Intellectual and neurological functioning in Morquio syndrome (MPS IVa)

Mucopolysaccharidosis type IVa (MPS IVa, Morquio syndrome OMIM #253000) is a lysosomal storage disease caused by deficiency in N-acetylgalactosamine-6-sulfatase (GALNS, EC 3.1.6.4; encoded by GALNS gene at 16q24.3). Unlike other MPS disorders involving excessive heparan and dermatan sulfate, Morquio syndrome has not been associated with neurological involvement nor with intellectual impairment as this disorder of keratan sulfate has been described as a purely visceral and skeletal disorder. Neurocognitive assessment was undertaken of MPS IVa patients with age appropriate intellectual tests as well as a Child Behaviour Checklist as part of clinical follow up. Available neuroimaging studies (MRI and MR spectroscopy) were reviewed. Whilst more than half of the overall IQ scores fell in the average range, scores for 3/8 children fell below average. A number of behavioural problems were highlighted, including anxiety/depression, attention and somatic complaints. Subtle neuroimaging abnormalities were demonstrated in over half of the children. These findings present a challenge to existing assumptions about the nature of Morquio A syndrome. A hypothesis regarding the potential role of calcium signalling is explored.

Navitoclax (ABT-263) and bendamustine ± rituximab induce enhanced killing of non-Hodgkin's lymphoma tumours in vivo

BACKGROUND AND PURPOSE

Bendamustine with or without rituximab provides an effective and more tolerable alternative to the polytherapy cyclophosphamide-doxorubicin-vincristine-prednisolone (CHOP) in the treatment of haematological tumours and is currently approved for the treatment of many haematological malignancies. Navitoclax (ABT-263) is a potent inhibitor of Bcl-2, Bcl-x(L) and Bcl-w, which has demonstrated efficacy in haematological tumours alone and in combination with other agents. This paper describes the in vivo efficacy of combining either bendamustine or bendamustine plus rituximab (BR) with navitoclax in xenograft models of non-Hodgkin's lymphoma

EXPERIMENTAL APPROACH

Activity was tested in xenograft models of diffuse large B-cell lymphoma (DoHH-2, SuDHL-4), mantle cell lymphoma (Granta 519) and Burkitt's lymphoma (RAMOS). Activity was also monitored in a systemic model of Granta 519.

KEY RESULTS

Navitoclax potentiated bendamustine activity in all cell lines tested. Bendamustine activated p53 in Granta 519 tumours, concurrent with activation of caspase 3. Navitoclax also improved responses to bendamustine-rituximab (BR) in a subset of tumours.

CONCLUSIONS AND IMPLICATIONS

Navitoclax in combination with bendamustine and BR is a viable combination strategy for use in the clinic and demonstrated superior efficacy compared with previously reported data for navitoclax plus CHOP and rituximab-CHOP.

Abstract P1-09-07: Topical 4-OHT trial in women with DCIS of the breast: report of plasma and breast tissue concentration of tamoxifen metabolites

Background: Earlier studies have shown that 1–2mg of 4-hydroxytamoxifen (4–OHT) gel applied to the breast skin reduced cell proliferation in estrogen receptor (ER) positive invasive cancers to a similar degree as oral tamoxifen (TAM), with significantly lower plasma levels. We now report results of a Phase IIB pre-surgical window trial of women with DCIS, designed to obtain pilot data in early lesions. Our ultimate goal is to develop transdermal 4-OHT as an alternative to oral TAM for women at high risk for breast cancer and those with DCIS. The study was closed early because the manufacturer discontinued the drug supply, but remains blinded until all biomarker analysis is complete. Here we report the plasma and breast adipose tissue concentration of TAM metabolites from the topical 4-OHT gel group (4 mg) in comparison with the oral TAM group (20mg).

Methods: Women with DCIS were enrolled, and randomized to 4-OHT gel (4mg/day, 2mg per breast, E: Z isomers = 1:1,) or to oral (Z) TAM (20mg/day) for 4–10 weeks before surgery. Blood was collected on the day of surgery, and breast adipose tissue was collected at surgery. There were a total of 22 patients with matched blood and breast adipose tissue. The concentration of TAM metabolites in plasma and breast tissue was determined with liquid chromatography/tandem mass spectrometry. We assumed that the subjects with detectable N-desmethyl TAM (NDT) in plasma belong to the oral TAM group because NDT is not a product of 4-OHT metabolism. Under this assumption, 13 subjects were categorized into oral TAM group, and 9 subjects into the topical 4-OHT group. Wilcoxon rank-sum test was used for statistical analysis.

Results: The results are shown in the table. The concentration is presented as mean ± SD; the lowest quantitation limit (LQL) was 1 ng/mL for plasma, and 3 ng/g for tissue. TAM and its metabolites were found in the plasma of the presumed oral TAM group, with high levels of TAM and NDT. In the presumed 4-OHT gel group, only (Z) 4-OHT was found in the plasma although both (E) and (Z) forms were applied. The mean plasma level of 4-OHT in the gel group was 70% lower than the mean of 4-OHT in the oral TAM group (p = 0.004). In breast tissue, similar amounts of (E) and (Z) forms of 4-OHT were found in the 4-OHT gel group, with the (Z) 4-OHT level being equivalent to that in the oral TAM group (p = 0.48). Endoxifen was only found in the oral TAM group. We saw no evidence of further metabolic transformation of 4-OHT in the breast following topical administration.

Abstract P4-08-04: Abcc10 status affects proliferation, metastases and tumor sensitivity

Background: It has been proposed that therapy-induced overexpression of ATP-binding cassette (ABC) drug efflux pumps promotes resistance in many drug-treated cancers. While early studies focused on overexpression and activity of the P-glycoprotein (Pgp) pump, a structurally distinct group of ABC efflux pumps, known as the Multidrug Resistance Proteins (MRPs;ABCCs), have been gaining increasing attention as alternative sources of resistance. There are 9 ABCC family members (ABCC1-6, 10–12), and we have previously shown that ABCC10 is unique because it confers resistance to a wide variety of anticancer agents including taxanes, vinca alkaloids and nucleoside-based analogs (Hopper-Borge et al, 2004, Hopper-Borge et al, 2009). Importantly we have shown that Abcc10 null mice are sensitized to taxanes (Hopper-Borge et al, Cancer Research, 2011). This is the first transporter whose loss results in in vivo tissue sensitivity to taxanes.

Methods & Results: We recently bred a PyVmT mammary tumor model to our Abcc10 gene disrupted mice to investigate Abcc10's in vivo activities regarding breast cancer resistance mechanisms. We have observed that Abcc10+/+ (WT) status limits the rate of tumorigenesis (p = 0.020) and that WT tumors are more metastatic compared to Abcc10−/− (KO), (p = 0.0489). To better understand the potential resistance mechanisms in this model we determined the expression levels of relevant transporters with qRT-PCR and found no significant differences between WT and KO. The PI3K-AKT-mTOR, a major signaling pathway involved in breast cancer progression has been connected to ABCCs (Tazzari, et al, 2007), and we observed upregulation of AKT in KO versus WT mammary tumor cell lines via western analyses. Therefore, we decided to ask if Abcc10 status affects proliferation, attachment, and/or migration (CyQuant, Invitrogen and xCELLigence, Roche). We showed that WT cell lines grow 3 times slower compared to KO. For migration kinetic we observed that KO cell lines were more active compared to WT.

To determine the impact of Abcc10 loss in vivo we injected SCID mice with 3 WT or KO mammary tumor derived cell lines and treated tumors with docetaxel or vehicle. Tumors derived from WT and KO mice were both responsive to docetaxel (WT, p = 0.003 and KO, p = 0.001). However, over 21 days, the WT tumors were reduced by 50% compared to KO reduction of 86%. Kaplan-Meier survival analysis of treated/untreated SCID mice reveals that Abcc10 status is related to a poorer prognosis (KO p < 0.0001, WT p = 0.0648).

Conclusion: Here we show that Abcc10 status limits tumorigenesis (proliferation, attachment, migration) of MMTV-PyVmT mammary tumor model and Abcc10+/+ tumors are more metastatic compared to KO tumors. Thus Abcc10 may be involved in breast cancer development and progression. mRNA expression analysis of ABC transporters in mammary tumors derived cell lines reveals that other transporters do not compensate for Abcc10 loss. In vivo experiments show that treatment with docetaxel is more effective for KO tumors compared to WT tumors, suggesting Abcc10 is a breast cancer resistance factor.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-08-04.

Differential RET signaling pathways drive development of the enteric lymphoid and nervous systems

During the early development of the gastrointestinal tract, signaling through the receptor tyrosine kinase RET is required for initiation of lymphoid organ (Peyer's patch) formation and for intestinal innervation by enteric neurons. RET signaling occurs through glial cell line-derived neurotrophic factor (GDNF) family receptor α co-receptors present in the same cell (signaling in cis). It is unclear whether RET signaling in trans, which occurs in vitro through co-receptors from other cells, has a biological role. We showed that the initial aggregation of hematopoietic cells to form lymphoid clusters occurred in a RET-dependent, chemokine-independent manner through adhesion-mediated arrest of lymphoid tissue initiator (LTin) cells. Lymphoid tissue inducer cells were not necessary for this initiation phase. LTin cells responded to all RET ligands in trans, requiring factors from other cells, whereas RET was activated in enteric neurons exclusively by GDNF in cis. Furthermore, genetic and molecular approaches revealed that the versatile RET responses in LTin cells were determined by distinct patterns of expression of the genes encoding RET and its co-receptors. Our study shows that a trans RET response in LTin cells determines the initial phase of enteric lymphoid organ morphogenesis, and suggests that differential co-expression of Ret and Gfra can control the specificity of RET signaling.

Materials Issues In X-Ray Lithography

In this paper, an outline of materials-related activities in the national X-Ray Lithography Program is given. The program is directed towards the development of sub-quarter micron design-rule x-ray lithography together with the ancillary technologies required to fabricate defect-free x-ray masks. Work done at the Naval Research Laboratory is highlighted and used for examples. Most materials related work occurs in conjunction in the x-ray mask fabrication pro. cess. Topics discussed include electron beam-matter interaction in the mask patterning process, membane fabrication, stress control in thin membranes, reactive-ion etching of absorber-layers, mask inspection and repair.

Cohort study of a campylobacteriosis outbreak associated with chicken liver parfait, United Kingdom, June 2010

In an outbreak of 24 cases of gastroenteritis among guests at a wedding reception, 13 cases had confirmed Campylobacter infection. In a cohort study, univariate analysis revealed a strong association with consumption of chicken liver parfait: risk ratio (RR): 30.08, 95% confidence interval (CI): 4.34-208.44, p<0.001, which remained after adjustment for potential confounders in a multivariable model: RR=27.8, 95% CI=3.9-199.7, p=0.001. These analyses strongly support the hypothesis that this outbreak was caused by the consumption of chicken liver parfait.

Pandemic Influenza A (H1N1) 2009 and mortality in the United Kingdom: risk factors for death, April 2009 to March 2010

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Pandemic Influenza A (H1N1) 2009 and mortality in the United Kingdom: risk factors for death, April 2009 to March 2010

This paper describes the epidemiology of fatal pandemic influenza A(H1N1) cases in the United Kingdom (UK) since April 2009 and in particular risk factors associated with death. A fatal case was defined as a UK resident who died between 27 April 2009 and 12 March 2010, in whom pandemic influenza A(H1N1) infection was confirmed by laboratory or recorded on death certificate. Case fatality ratios (CFR) were calculated using the estimated cumulative number of clinical cases as the denominator. The relative risk of death was estimated by comparing the population mortality rate in each risk group, with those not in a risk group. Across the UK, 440 fatal cases were identified. In England, fatal cases were mainly seen in young adults (median age 43 years, 85% under 65 years), unlike for seasonal influenza. The majority (77%) of cases for whom data were available (n=308) had underlying risk factors for severe disease. The CFR in those aged 65 years or over was nine per 1,000 (range 3 - 26) compared to 0.4 (range 0.2 to 0.9) for those aged six months to 64 years. In the age group between six month and 64 years, the relative risk for fatal illness for those in a risk group was 18. The population attributable fractions in this age group were highest for chronic neurological disease (24%), immunosuppression (16%) and respiratory disease (15%). The results highlight the importance of early targeted effective intervention programmes.