Abstract 24: Extracellular HMGA1 promotes tumor invasion and metastasis in breast cancer

The recent in-depth study of the cancer secretome suggests that a fraction of the intracellular proteome might be playing alternative roles in the extracellular space during tumorigenesis through its unconventional secretion. A proteomic study aimed at evaluating the role of unconventional protein secretion in the context of tumor invasion led us to investigate the high mobility group A1 (HMGA1) chromatin-binding protein whose overexpression has been correlated with high-grade carcinomas and reduced patient-survival. Here we show that HMGA1 is not only oversecreted in invasive breast tumor cells, but its blockage with specific antibodies in the extracellular space impairs tumor cell migration and invasion. The invasive phenotype caused by extracellular HMGA1 (eHMGA1) is dependent on ERK1/2 signaling and a blocking-Ab against eHMGA1 decreases pERK and re-localizes HMGA1 to the nucleus concomitantly to the loss of invasion capacity. Remarkably, pre-treatment of invasive breast tumor cells with an HMGA1-blocking Ab reduces their metastatic ability in an orthotopic breast cancer xenograft model. HMGA1 also shows a cytoplasmic localization in primary human triple-negative breast cancer (TNBC) tumors that developed distant metastasis while displaying a nuclear localization in TNBC tumors that did not progress to metastatic disease. Thus, eHMGA1 could be a novel drug target in aggressive breast cancer and a biomarker predicting the onset of distant metastasis.

Citation Format: Olga Méndez, Vicente Peg, Candida Salvans, Mireia Pujals, Yolanda Fernández, Ibane Abasolo, Jose Perez, Ana Matres, Josep Tabernero, Javier Cortés, Joaquín Arribas, Josep Villanueva. Extracellular HMGA1 promotes tumor invasion and metastasis in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 24.

Transcriptomic analysis of synovial extracellular RNA following knee trauma: A pilot study

Traumatic knee injuries often result in damage to articular cartilage and other joint structures. Such trauma is a strong risk factor for the future development and progression of osteoarthritis (OA). The molecular mechanisms and signaling pathways modulating response to knee joint trauma remain unclear. Moreover, investigations of biomarkers influencing responses have been targeted rather than broad, unbiased discovery studies. Herein, we characterize the complete complement of extracellular RNA (exRNA) in the synovial fluid of 14 subjects following knee injury. Fluid was collected during surgery from the injured knees, and from the contralateral knee in a subset, undergoing surgical repair of the ACL and/or meniscal repair/debridement. Arthroscopic grading of chondral damage in four knee compartments was performed using the Outerbridge classification. exRNA was extracted and subjected to massively parallel total RNA sequencing. Differential abundance of RNA was calculated between the subject cohorts of injured and non-injured knee, average Outerbridge score ≥0.5 and less, and chronic and acute injury duration defined as ≤4 months till surgery or longer. Overall, expression of several thousand genes was identified in the synovial fluid. Furthermore, differential expression analysis suggests a role of exRNA fragments of matrix metalloproteinases and skeletal muscle fiber genes in the response to traumatic injury. Together, these data suggest that high-throughput approaches can indicate exRNA molecular signatures following knee trauma. Future studies are required to more fully characterize the biological roles of these exRNA and the cadence of their respective release that may lead to translational treatment options for post-traumatic OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1659-1665, 2018.

Retrieval practice enhances the ability to evaluate complex physiology information

OBJECTIVE

Many investigations have shown that retrieval practice enhances the recall of different types of information, including both medical and physiological, but the effects of the strategy on higher-order thinking, such as evaluation, are less clear. The primary aim of this study was to compare how effectively retrieval practice and repeated studying (i.e. reading) strategies facilitated the evaluation of two research articles that advocated dissimilar conclusions. A secondary aim was to determine if that comparison was affected by using those same strategies to first learn important contextual information about the articles.

METHODS

Participants were randomly assigned to learn three texts that provided background information about the research articles either by studying them four consecutive times (Text-S) or by studying and then retrieving them two consecutive times (Text-R). Half of both the Text-S and Text-R groups were then randomly assigned to learn two physiology research articles by studying them four consecutive times (Article-S) and the other half learned them by studying and then retrieving them two consecutive times (Article-R). Participants then completed two assessments: the first tested their ability to critique the research articles and the second tested their recall of the background texts.

RESULTS

On the article critique assessment, the Article-R groups' mean scores of 33.7 ± 4.7% and 35.4 ± 4.5% (Text-R then Article-R group and Text-S then Article-R group, respectively) were both significantly (p < 0.05) higher than the two Article-S mean scores of 19.5 ± 4.4% and 21.7 ± 2.9% (Text-S then Article-S group and Text-R then Article-S group, respectively). There was no difference between the two Article-R groups on the article critique assessment, indicating those scores weren't affected by the different contextual learning strategies.

CONCLUSION

Retrieval practice promoted superior critical evaluation of the research articles, and the results also indicated the strategy enhanced the recall of background information.

Fasciola and fasciolosis in ruminants in Europe: Identifying research needs

Fasciola hepatica is a trematode parasite with a global distribution, which is responsible for considerable disease and production losses in a range of food producing species. It is also identified by WHO as a re-emerging neglected tropical disease associated with endemic and epidemic outbreaks of disease in human populations. In Europe, F. hepatica is mostly associated with disease in sheep, cattle and goats. This study reviews the most recent advances in our understanding of the transmission, diagnosis, epidemiology and the economic impact of fasciolosis. We also focus on the impact of the spread of resistance to anthelmintics used to control F. hepatica and consider how vaccines might be developed and applied in the context of the immune-modulation driven by the parasite. Several major research gaps are identified which, when addressed, will contribute to providing focussed and where possible, bespoke, advice for farmers on how to integrate stock management and diagnosis with vaccination and/or targeted treatment to more effectively control the parasite in the face of increasing the prevalence of infection and spread of anthelmintic resistance that are likely to be exacerbated by climate change.

Functionally Biased D2R Antagonists: Targeting the β-Arrestin Pathway to Improve Antipsychotic Treatment

Schizophrenia is a severe neuropsychiatric disease that lacks completely effective and safe therapies. As a polygenic disorder, genetic studies have only started to shed light on its complex etiology. To date, the positive symptoms of schizophrenia are well-managed by antipsychotic drugs, which primarily target the dopamine D2 receptor (D2R). However, these antipsychotics are often accompanied by severe side effects, including motoric symptoms. At D2R, antipsychotic drugs antagonize both G-protein dependent (Gα_i/o) signaling and G-protein independent (β-arrestin) signaling. However, the relevant contributions of the distinct D2R signaling pathways to antipsychotic efficacy and on-target side effects (motoric) are still incompletely understood. Recent evidence from mouse genetic and pharmacological studies point to β-arrestin signaling as the major driver of antipsychotic efficacy and suggest that a β-arrestin biased D2R antagonist could achieve an additional level of selectivity at D2R, increasing the therapeutic index of next generation antipsychotics. Here, we characterize BRD5814, a highly brain penetrant β-arrestin biased D2R antagonist. BRD5814 demonstrated good target engagement via PET imaging, achieving efficacy in an amphetamine-induced hyperlocomotion mouse model with strongly reduced motoric side effects in a rotarod performance test. This proof of concept study opens the possibility for the development of a new generation of pathway selective antipsychotics at D2R with reduced side effect profiles for the treatment of schizophrenia.

Evaluation of Early Onset Sepsis, Complete Blood Count, and Antibiotic Use in Gastroschisis

OBJECTIVE

Gastroschisis is a congenital defect in which the abdominal viscera herniate through the abdominal wall. In this population, antibiotics are often initiated immediately following delivery; however, this may be unnecessary as infections typically develop as a consequence of chronic issues in gastroschisis. The objective of this study was to evaluate the incidence of culture positive early onset sepsis, the reliability of the immature to mature neutrophil count (I:T) ratio as an infectious biomarker, and antibiotic use in infants with gastroschisis.

STUDY DESIGN

This retrospective chart review analyzed clinical data from 103 infants with gastroschisis and 103 weight-matched controls that were evaluated for early onset infection.

RESULTS

Compared with the control group, there was a significantly increased percentage of infants with an I:T ratio > 0.2 in the gastroschisis group (43% vs. 12%, p < 0.001) and an increased percentage of infants exposed to greater than 5 days of antibiotics regardless of their I:T ratio (75% vs. 6%, p < 0.001). There were no episodes of culture positive early onset sepsis in either group.

CONCLUSION

Our results indicate that I:T ratio is not a reliable marker of infection in gastroschisis, and suggest that empiric septic evaluation and antibiotic use, immediately following delivery in gastroschisis infants, may be unnecessary.

Abstract OT1-03-01: Chemotherapy-free trastuzumab and pertuzumab in HER2 [+] breast cancer: FDG-PET response-adapted strategy. The PHERGain study

BACKGROUND:

Several studies have confirmed that a significant subset of patients (pts) with early stage HER2[+]breast cancer (BC) achieve pathological complete response (pCR) with a dual HER2 neoadjuvant blockade without chemotherapy (chemo). Early metabolic evaluation using 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) might help to recognize those pts with a higher likelihood of obtaining a pCR and an excellent outcome with a chemo-free strategy.

TRIAL DESIGN:

This is a randomized, multicenter, non-comparative phase II trial. Pts age ≥ 18 years with centrally-confirmed, treatment-naïve, HER2 [+] operable BC will be randomized, in a 1:4 ratio, and stratified by HR status, to receive docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) (cohort A), or trastuzumab and pertuzumab (HP) ± endocrine therapy (ET) according to HR status (cohort B). Centrally-reviewed 18F-FDG PET/CT scans will be performed prior to randomization and after 2 cycles of therapy. Pts allocated into cohort A will continue with the same therapy for a total of 6 cycles regardless of 18F-FDG PET/CT results. Pts enrolled into cohort B showing at least a 40% reduction of the SUVmax on 18F-FDG PET/CT respect to baseline (PET responders) will continue with the same therapy for a total of 8 cycles. PET non-responders pts will receive 6 cycles of TCHP. After surgery, cohort B/PET responders pts who do not achieve a pCR will receive 6 cycles of TCHP. Moreover, all pts from cohorts A/B must complete 18 cycles of HP, along with adjuvant ET and radiotherapy (RT) according to HR status and institutional practices, respectively. Pts with subclinic metastases will be assigned to cohort C to receive 6 cycles of TCHP. Surgery and RT will be evaluated on a case-by-case basis on cohort C, and all pts will continue with HP for at least 12 additional cycles ± ET according to HR status.

The first co-primary endpoint is to evaluate the rate of pCR defined as the absence of invasive disease in the breast and axilla (ypT0/isN0) achieved with HP ± ET in PET responders pts (cohort B/PET responders).The second co-primary endpoint is to evaluate 3-year (3-y) invasive disease-free survival (iDFS) rate defined as time from the first date of no disease to invasive recurrence, new invasive disease, or death by any cause in cohort B.

Total accrual will be 400 pts. Considering a 10% and 25% of drop-out rates at the time of first and second co-primary analysis, the study will be positive if ≥41 pts achieved a pCR in cohort B/PET responders; or if we observe ≤14 events of 3-y iDFS in cohort B. Decisions will be based on one-sided, exact binomial test. With a 2.5% type I error rate (H0: pCR ≤20% and 3-y iDFS ≤89%) and 80% power (HA: pCR ≥30% and 3-y iDFS ≥95%).

The secondary objectives are to evaluate other definitions of pCR, rates of breast-conserving surgery, tumor response by magnetic resonance imaging, optimal 18F-FDG PET cut-off for pCR and other 18F-FDG PET quantification parameters for pCR prediction, DFS, distant-DFS, overall survival, progression-free survival, and health-related quality of life. Translational sub-studies will analyze biomarkers that may be predictive of response to dual HER2 blockade with HP.

Citation Format: Llombart-Cussac A, Curigliano G, Gebhart G, Gligorov J, Khaldoun K, Marmé F, Prat A, Schmid P, Cortes J, Perez J. Chemotherapy-free trastuzumab and pertuzumab in HER2 [+] breast cancer: FDG-PET response-adapted strategy. The PHERGain study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-03-01.

Distributed retrieval practice promotes superior recall of anatomy information

Effortful retrieval produces greater long-term recall of information when compared to studying (i.e., reading), as do learning sessions that are distributed (i.e., spaced apart) when compared to those that are massed together. Although the retrieval and distributed practice effects are well-established in the cognitive science literature, no studies have examined their additive effect with regard to learning anatomy information. The aim of this study was to determine how the benefits of retrieval practice vary with massed versus distributed learning. Participants used the following strategies to learn sets of skeletal muscle anatomy: (1) studying on three different days over a seven day period (SSSS_7,2,0 ), (2) studying and retrieving on three different days over a seven day period (SRSR_7,2,0 ), (3) studying on two different days over a two day period (SSSSSS_2,0 ), (4) studying and retrieving on two separate days over a two day period (SRSRSR_2,0 ), and (5) studying and retrieving on one day (SRx6₀ ). All strategies consisted of 12 learning phases and lasted exactly 24 minutes. Muscle information retention was assessed via free recall and using repeated measures ANOVAs. A week after learning, the recall scores were 24.72 ± 3.12, 33.88 ± 3.48, 15.51 ± 2.48, 20.72 ± 2.94, and 12.86 ± 2.05 for the SSSS_7,2,0 , SRSR_7,2,0 , SSSSSS_2,0 , STSTST_2,0 , and SRx6₀ strategies, respectively. In conclusion, the distributed strategies produced significantly better recall than the massed strategies, the retrieval-based strategies produced significantly better recall than the studying strategies, and the combination of distributed and retrieval practice generated the greatest recall of anatomy information. Anat Sci Educ 10: 339-347. © 2016 American Association of Anatomists.

Immune signatures of pathogenesis in the peritoneal compartment during early infection of sheep with Fasciola hepatica

Immune signatures of sheep acutely-infected with Fasciola hepatica, an important pathogen of livestock and humans were analysed within the peritoneal compartment to investigate early infection. Within the peritoneum, F. hepatica antibodies coincided with an intense innate and adaptive cellular immune response, with infiltrating leukocytes and a marked eosinophilia (49%). However, while cytokine qPCR analysis revealed IL-10, IL-12, IL-13, IL-23 and TGFβ were elevated, these were not statistically different at 18 days post-infection compared to uninfected animals indicating that the immune response is muted and not yet skewed to a Th2 type response that is associated with chronic disease. Proteomic analysis of the peritoneal fluid identified infection-related proteins, including several structural proteins derived from the liver extracellular matrix, connective tissue and epithelium, and proteins related to the immune system. Periostin and vascular cell adhesion protein 1 (VCAM-1), molecules that mediate leukocyte infiltration and are associated with inflammatory disorders involving marked eosinophilia (e.g. asthma), were particularly elevated in the peritoneum. Immuno-histochemical studies indicated that the source of periostin and VCAM-1 was the inflamed sheep liver tissue. This study has revealed previously unknown aspects of the immunology and pathogenesis associated with acute fascioliasis in the peritoneum and liver.

The use of charcoal in modified cigarette filters for mainstream smoke carbonyl reduction

Carbonyls are harmful and potentially harmful constituents (HPHCs) in mainstream cigarette smoke (MSS). Carbonyls, including formaldehyde and acrolein, are carcinogenic or mutagenic in a dose-dependent manner. Past studies demonstrate significant reduction of HPHCs by charcoal filtration. However, limits of charcoal filtration and cigarette design have not yet been investigated in a systematic manner. Objective data is needed concerning the feasibility of HPHC reduction in combustible filtered cigarettes. This systematic study evaluates the effect of charcoal filtration on carbonyl reduction in MSS. We modified filters of ten popular cigarette products with predetermined quantities (100-400 mg) of charcoal in a plug-space-plug configuration. MSS carbonyls, as well as total particulate matter, tar, nicotine, carbon monoxide (TNCO), and draw resistance were quantified. Significant carbonyl reductions were observed across all cigarette products as charcoal loading increased. At the highest charcoal loadings, carbonyls were reduced by nearly 99%. Tar and nicotine decreased modestly (<20%) compared to reductions in carbonyls. Increased draw resistance was significant at only the highest charcoal loadings. This work addresses information gaps in the science base that can inform the evaluation of charcoal filtration as an available technological adaptation to cigarette design which reduces levels of carbonyls in MSS.