shear Alfvén eigenmodes between sawtooth crashes in the Alcator C-Mod tokamak

Groups of frequency chirping modes observed between sawtooth crashes in the Alcator C-Mod tokamak are interpreted as reversed shear Alfvén eigenmodes near the q=1 surface. These modes indicate that a reversed shear q profile is generated during the relaxation phase of the sawtooth cycle. Two important parameters, q_{min} and its radial position, are deduced from comparisons of measured density fluctuations with calculations from the ideal MHD code NOVA. These studies provide valuable constraints for further modeling of the sawtooth cycle.

Termination and suppression of idiopathic left ventricular tachycardia by diltiazem

Idiopathic left ventricular tachycardia is known to be responsive to verapamil in many cases. However, the role of other calcium-channel blockers, such as diltiazem, in treating this specific type of ventricular tachycardia is unknown. We report a case of idiopathic left ventricular tachycardia in a patient with a structurally normal heart, which was terminated and suppressed in the electrophysiology laboratory by a single dose of diltiazem intravenously, and was subsequently suppressed long-term with sustained-release diltiazem. Our finding suggests that idiopathic left ventricular tachycardia may be managed effectively with diltiazem in both the acute and chronic settings.

LLL-3 inhibits STAT3 activity, suppresses glioblastoma cell growth and prolongs survival in a mouse glioblastoma model

Persistent activation of the signal transducer and activator of transcription 3 (STAT3) signalling has been linked to oncogenesis and the development of chemotherapy resistance in glioblastoma and other cancers. Inhibition of the STAT3 pathway thus represents an attractive therapeutic approach for cancer. In this study, we investigated the inhibitory effects of a small molecule compound known as LLL-3, which is a structural analogue of the earlier reported STAT3 inhibitor, STA-21, on the cell viability of human glioblastoma cells, U87, U373, and U251 expressing constitutively activated STAT3. We also investigated the inhibitory effects of LLL-3 on U87 glioblastoma cell growth in a mouse tumour model as well as the impact it had on the survival time of the treated mice. We observed that LLL-3 inhibited STAT3-dependent transcriptional and DNA binding activities. LLL-3 also inhibited viability of U87, U373, and U251 glioblastoma cells as well as induced apoptosis of these glioblastoma cell lines as evidenced by increased poly (ADP-ribose) polymerase (PARP) and caspase-3 cleavages. Furthermore, the U87 glioblastoma tumour-bearing mice treated with LLL-3 exhibited prolonged survival relative to vehicle-treated mice (28.5 vs 16 days) and had smaller intracranial tumours and no evidence of contralateral invasion. These results suggest that LLL-3 may be a potential therapeutic agent in the treatment of glioblastoma with constitutive STAT3 activation.

A comparative genomic analysis between human breast cancer and paired tumor lines derived from transplanation of tumor biopsies into NOD/SCID mice

Abstract #41

Background: Successful preclinical studies of experimental anticancer agents require model systems that recapitulate breast cancer biology and genomic abnormalities as accurately as possible. The use of primary human tumor explants engrafted into the humanized mammary fat pad of NOD SCID mice (HIM technique for "human in mouse") is promising in this regard, but the evidence that the genomic profile of the tumor is stable during serial translatation of human tumors into mice and between mouse passages has not beeen clearly demonstrated.&#x2028; Methods: 4th mammary glands of NOD/SCID mice were humanized by removing mouse mammary epithelia and implanting immortalized human breast fibroblasts. Human breast tumor tissues were dissociated into single cell suspensions and injected into the “humanized” mammary fat pads of NOD/SCID mice. Patient tumors were micro-dissected from the surrounding normal tissue by laser capture microdissection and tumor RNA and DNA was isolated. In addition, tumor RNA and DNA was isolated from xenografts at passage 1, 2, and 3. Agilent 4 x 44K whole genome expression array and 244K array-based comparative genomic hybridization (aCGH) was performed on established xenografts (passage 1-3) as well as the original tumor samples. Exon 9 and 20 of PIK3CA and exon 4 to 9 of TP53 were targeted for mutation detection since these genes are commonly mutated in human breast cancer.&#x2028; Results: To date, eight HIM tumor lines have been successfully established and serially passaged. The HIM number and source of tumor are as follows: HIM2 (primary tumor); HIM 3 (primary tumor); HIM 4 (abdominal wall metastasis); HIM 5 (brain metastasis from the patient used to establish HIM 2); HIM6 (primary breast cancer); HIM7 (chest wall metastasis); HIM 8 (chest wall metastasis); HIM9 (chest wall metastasis). Passage 3 HIM tumors serially transplanted in NOD/SCID mice have similar histopathological features to their original human counterparts (HCP). Sequence analyses of the eight HIM lines reveals mutations in the TP53 gene in three tumor lines and a mutation in PIK3CA gene in one tumor line that are also present in the HCP. aCGH analysis, where available, also demonstated that the positions of the major gene amplifications and deletions in HIM lines are also consistent with the HCP. Furthermore, aCGH shows that genomic structure of the grafts are stable with passage. Immunohistochemistry shows that HIM8 and its HCP are positive for HER2. Molecular subtyping by PAM50 gene list indicates that HIM 2 – 8 tumor lines and their HCP are basal type breast cancer. HIM9 tumor line and its HCP are luminal subtypes, although the proliferation signature was activated in the mouse graft.&#x2028; Conclusions: The HIM mouse system faithfully reproduces the genotypic features of the respective HCP's and is therefore a valuable research engine for the preclinical development of biomarkers, imaging techniques and for the assessment of novel therapeutic approaches, particularly for Basal-type breast cancer.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 41.

Targeted therapies for triple negative breast cancer based on TP53 status

Abstract #403

Background: Triple negative breast cancer (TNBC: negative for ER, PR and HER2) presents a significant clinical challenge. The frequent occurrence of mutations in TP53, the gene encoding the p53, in TNBC provides an opportunity for therapeutic intervention. p53 is required for cells to respond to DNA damage in the G1 phase of the cell cycle. Tumors with a defective p53 pathway fail to arrest (or undergo apoptosis) in G1 and rely on p53-independent pathways at S and G2 for their survival following DNA damage. Therefore, a potential therapeutic strategy for TP53 mutant tumors is to inhibit the S- and G2-checkpoints. Chk1 is a key regulator of both the S- and G2- checkpoints as such, p53 mutant cells are absolutely dependent on Chk1 activity to respond to DNA damage. This property makes Chk1 a potential therapeutic target in p53 defective tumors. Therefore, we tested the combination of irinotecan (DNA damaging agent) and UCN-01 (non-specific Chk1 inhibitor) in a preclinical model of TNBC. This combination was chosen based on preliminary results obtained in patients with TNBC on a Phase I trial conducted at our institution. UCN-01 is also a potent inhibitor of PDK1 and therefore inhibits the PI3K pathway. Given that PTEN is frequently deficient in TNBC, we also monitored components of the PI3K pathway in our preclinical model of TNBC.&#x2028; Material and Method: Tumor biopsies from patients with TNBC were engrafted into the humanized mammary fat pad of immunodeficient NOD/SCID mice. TP53 was sequenced in each engrafted tumor explant and the integrity of the p53 pathway was determined by monitoring p53 stabilization and p21 induction following DNA damage. Three independent TNBC tumor explants, one wild-type and two mutant for TP53 were analyzed for their response to irinotecan and UCN-01 either as single agents or in combination. UCN-01 was administered 24h post irinotecan in mice treated with the combination. Mice were sacrificed 48 h later and tumors were harvested and analyzed for cell cycle arrest (geminin, pCdk1), DNA damage (pChk1, gamma H2AX), apoptosis (cleaved caspase 3), checkpoint bypass (pHistone H3) and the PI3K pathway (pS6) by Western blotting and immunohistochemistry.&#x2028; Results: Expression profiling revealed that the characteristics of the tumor are preserved in the tumor explants suggesting this is a valid model system to study experimental therapy for TNBC. Irinotecan induced similar levels of DNA damage in TP53 wild-type and TP53 mutant TNBCs. UCN-01 potently inhibited levels of pS6 independent of p53 status. Strikingly, the combination of irinotecan and UCN-01 selectively induced checkpoint bypass and apoptosis in p53 mutant TNBCs.&#x2028; Conclusion: p53 status is a significant predictor of response to combination therapies involving DNA damage followed by Chk1 inhibition. Tumors, like TNBC, that frequently lack a functional p53 pathway may be effectively treated using this strategy. Studies are underway to test different chemotherapy agents and more selective Chk1 and PI3K inhibitors in this preclinical model of TNBC.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 403.

The STAT3 inhibitor NSC 74859 is effective in hepatocellular cancers with disrupted TGF-beta signaling

Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide, with few effective therapeutic options for advanced disease. At least 40% of HCCs are clonal, potentially arising from STAT3+, NANOG+ and OCT3/4+ liver progenitor/stem cell transformation, along with inactivation of transforming growth factor-beta (TGF-beta) signaling. Here we report significantly greater signal transducer and activator of transcription 3 (STAT3) and tyrosine phosphorylated STAT3 in human HCC tissues (P<0.0030 and P<0.0455, respectively) than in human normal liver. Further, in HCC cells with loss of response to TGF-beta, NSC 74859, a STAT3-specific inhibitor, markedly suppresses growth. In contrast, CD133(+) status did not affect the response to STAT3 inhibition: both CD133(+) Huh-7 cells and CD133(-) Huh-7 cells are equally sensitive to NSC 74859 treatment and STAT3 inhibition, with an IC(50) of 100 muM. Thus, the TGF-beta/beta2 spectrin (beta2SP) pathway may reflect a more functional 'stem/progenitor' state than CD133. Furthermore, NSC 74859 treatment of Huh-7 xenografts in nude mice significantly retarded tumor growth, with an effective dose of only 5 mg/kg. Moreover, NSC 74859 inhibited tyrosine phosphorylation of STAT3 in HCC cells in vivo. We conclude that inhibiting interleukin 6 (IL6)/STAT3 in HCCs with inactivation of the TGF-beta/beta2SP pathway is an effective approach in management of HCCs. Thus, IL6/STAT3, a major signaling pathway in HCC stem cell renewal and proliferation, can provide a novel approach to the treatment of specific HCCs.