Abstract P1-04-01: Breast milk exosomes promote breast cancer progression

Background: The stimulation of extant neoplastic cells vs. their inhibition during breast involution is a key concept in whether pregnancy and lactation decrease or increase breast cancer risk. The time of weaning, a period of breast involution and remodeling, appears critical to future breast cancer risk, as during involution the breast microenvironment becomes tumor promotional. Both matrix metalloproteinases (MMPs) and transforming growth factor (TGF)β isoforms have been implicated in this process. We previously reported that TGFβ2 (but not TGFβ1) expression was significantly higher in milk collected from the cancer containing (vs. matched clinically normal) breast of women diagnosed with cancer during lactation.

Hypothesis: TGFβ2 in milk exosomes from healthy lactating women modulates the development and progression of breast cancer.

Methods: Matched (early, mature and wean-early involution) milk samples were collected from 13 lactating women, exosomes isolated and the levels of five (MMP2, 3, 9; TGFβ1, 2) proteins measured. Based on the results, additional wean samples were analyzed for TGFβ2 expression and samples divided based on their TGFβ2 expression. The highest and lowest TGFβ2 expressing milk exosome samples were co-cultured with MCF-7 breast cancer cells grown in exosome-depleted media. Cell proliferation was measured after 24h. Confocal microscopy was performed after 72h to evaluate epithelial to mesenchymal transition (EMT) in the cells. A TGFβ2 neutralizing blocking antibody was applied after 72 h co-culture.

Results: The greatest increase in expression (four-fold) at the time of involution was in TGFβ2. Confocal microscopy performed 24h after co-culture confirmed the uptake of the exosomes (both those expressing hi and lo TGFβ2) in the MCF-7 cells. There was a significant increase in cell proliferation compared to control (p<0.001) in cells treated with hi TGFβ2 milk exosomes. 72h after co-culture, bright field microscopy demonstrated that MCF-7 cells treated with hi TGFβ2 underwent EMT including the formation of filopodia, whereas those treated with low TGFβ2 did not. A TGFβ2 blocking antibody reversed the EMT phenotype and filopodia formation.

Impact: Pregnancy has a lasting influence on breast cancer risk, and pregnancy associated breast cancers (PABCs) diagnosed after delivery are generally aggressive, with a poor prognosis. Part of the reason for the development of PABCs, and the aggressive nature of PABCs may be the influence of high-expressing TGFβ2 exosomes in the milk on the breast ductal epithelium.

Citation Format: Sauter ER, Qin W, Dasgupta S. Breast milk exosomes promote breast cancer progression. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-04-01.

Orbital foreign body- Study of a case series

BACKGROUND

Orbital foreign bodies (OFBs) may remain in the orbital cavity for considerable time and manifest with secondary complications.

OBJECTIVE

To report five consecutive cases of orbital trauma with OFBs, who presented at our institute from Jan 2010 to Dec 2013.

CASES

The first case of our series with a non-specific history of injury had a chronic granulomatous discharging sinus in the left upper eyelid and an intact globe. The second case, with an injury to the left lower eyelid following an assault, presented late and the manifestations were similar to that of the first case. The third case, of a road traffic accident, had sustained multiple facial and periocular injuries. The nature of all of three OFBs was uncertain by CT- scan, till surgical exploration. The fourth case had sustained injury to his left eye by a flying metal object. X-ray was sufficient to detect the OFB, but as scleral penetration was associated, management was complex. The fifth case had a nonspecific history of injury and the manifestation was similar to that of the first case. The surgical exploration revealed multiple OFB (wood).

CONCLUSION

The OFBs pose difficult diagnostic and therapeutic challenges. Management of such cases, at times, calls for innovation in decision making and formulation of strategies.

Observation of a New Narrow Axial-Vector Meson a1(1420)

The COMPASS Collaboration at CERN has measured diffractive dissociation of 190  GeV/c pions into the π(-)π(-)π(+) final state using a stationary hydrogen target. A partial-wave analysis (PWA) was performed in bins of 3π mass and four-momentum transfer using the isobar model and the so far largest PWA model consisting of 88 waves. A narrow peak is observed in the f0(980)π channel with spin, parity and C-parity quantum numbers J(PC)=1(++). We present a resonance-model study of a subset of the spin-density matrix selecting 3π states with J(PC)=2(++) and 4(++) decaying into ρ(770)π and with J(PC)=1(++) decaying into f0(980)π. We identify a new a1 meson with mass (1414(-13)(+15))  MeV/c2 and width (153(-23)(+8))  MeV/c2. Within the final states investigated in our analysis, we observe the new a1(1420) decaying only into f0(980)π, suggesting its exotic nature.

Effects of an Educational Module in Rationalizing Surgical Prophylaxis

Assessment of current antibiotic prescribing patterns is an important step towards appropriate use of antimicrobial agents. This study was planned to know the surgical prophylaxis practices and the influence of educational intervention. In this educational interventional study, only clean and clean-contaminated surgeries were included. Preinterventional study was done by collecting data regarding the use of surgical prophylaxis in the Department of Surgery. After analyzing the preinterventional data, educational intervention was done. A pretest questionnaire was given to all the surgeons to assess knowledge and practice of surgical prophylaxis in our institute. The questionnaire was designed to collect information regarding the use of prophylactic antibiotic, its duration, time of administration, and prevention of surgical site infections (SSI). In our study, third-generation cephalosporin was used in maximum cases in preinterventional analysis and prophylaxis was continued for 3-5 days. Surgeon's decision in selecting a prophylactic agent was based on information taken from departmental colleagues or drug companies. Two or more doses of antibiotic were used even when duration of surgery did not exceed more than two and half hours. Definite improvement was seen after the education where single antibiotic was used as prophylactic drug and the first dose of antibiotic was administered 30 to 60 min before incision. This shows that educational intervention makes a change in antibiotic prescribing habit. Hence, there is an urgent need for adoption of specific guidelines to ensure standardization of surgical antibiotic prophylaxis practices in hospitals.

Measurement of the charged-pion polarizability

The COMPASS collaboration at CERN has investigated pion Compton scattering, π(-)γ→π(-)γ, at center-of-mass energy below 3.5 pion masses. The process is embedded in the reaction π(-)Ni→π(-)γNi, which is initiated by 190 GeV pions impinging on a nickel target. The exchange of quasireal photons is selected by isolating the sharp Coulomb peak observed at smallest momentum transfers, Q(2)<0.0015  (GeV/c)(2). From a sample of 63,000 events, the pion electric polarizability is determined to be α(π)=(2.0±0.6(stat)±0.7(syst))×10(-4)  fm(3) under the assumption α(π)=-β(π), which relates the electric and magnetic dipole polarizabilities. It is the most precise measurement of this fundamental low-energy parameter of strong interaction that has been addressed since long by various methods with conflicting outcomes. While this result is in tension with previous dedicated measurements, it is found in agreement with the expectation from chiral perturbation theory. An additional measurement replacing pions by muons, for which the cross-section behavior is unambiguously known, was performed for an independent estimate of the systematic uncertainty.

A vapor phase adsorptive desulfurization process for producing ultra low sulphur diesel using NiY zeolite as a regenerable adsorbent

A NiY zeolite based vapor phase adsorptive desulfurization process has been described which can bring down sulphur concentration of a commercial BS IV grade (Euro IV equivalent) diesel from 50 ppm to a <5 ppm level.

Depression and anxiety as potential correlates of post-transplantation renal function and quality of life

The objective of this study was to determine anxiety and depression and its relationship with quality of life (QOL) in renal transplant (RT) recipients. A total of 105 consecutive patients were assessed cross-sectionally at least 3 months after RT. Hospital Anxiety and Depression Scale was applied to assess anxiety and depression. QOL was assessed through the abbreviated version of World Health Organization QOL scale. Patients’ awareness of illness and treatment was assessed through Structured Interview for Renal Transplantation. Nine (8.57%) patients had syndromal anxiety and 9 (8.57%) had syndromal depression. Both these groups had significantly lower scores in almost all domains of QOL compared with their non-anxious and non-depressed counterparts. There were a higher number of hospitalizations and episodes of complication or rejection in post-RT patients with anxiety as compared to those without (P = 0.001). Syndromal depression and anxiety are associated with poor QOL and syndromal anxiety is associated with significantly higher number of hospitalizations, rejections and complications in post-RT patients.

Molecular cloning, sequencing and tissue-level expression of complement C3 of Labeo rohita (Hamilton, 1822)

Complement component C3 plays a central role in all known complement activation pathways. In the present study, we cloned, sequenced and analyzed the full-length cDNA sequence of Labeo rohita complement C3 (LRC3). The expression pattern of complement C3 mRNA in different tissues of healthy rohu and after challenge with Aeromonas hydrophila were evaluated using real-time PCR. The LRC3 cDNA sequence of rohu comprised of 5081 bp encoding a predicted protein of 1645 amino acids. The deduced amino acid sequence had the characteristic domain architecture. About eight domains specific to complement C3 are present in the sequence starting from signal peptide to netrin C345C (NTR) domain. The post-translational processing signal sequence (RKRR), the C3-convertase cleavage site sequence (LAR) and the canonical thiol-ester motif (GCGEQ) were found to be conserved in the LRC3. Real-time PCR analysis revealed the highest expression of C3 in liver and extra-hepatic expression of C3 was also observed in all the tissues studied. A. hydrophila challenge resulted in significant up-regulated expression of C3 transcripts in both liver and kidney at 6, 12, 24, 48 and 72 h post-infection.

A clinical audit of the management of acute asthmatic attacks in adults and children presenting to an emergency department

OBJECTIVE

To compare the guidelines in the University Hospital of the West Indies (UHWI) acute asthma management protocol with actual practice in the Accident and Emergency Department.

METHODS

A prospective docket audit was done of all consecutive medical records of patients, presenting with a diagnosed acute asthmatic attack between June 1 and September 30, 2010, to the emergency department of the UHWI. A convenient sample was used. The audit tool used was created from the UHWI protocol for the emergency management of asthma in adults and children, as well as the British Adult Asthma Audit Tool. The audit tool assessed three main sections: initial assessment, initial management, and discharge considerations. Data were coded and entered in Microsoft Excel 2007 and statistical analyses conducted using Stata version 10. Management patterns were compared to the actual protocol and then discussed.

RESULTS

A total of 15 864 patients were seen during the study period. Of these, a total of 293 patients were seen for a presentation of acute asthma. More females (57.3%) than males were seen, with the mean age of 33.53 years. Only 31% of patients were given a severity assessment of mild, moderate, or severe. Peak expiratory flow rate (PEFR) was attempted and recorded in 62%, but only 18.1% of patients had both pre and post PEFR done. Only 4.4% of patients were administered nebulizations within the suggested time frame. Positively, 94.2% of patients were given a prescription for inhaled corticosteroids and bronchodilators to continue post-discharge.

CONCLUSIONS

Acute asthma management still remains an area of medical practice that continues to have long-standing difficulties. Failure to assess and document the severity of asthma attacks along with the under-utilization of PEFR was noted.

Acclimation of brackish water pearl spot (Etroplus suratensis) to various salinities: relative changes in abundance of branchial Na(+)/K (+)-ATPase and Na (+)/K (+)/2Cl (-) co-transporter in relation to osmoregulatory parameters

The present study was conducted to elucidate the osmoregulatory ability of the fish pearl spot (Etroplus suratensis) to know the scope of this species for aquaculture under various salinities. Juvenile pearl spot were divided into three groups and acclimated to freshwater (FW), brackish water (BW) or seawater (SW) for 15 days. The fish exhibited effective salinity tolerance under osmotic challenges. Although the plasma osmolality and Na(+), K(+) and Cl(-) levels increased with the increasing salinities, the parameters remained within the physiological range. The muscle water contents were constant among FW-, BW- and SW-acclimated fish. Two Na+/K+-ATPase α-isoforms (NKA α) were expressed in gills during acclimation in FW, BW and SW. Abundance of one isoform was up-regulated in response to seawater acclimation, suggesting its role in ion secretion similar to NKA α1b, while expression of another isoform was simultaneously up-regulated in response to both FW and SW acclimation, suggesting the presence of isoforms switching phenomenon during acclimation to different salinities. Nevertheless, NKA enzyme activities in the gills of the SW and FW individuals were higher (p < 0.05) than in BW counterparts. Immunohistochemistry revealed that Na(+)/K(+)-ATPase immunoreactive (NKA-IR) cells were mainly distributed in the interlamellar region of the gill filaments in FW groups and in the apical portion of the filaments in BW and SW groups. The number of NKA-IR cells in the gills of the FW-acclimated fish was almost similar to that of SW individuals, which exceeded that of the BW individuals. The NKA-IR cells of BW and SW were bigger in size than their FW counterparts. Besides, the relative abundance of branchial Na(+)/K(+)/2Cl(-) co-transporter showed stronger evidence in favor of involvement of this protein in hypo-osmoregulation, requiring ion secretion by the chloride cells. To the best of our knowledge, this is the first study reporting the wide salinity tolerance of E. suratensis involving differential activation of ion transporters and thereby suggesting its potential as candidate for fish farming under different external salinities.

Hashimoto's Thyroiditis and Medullary Carcinoma of Thyroid

Hashimoto's thyroiditis (HT) has been found to be associated with lymphoma, papillary carcinoma and Hürthle cell neoplasms of thyroid. In contrast, there are only a few reports of co-existence of HT with medullary carcinoma of thyroid. An overall prevalence of medullary carcinoma of only 0.35% has been reported in HT patients. Such a rare combination is being presented here. A 33 year old female presented with history of goiter for one year. Fine needle aspiration cytology (FNAC) of the swelling revealed cytological features suggestive of medullary carcinoma of thyroid. Histopathological examination of total thyroidectomy specimen revealed Hashimoto's thyroiditis along with medullary carcinoma of thyroid. Although Hashimoto's thyroiditis can uncommonly co-exist with thyroid neoplasm, its association with medullary carcinoma is extremely rare and hence being presented.

Pregnancy outcome in chronic myeloid leukemia patients on imatinib therapy

INTRODUCTION

Imatinib is a first-line therapy to treat chronic myeloid leukemia (CML) patients.

MATERIALS AND METHODS

We selected 22 CML cases of pregnancies and reported 9 accidental and 13 planned pregnancies that were on imatinib therapy. Willing female patients remaining in complete hematological, cytogenetic and major molecular responses for at least 2 years planned for pregnancy and were advised to stop imatinib for 1 month prior to conception and 3 months after conception (first trimester). Willing male patients stopped therapy 1 month prior to conception of their wives. In unplanned cases, all patients were in exposure to imatinib during conception. Twenty-two pregnancies resulted in seven male children and eight female children. There were three spontaneous abortions and four elective abortions along with one case of hypospadia and another one of mild hydrocephalus.

CONCLUSION

We may suggest that planned pregnancy during therapy may be encouraged but imatinib therapy in unplanned pregnancy can cause spontaneous abortion or congenital anomaly.

Chemoprevention gene therapy (CGT): novel combinatorial approach for preventing and treating pancreatic cancer

Pancreatic cancer remains one of the deadliest of all cancers despite aggressive surgical treatment combined with adjuvant radiotherapy and chemotherapy. Chemoresistance and radioresistance are the principal causes of failure of pancreatic cancer patients to respond to therapy. Conditionally replication competent adenovirus (CRCA)-based cancer gene therapy is an innovative strategy for treating cancers displaying inherent resistance to treatment. Limitations of current adenovirus (Ad)-based gene therapies for malignant tumors include lack of cancer-specificity, and effective and targeted delivery. To remedy this situation, CRCAs have been designed that express E1A, necessary for Ad replication, under the control of a cancer-specific progression elevated gene-3 promoter (PEG-Prom) with concomitant expression of an immunomodulatory cytokine, such as mda-7/IL-24 or interferon-γ (IFN-γ), under the control of a ubiquitous and strong cytomegalovirus promoter (CMV-Prom) from the E3 region. These bipartite CRCAs, when armed with a transgene, are called cancer terminator viruses (CTVs), i.e., Ad.PEG-E1A-CMV-mda-7 (CTV-M7) and Ad.PEG-E1A-CMV-IFN-γ (CTV-γ), because of their universal effectiveness in cancer treatment irrespective of p53/pRb/p16 or other genetic alterations in tumor cells. In addition to their selective oncolytic effects in tumor cells, the potent 'bystander antitumor' properties of MDA-7/IL-24 and IFN-γ embody the CTVs with expanded treatment properties for both primary and distant cancers. Pancreatic cancer cells display a "translational block" of mda-7/IL-24 mRNA, limiting production of MDA-7/IL-24 protein and cancer-specific apoptosis. Specific chemopreventive agents abrogate this "translational block" resulting in pancreatic cancer-specific killing. This novel chemoprevention gene therapy (CGT) strategy holds promise for both prevention and treatment of pancreatic cancers where all other strategies have proven ineffective.

Serum uric acid: an early indicator of oxidative stress in beta thalassemia population

Iron induced alteration in the redox balance is a major complication in the beta thalassemia major patients receiving regular blood transfusion. Variable degrees of association between uric acid level with the free iron and its storage form ferritin in thalassemic patients are suggested to play a significant role in this alteration by an unclear mechanism. In the present study, we made an effort to analyze the association of serum uric acid with oxidative stress and to evaluate the predictive value of serum iron, serum ferritin and serum uric acid level on oxidative stress induced lipid peroxidation in beta thalassemic patients. For this we assayed these parameters in 61 patients of β thalassemia major and 51 age and sex matched controls of a rural area of West Bengal. Serum TBARS, serum Uric acid, serum Ferritin and serum Iron levels were significantly higher in the patient group (p<0.001 for all of them). Significant correlations existed between serum levels of TBARS, Uric acid, Ferritin and Iron levels in the patient group whereas only serum TBARS levels showed significant correlation with serum iron level in the control group. Regression analysis revealed that uric acid levels have a better predictive value (β=0.3, p=0.001) than serum ferritin value (β=0.013, p=0.871) for indicating TBARS production.

Does follistatin gene have any direct role in the manifestation of polycystic ovary syndrome in Indian women?

BACKGROUND

Out of a panel of 37 candidate genes tested for linkage with polycystic ovary syndrome (PCOS), the strongest evidence of linkage was reported in the follistatin (FST) gene region. Subsequently, a couple of studies outside India investigated the FST gene for the presence of any mutations and its association with PCOS and the results were found to be largely inconsistent probably due to differences in the ethnic backgrounds and small sample sizes.

AIMS

To screen the FST gene for mutations and to establish their association pattern with PCOS among a large cohort of South Indian women.

SETTINGS AND DESIGN

Case-control study.

MATERIALS AND METHODS

PCOS cases were recruited according to the 2003 Rotterdam diagnostic criteria. All the exons of the FST gene were amplified and analyzed in all the cases and controls for the presence of mutations using polymerase chain reaction (PCR) and direct DNA sequencing.

RESULTS

A total of 549 women consisting of 250 PCOS cases and 299 controls were recruited for the study. No mutations were found in any of the exons of the FST gene in our Indian sample which is consistent with an earlier finding among the Asian women from Singapore. Although three of the four cohorts of Caucasian background studied earlier reported variants, none of them could establish a strong association with PCOS.

CONCLUSIONS

The occurrence of the exonic variants of FST gene seems to be dependent on the ethnic background of the subjects under study and its role in the PCOS pathophysiology cannot be established with hitherto available evidence.