Neurotrophins, their receptors and KI-67 in human GH-secreting pituitary adenomas: an immunohistochemical analysis

Pituitary adenomas are a diverse group of tumors arising from the pituitary gland. Typically, they are small, slow-growing, hormonally inactive lesions that come to light as incidental findings on radiologic or postmortem examinations, although some small, slow-growing lesions with excessive hormonal activity may manifest with a clinical syndrome. The family of neurotrophins plays a key role in the development and maintenance of the pituitary endocrine cell function and in the regulation of hypothalamo-pituitary-adrenocortical axis activity. The objective of our experimental study is to investigate the localization of the neurotrophins, their relative receptors and to detect the expression level of Ki-67 to determine whether all these factors participate in the transformation and development of human pituitary adenomas. A very strong expression of Neurotrophin-3 (NT-3) and its receptor TrKC was observed in the extracellular matrix (ECM) and vessel endothelium, together with a clear/marked presence of Brain-derived neurotrophic factor (BDNF), and its receptor TrKB, thus confirming their direct involvement in the progression of pituitary adenomas. On the contrary, NGF (Nerve growth factor) and its receptor TrKA and p75NTR were weakly expressed in the epithelial gland cells and the ECM.

Rescue of murine silica-induced lung injury and fibrosis by human embryonic stem cells

Alveolar type II pneumocytes (ATII cells) are considered putative alveolar stem cells. Since no treatment is available to repair damaged epithelium and prevent lung fibrosis, novel approaches to induce regeneration of injured alveolar epithelium are desired. The objective of this study was to assess both the capacity of human embryonic stem cells (HUES-3) to differentiate in vitro into ATII cells and the ability of committed HUES-3 cells (HUES-3-ATII cells) to recover in vivo a pulmonary fibrosis model obtained by silica-induced damage. In vitro differentiated HUES-3-ATII cells displayed an alveolar phenotype characterised by multi-lamellar body and tight junction formation, by the expression of specific markers such as surfactant protein (SP)-B, SP-C and zonula occludens (ZO)-1 and the activity of cystic fibrosis transmembrane conductance regulator-mediated chloride ion transport. After transplantation of HUES-3-ATII cells into silica-damaged mice, histological and biomolecular analyses revealed a significant reduction of inflammation and fibrosis markers along with lung function improvement, weight recovery and increased survival. The persistence of human SP-C, human nuclear antigen and human DNA in the engrafted lungs indicates that differentiated cells remained engrafted up to 10 weeks. In conclusion, cell therapy using HUES-3 cells may be considered a promising approach to lung injury repair.

Anti-tumour and anti-angiogenetic effects of zoledronic acid on human non-small-cell lung cancer cell line

OBJECTIVES

Although emerging data suggest that zoledronic acid (Zol) may have different anti-tumour activities against a broad range of cancers, its effects on lung cancer remain largely unknown. The aim of this study was to evaluate in vitro the anti-tumoural and anti-angiogenetic effect of zoledronic acid in non-small-cell lung cancer (NSCLC) cells.

MATERIAL AND METHODS

We treated A549 NSCLC cells with zoledronic acid to investigate survival, cell cycle activity, anti-angiogenic activity and apoptotic responses to it.

RESULTS

We observed that highest Zol concentration (100μm) caused arrest in G1 phase of the cell cycle and also induced different percentages of apoptosis in presence (0.9% versus 4.4%) or absence (2.4% versus 28.5%) of serum (P=0.0001). Zol concentration from 5 to 100μm for 2 days induced significant concentration-dependent cell death in adherent cells. Furthermore, Zol (10-100μm) induced dose-dependent reduction both of mRNA and protein expression of VEGF associated with parallel decrease in VEGF secretion in the culture medium.

CONCLUSION

Taken together, these results support a possible anti-cancer and anti-angiogenetic activity of Zol. Our data may not only provide a basis for the clinical use of this drug as preventive agent of bone metastases but also suggest that Zol deserves attention as an anti-cancer agent in non-small-cell lung cancer.

A study of the 1 and 2 January 2010 sea-storm in the Ligurian Sea

Abstract. During the last days of 2009 and the first days of 2010, a wide and deep low pressure system over Western Europe generated a very extended and strong southerly pressure gradient on the whole Western Mediterranean Sea with a resulting very rough to high sea state. Over the Ligurian Sea (North Western Mediterranean) the resulting sea state was a combination of a very tuned (in both frequency and direction) swell coming from the south-west, with nearly oceanic peak wave period, and a broader north-westerly wind sea with shorter period. This kind of sea state, not extreme in terms of significant wave height, caused unusual widespread damages to Ligurian coastal structures. In this study, authors investigated the structure of such a combined sea state by analysing numerical weather prediction outputs coming from atmospheric and wave models and comparing them with data coming from ondametric buoys and meteorological stations located in the Ligurian Sea area. As a result, it was found that the forecasting model chain almost correctly predicted the wave height in a first phase, when the sea state was only due to the first south-westerly swell peak, while significantly underestimated the combined sea state, when also the second north-westerly wind sea developed and interacted with the first one. By analysing the structure of directional wave spectra forecasted by the operational wave model and measured by the buoys, authors have attempted to find out the reasons for model deficiencies in forecasting the time evolution of significant parameters characterising the sea state.

Vitamin K1 cream in the management of skin rash during anti-EGFR monoclonal antibody (mAb) treatment in patients with metastatic cancer: First analysis of an observational Italian study

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Background: Cutaneous toxicity, and especially skin rash, is a predictable side- effect of anti-EGFR mAb therapy. Preclinical studies have shown that vitamin K1 reactivated EGFR-mediated signal transduction after inhibition via EGFR receptor antagonists. The aim of this study was to evaluate the impact of vitamin K1 cream in skin rash management.

Methods: In two Italian Oncology Centers sequential pts at the first therapy with cetuximab/panitumumab for metastatic cancer were treated with vitamin K1 cream at the first onset of grade ≥2 skin rash. Topical treatment with vitamin K1 (phytomenadione 0.1%) cream twice/die was administered continuously until the end of anti-EGFR treatment. Skin toxicity, according to NCI-CTC v3.0 grading system, was clinically evaluated every week and in a standardized way, taking pictures of 5 different body areas. Treatment benefit was evaluated according to symptom reduction and compliance to therapy.

Results: From February to September 2010, 33 pts, 22M (66.6%) and 11F (33.4%), median age 63 years (range 27-79), were evaluated. The primary tumor site was 3 (9.1%) esophagus/stomach, 28 (84.8%) colon-rectum, 2 (6.1%) head-neck. Eighteen (54.5%) pts were treated as first-line and 15 (45.5%) were pretreated. The regimen contained cetuximab in 26 (78.7%) pts and panitumumab in 7 (21.3%). The combination regimens were platinum compounds-based in 23 (69.6%) pts, and irinotecan-based in 6 (18.2%); panitumumab was administered in monotherapy in 4 (12.2%) pts. The median time of vitamin K1 cream treatment was 24 weeks (range 6-28); the oral tetracyclines therapy was associated in 13 (39.4%) pts. The decrease in skin rash to grade 1-0 was observed in 12 (36.4%) pts, and 13 (39.4%) pts showed unchanged grade 2. The increase to grade 3 in skin rash was observed in 8 (24.2%) pts. Good skin rash symptom control was obtained in 69.2% of pts. Cetuximab/panitumumab dose reduction and treatment delays was required in 9 (27.3%) pts.

Conclusions: These preliminary results suggest a favorable impact of vitamin K1 cream in skin rash management, which should be considered in a future clinical trial.

No significant financial relationships to disclose.

[Guidelines for the safe outpatient practice of aesthetic surgery]

This paper presents guidelines for the safe outpatient practice of aesthetic surgery. These guidelines have been prepared by the Lombard Association of Plastic Surgery for Outpatients (ALChiPlA), an association confined to board certified plastic surgeons and holders of official authorizations issued by the Lombard ASL to perform outpatient surgery. The cornerstone of these guidelines is the health and safety of patients, who are turning to this type of surgery in ever increasing numbers. This is the first and thus far the only attempt of its kind and its value is increased by the fact that it has been prepared by specialists who have been carrying out this type of surgery in outpatient situations for years.

Placenta Growth Factor is a Survival Factor for Human Malignant Mesothelioma Cells

Placenta growth factor (PlGF) is a key regulator of pathological angiogenesis and its overexpression has been linked to neoplastic progression. To assess whether PlGF could have a role in malignant mesothelioma (MM), we analyzed the expression of PlGF, VEGF, and their cognate receptors (VEGF-R1 and VEGF-R2) and co-receptors (neuropilin-1 and neuropilin-2) in MM cell lines as well as in resected MM tissues, hyperplastic/reactive mesothelium and normal mesothelium. MM cell cultures expressed both ligands and the associated receptors to a variable extent and released different amounts of PlGF. As assessed by immunohistochemistry, PlGF expression was switched on in hyperplastic/reactive compared to normal mesothelium. Moreover, 74 and 94% of MM tissues overexpressed PlGF and VEGF-R1, respectively ( p<0.05 MM vs normal mesothelium). Administration of recombinant PlGF-2 did not elicit a significant stimulation of MM cell growth, while it was associated with a transient phosphorylation of Akt, suggesting that PlGF-2 could activate downstream effectors of proliferative and cytoprotective signals via VEGF-R1 in MM cells. Indeed, the administration of an anti-PlGF antibody was found to cause a significant reduction of MM cell survival. In conclusion, our data demonstrate that, by acting as a survival factor, PlGF can play a role which goes beyond the stimulation of angiogenesis in MM. This evidence could help the rational design of new therapeutic interventions for this aggressive tumor.

Melanoma-associated markers expression in blood: MUC-18 is associated with advanced stages in melanoma patients

BACKGROUND

Multimarker reverse transcriptase-polymerase chain reaction (RT-PCR) was originally reported to reveal melanoma-associated mRNAs (MAMs) in melanoma cells but not in the peripheral blood of healthy individuals.

OBJECTIVES

To evaluate the expression of MAMs in the peripheral blood of melanoma patients at different American Joint Committee on Cancer (AJCC) stages, and to correlate their presence with early and/or advanced stages of the disease.

MATERIALS AND METHODS

One hundred blood samples of melanoma patients (AJCC I-IV) were analysed using multimarker RT-PCR to assess the co-expression of Tyr-OH, MART-1, MAGE-3, MUC-18/MCAM and p97. Patients were stratified into two disease categories: early and advanced stages. The former includes in situ and melanoma stages AJCC I-II, the latter AJCC III-IV. chi(2) and Fisher's exact tests were used to statistically evaluate the association between each MAM and disease categories. The recognized significant associations were subsequently resubmitted to univariate logistic regression. Furthermore, sensitivity and specificity were established.

RESULTS

At least one MAM could be detected in 24% of our series. Tyr-OH was the most common marker (14%), followed by MUC-18 (12%), MART-1 (5%), MAGE-3 (4%) and p97 (3%). No significant association among Tyr-OH, MART-1, MAGE-3, p97 and disease stages were evidenced. Only MUC-18 was statistically associated (P < 0.009) with advanced stages alone or co-expressed with other MAMs. According to logistic regression univariate analysis, MUC-18 increases the probability (odds ratio: 33) being in advanced stages and the incidence of recurrences (95% CI 2.9-374).

CONCLUSIONS

MUC-18 RT-PCR assay could be proposed as an adjunctive molecular method in the management of melanoma patients and is useful in the monitoring of study protocols.

Del-1, an endogenous leukocyte-endothelial adhesion inhibitor, limits inflammatory cell recruitment

Leukocyte recruitment to sites of infection or inflammation requires multiple adhesive events. Although numerous players promoting leukocyte-endothelial interactions have been characterized, functionally important endogenous inhibitors of leukocyte adhesion have not been identified. Here we describe the endothelially derived secreted molecule Del-1 (developmental endothelial locus-1) as an anti-adhesive factor that interferes with the integrin LFA-1-dependent leukocyte-endothelial adhesion. Endothelial Del-1 deficiency increased LFA-1-dependent leukocyte adhesion in vitro and in vivo. Del-1-/- mice displayed significantly higher neutrophil accumulation in lipopolysaccharide-induced lung inflammation in vivo, which was reversed in Del-1/LFA-1 double-deficient mice. Thus, Del-1 is an endogenous inhibitor of inflammatory cell recruitment and could provide a basis for targeting leukocyte-endothelial interactions in disease.

The Wnt Antagonist Dickkopf-1 Mobilizes Vasculogenic Progenitor Cells via Activation of the Bone Marrow Endosteal Stem Cell Niche

Therapeutic mobilization of vasculogenic progenitor cells is a novel strategy to enhance neovascularization for tissue repair. Prototypical mobilizing agents such as granulocyte colony-stimulating factor mobilize vasculogenic progenitor cells from the bone marrow concomitantly with inflammatory cells. In the bone marrow, mobilization is regulated in the stem cell niche, in which endosteal cells such as osteoblasts and osteoclasts play a key role. Because Wnt signaling regulates endosteal cells, we examined whether the Wnt signaling antagonist Dickkopf (Dkk)-1 is involved in the mobilization of vasculogenic progenitor cells. Using TOP-GAL transgenic mice to determine activation of β-catenin, we demonstrate that Dkk-1 regulates endosteal cells in the bone marrow stem cell niche and subsequently mobilizes vasculogenic and hematopoietic progenitors cells without concomitant mobilization of inflammatory neutrophils. The mobilization of vasculogenic progenitors required the presence of functionally active osteoclasts, as demonstrated in PTPε-deficient mice with defective osteoclast function. Mechanistically, Dkk-1 induced the osteoclast differentiation factor RANKL, which subsequently stimulated the release of the major bone-resorbing protease cathepsin K. Eventually, the Dkk-1–induced mobilization of bone marrow–derived vasculogenic progenitors enhanced neovascularization in Matrigel plugs. Thus, these data show that Dkk-1 is a mobilizer of vasculogenic progenitors but not of inflammatory cells, which could be of great clinical importance to enhance regenerative cell therapy.

An observational and numerical case study of a flash sea storm over the Gulf of Genoa

Abstract. During the night between the 8 and 9 December 2006 the seawall of the Savona harbour (Liguria Region in north west of Italy) was overtopped by waves. In this work the "Savona flash sea storm" has been studied by analyzing the data recorded by meteo-marine observing stations and the data produced by high resolution meteo-marine numerical models. The data show that, due to the presence of a fast moving low pressure system, the event was characterized by a rapid transition and interaction between two different regimes of winds and related sea states. The results of the study suggest that the most damaging dynamics of the event could be correlated to a bi-modal structure of the wave spectrum. Based on this the authors suggest that a deeper study of the spectral structure of sea storms could lead to define new operational forecasting tools for the preventive evaluation of sea storms damaging potential.

Functional properties of cells obtained from human cord blood CD34+ stem cells and mouse cardiac myocytes in coculture

Prior in vitro studies suggested that different types of hematopoietic stem cells may differentiate into cardiomyocytes. The present work examined whether human CD34(+) cells from the human umbilical cord blood (hUCB), cocultured with neonatal mouse cardiomyocytes, acquire the functional properties of myocardial cells and express human cardiac genes. hUCB CD34(+) cells were cocultured onto cardiomyocytes following an infection with a lentivirus-encoding enhanced green fluorescent protein (EGFP). After 7 days, mononucleated EGFP(+) cells were tested for their electrophysiological features by patch clamp and for cytosolic [Ca(2+)] ([Ca(2+)](i)) homeostasis by [Ca(2+)](i) imaging of X-rhod1-loaded cells. Human Nkx2.5 and GATA-4 expression was examined in cocultured cell populations by real-time RT-PCR. EGFP(+) cells were connected to surrounding cells by gap junctions, acquired electrophysiological properties similar to those of cardiomyocytes, and showed action potential-associated [Ca(2+)](i) transients. These cells also exhibited spontaneous sarcoplasmic reticulum [Ca(2+)](i) oscillations and the associated membrane potential depolarization. However, RT-PCR of both cell populations showed no upregulation of human-specific cardiac genes. In conclusion, under our experimental conditions, hUCB CD34(+) cells cocultured with murine cardiomyocytes formed cells that exhibited excitation-contraction coupling features similar to those of cardiomyocytes. However, the expression of human-specific cardiac genes was undetectable by RT-PCR.