An analysis of a second-line S-1 monotherapy for gemcitabine-refractory biliary tract cancer

BACKGROUND/AIMS

Gemcitabine is widely used as a first-line therapy for biliary tract cancer (BTC). However, few studies have been conducted to analyze second- line therapies.

METHODOLOGY

From 33 patients who had been administered gemcitabine following resection between May 2005 and August 2007, we retrospectively analyzed the safety and efficacy of S-1 in 11 cases who received S-1 as second-line therapy due to recurrence or relapse of the primary disease.

RESULTS

Among the adverse events (AEs) observed during S-1 administration, the most common was a decrease in the concentration of hemoglobin, followed by thrombocytopenia. No Grade 4 AEs or worse were detected. In addition, the AEs and their respective severity strongly resembled those of gemcitabine used as a first-line therapy. There were 7 cases that could be evaluated according to RECIST criteria, of which 1 was considered in the partial response and 3 as stable disease. The medians of time to progression after S-1 administration and survival after S-1 administration were 5.6 months and 31 months, respectively.

CONCLUSIONS

S-1 could be taken safely as a second-line therapy without provoking severe AEs. By preventing the cessation of S-1 administration due to its AEs, more continued S-1 administration could lead to a better prognosis for BTC.

Intracerebral microinjection of interleukin-4/interleukin-13 reduces β-amyloid accumulation in the ipsilateral side and improves cognitive deficits in young amyloid precursor protein 23 mice

We previously reported that the anti-inflammatory cytokine interleukin (IL)-4 induced selective clearance of oligomeric β-amyloid (Aβ(1-42)) in rat primary type 2 microglial cells. For the present study, we investigated whether IL-4 and IL-13 could activate microglial cells to induce Aβ clearance in vivo and improve cognitive deficits in APP23 mice, which are amyloid precursor protein transgenic mice. We administered an intracerebral microinjection of a mixture of IL-4 and IL-13 or of saline vehicle into one hemisphere of APP23 mice and their wild-type littermates, 4.5 and 9 months old, after which we evaluated the effects of these treatments on spatial learning and memory by Morris Water Maze test and on accumulated amounts of Aβ. The cytokine injection significantly improved memory deficits of 4.5-month-old APP23 mice, but did not do so in 9-month-old APP23 mice, even though similar Aβ reductions were observed in both age groups of APP23 mice in the ipsilateral neocortex. The cytokine injection improved memory impairment of 9-month-old wild-type (WT) mice in the probe trial. Immunohistochemical analysis of the 4.5-month-old APP23 mice revealed the presence of increased numbers of microglial cells at 2 days after the cytokine injection. In addition to induced CD36 expression in the activated microglia, increased expression of neprilysin, mainly in neurons, suggested that the cytokines improved the cognitive deficits via degradation and clearance of intra- and extraneuronal Aβ peptides, of buffer-extractable nonplaque form. Double immunostaining also revealed that most of the activated microglia had the M2-like phenotype. This unique mechanism of IL-4/IL-13-induced clearance of Aβ may provide an additional strategy to prevent and/or cure Alzheimer's disease at early stage.

An experimental model of intraoperative venous injury in the rat

Intraoperative obliteration of cerebral veins occasionally causes unexpected severe complications, especially in elderly patients. However, very title information is available on the pathophysiology of cerebral venous circulation disturbance. Occlusion of cortical veins in rats by a photochemical thrombotic technique is a less invasive, clinically relevant and reproducible model that is suitable for the study of venous circulation disturbance. In the present study, 54 male Wistar rats were used. We examined changes of the cerebral venous flow pattern by fluorescence anglography and brain damage histologically in a one- or two-(cortical) vein occlusion model using a photochemical thrombotic technique. Approximately 30% (9 of 27) of animals in the single-vein occlusion group and 90% (15 of 17) of those in the two-vein occlusion group had microcirculation perturbation, which results very soon in the formation of venous thrombus accompanied by severe venous infarction. In addition, infarction size in the two-vein occlusion group (9.7 +/- 3.2%) was significantly larger than in the single-vein group (2.9 +/- 1.3%) (unpaired T-test, P < 0.01).In conclusion, the photochemical dye technique of attaining cerebral venous occlusion is a worth while addition to the study of circulation perturbations of the brain.

In vitro and in vivo antitumor effects of recombinant bispecific antibodies based on humanized anti-EGFR antibody

We performed in vitro and in vivo experiments of the anti-epidermal growth factor receptor (EGFR) x anti-CD3 bispecific diabody (hEx3-Db) with the IgG-like bispecific antibodies (BsAbs) (hEx3-scFv-Fc and hEx3-scDb-Fc) and the anti-EGFR therapeutic antibody cetuximab to assess the effect of BsAbs on cancer growth inhibition. In vitro, efficacy of the BsAbs and cetuximab were compared by growth inhibition assays of human cell lines of bile duct (TFK-1, HuCC-T1, OCUCh-LM1), epidermoid (A431), gastric (Kato-III), colon (DLD-1, SW480), and breast (SK-BR-3, MCF-7) cancer. In vivo, in three mouse models, we evaluated the anti-tumor activity of hEx3-Db and cetuximab, assessed the effect of hEx3-Db alone, and compared the antitumor activity of hEx3-Db with the IgG-like BsAbs. In vitro, hEx3-scFv-Fc showed nearly 100% killing activity for all cell lines. Both in vitro and in vivo, hEx3-Db needed CD3-positive phenotypes to induce a growth inhibitory effect. In contrast, IgG-like BsAbs showed monotherapeutic effects in vivo by inducing antibody-dependent cellular cytotoxicity (ADCC) similar to cetuximab. However, enhancement was not observed when lymphokine-activated killer cells with the T-cell phenotype were co-injected. Results suggest that IgG-like BsAbs could not efficiently direct T lymphocytes toward tumor cells to induce ADCC due to steric hindrance on binding to CD3- and Fc-receptor-positive phenotypes. Although hEx3-scFv-Fc showed high cytotoxicity in vitro, its high molecular weight limits its usefulness. With an in vivo effect comparable to hEx3-scFv-Fc and its realistic molecular weight, hEx3-scDb-Fc shows promise as a novel recombinant therapeutic antibody and may be modified to enhance its potency by prevention of steric hindrance.

Surgical outcomes of 23- and 20-gauge vitrectomies for rhegmatogenous retinal detachment associated with posterior vitreous detachment

BACKGROUND AND OBJECTIVE

To compare the outcomes of 23- and 20-gauge vitrectomies 1 year after primary repair of rhegmatogenous retinal detachments (RRDs) associated with a posterior vitreous detachment (PVD).

PATIENTS AND METHODS

One hundred seventy-five consecutive eyes were reviewed that had undergone 23- or 20-gauge vitrectomy for RRDs associated with PVD.

RESULTS

Retinal reattachment during the year after the first vitrectomy occurred in 88 (91%) of 97 eyes in the 23-gauge group and 70 (90%) of 78 eyes in the 20-gauge group. All eyes in both groups achieved anatomic success after another procedure. The surgical time in the 23-gauge group was significantly (P = .03) shorter than in the 20-gauge group. No significant difference was found between the preoperative and postoperative visual acuities in both groups.

CONCLUSION

Twenty-three-gauge vitrectomy can obtain anatomic and visual acuity results similar to those obtained with 20-gauge vitrectomy after primary repair of RRDs and may be a surgical option for treating the disorder.

Cystic lymphangioma of the pancreas with spontaneous rupture: report of a case

Lymphangioma is a benign and congenital malformation of the lymphatic system. Most lymphangiomas are preferentially located in the head and neck region. The abdominal organs are uncommon sites of origin. Several cases of lymphangioma in abdominal organs were reported, however, the pancreas is one of the rarest origins. Generally, intra-abdominal lymphangioma is asymptomatic and found incidentally, but in some cases, the patient complains of abdominal distension or a palpable mass. We describe the case of a 38-year-old male who presented with sudden-onset upper abdominal pain. Rupture of a cystic tumor of the pancreatic head was suspected, based on the findings of computed tomography, magnetic resonance imaging and endoscopic ultrasonography. Subtotal stomach-preserving pancreaticoduodenectomy was undertaken. The tumor, which was 4 × 4.5 × 8 cm in size, was pathologically diagnosed as a cystic lymphangioma. In conclusion, pancreatic lymphangioma is mostly asymptomatic, a ruptured case causing ‘acute abdomen’ has never been reported. Since lymphangioma is benign, it could be observed with accurate diagnosis. The surgical indication would be limited to cases of symptomatic lymphangiomas.

GC-binding factor 2 interacts with dishevelled and regulates Wnt signaling pathways in human carcinoma cell lines

GC-binding factor 2 (GCF2), a transcriptional repressor that decreases the activity of several genes is capable of binding directly to the GC-rich sequence of the EGFR promoter and repressing the transcriptional activity of EGFR. In addition to its function as a transcriptional repressor, GCF2 can directly interact with other proteins such as flightless-1 (Fli-1). Many previous findings pertaining to the function of Fli-1 have suggested a role for fli-1 in providing a direct link between molecules involved in signal transduction pathways and the actin cytoskeleton. We hypothesized that GCF2, together with Fli-1, plays a role in regulating cytoskeleton function, cell migration, and/or morphology. In our study, we observed that GCF2 is crucial for the activation of RhoA, a small GTPase that plays a key role in the regulation of the actin cytoskeleton. RhoA was markedly inactivated as a result of the decreased expression of GCF2. Co-immunoprecipitations were subsequently performed to further investigate the mechanism for the repressive function. We identified dishevelled (Dvl), which is the key mediator for the Wnt pathway, as a binding partner with GCF2. These results strongly suggest that GCF2 plays a role in the Wnt-noncanonical planar cell polarity (PCP) signaling pathway. Consequently, GCF2 may regulate the cytoskeleton or migration via Dvls and RhoA.

Computed tomography reflected endocrine function of the pancreas

BACKGROUNS/AIMS: There are few studies about the assessment of pancreatic function using computed tomography (CT) volumetry. In this study, we examined the correlation between CT volumetry and endocrine parameters (blood glucose and HbA1c) of the pancreas.

METHODS

A total of 68 patients underwent enhanced CT for pancreatic disease from January to December in 2008. In particular, we analyzed the correlation of diabetic status and pancreatic CT parameters at 1 year after pancreatoduodenectomy in 32 patients. CT parameters including volume, volume/body weight, arterial phase density, the arterial phase to portal phase density ratio (A/P ratio) of the pancreas, and size of pancreatic duct were also analyzed. Correlation between CT parameters and diabetic status was analyzed preoperatively and postoperatively by ANOVA test.

RESULTS

The preoperative diabetic status and parameters correlated well with arterial phase density (p = 0.004), A/P ratio, and pancreatic duct size (p < 0.0001). In the patients who underwent pancreatectomy, two out of 25 patients without preoperative diabetes mellitus (DM) had DM, and two out of seven patients with preoperative DM recovered from DM. Postoperative CT parameters correlated with the DM status 1 year after pancreatectomy.

CONCLUSION

CT is a useful modality for evaluation of the pancreatic endocrine function and could be used for the prediction of postoperative diabetic outcome.

Improvement of angiographic findings of polypoidal choroidal vasculopathy after intravitreal injection of ranibizumab monthly for 3 months

PURPOSE

To evaluate the efficacy of 1 intravitreal injection of ranibizumab monthly for 3 months in eyes with polypoidal choroidal vasculopathy (PCV), with attention to changes on indocyanine green angiography (ICGA) with confocal scanning laser ophthalmoscopy (cSLO).

DESIGN

Prospective, consecutive case series.

METHODS

Fifty consecutive eyes of 50 patients with symptomatic PCV who had not been treated previously received 1 intravitreal injection of 0.5 mg ranibizumab monthly for 3 months. Changes in ICGA findings with cSLO 3 months after the primary injection were evaluated.

RESULTS

The mean visual acuity (VA) at baseline (0.25; range, 0.1-0.8) improved to 0.38 (P = .001) 3 months after the primary injection. Nineteen eyes (38%) had an improvement in VA of 0.3 or more logMAR unit, and 5 eyes (10%) had a decrease in VA of 0.3 or more logMAR unit. Polypoidal lesions disappeared on ICGA in 13 eyes (26%) and the number of lesions decreased but did not disappear in 26 eyes (52%), with absorption of the accompanying fluid on optical coherence tomography. The remaining 11 eyes (22%) had unchanged or worsened polypoidal lesions. A branching vascular network remained in all 48 eyes in which the network was detected at baseline. Although resolution of the branching vascular networks or decreased diameter of the branching vascular network occurred in 11 eyes (23%), the branching vascular network was unchanged or worse in 37 eyes (77%).

CONCLUSION

Although a limitation of this study is the short-term follow-up, polypoidal lesions tended to respond to ranibizumab therapy, but the branching vascular network responded poorly.

Abstract 2705: Quantitative targeted proteomics in pancreatic cancer: Combinations of enzyme and transporter protein expression are novel indicators for gemcitabine sensitivity

Background and Aims: Gemcitabine (GEM) is widely used as a first line agent for the treatment of pancreatic cancer. In some patients, it provides a long-term survival, while there are many non-responders. Recent advances in proteomics technology made it possible to quantitate trace proteins such as transporters and metabolic enzymes at high sensitivity enough to reflect the function of proteins in living organisms. In this study, we exhaustively quantitated the protein profiles of GEM related transporters and metabolic enzymes in pancreatic cancer cell lines and resected specimen using LC-MS/MS technique. We created the GEM sensitivity equation based on the profiles and the IC50 values of cell lines. This equation was validated using surgical specimens of pancreatic cancer.

Materials and Methods: We used 6 pancreatic cancer cell lines for profiling. Surgical specimens from 9 patients from March 2004 to January 2006 were classified GEM respond group (RS), GEM non-respond group (NR) and surgery effect group (SE) according to post-operative CA 19-9 value. The expression levels of 90 membrane proteins and 15 enzymes were quantified in 6 pancreatic cancer cell lines and 9 surgical specimens, by means of multiplexed MRM analysis with LC-MS/MS.

Results: Significant differences in the expression levels of dCK and Purine-5-NT were observed between responsive and non-responsive groups of patients, although no correlation of the expression levels of these proteins with IC50 of gemicitabine was found in the cell lines. The expression levels of ten membrane proteins in the cell lines were correlated to IC50 of gemcitabine, but the expression levels of these proteins failed to predict the gemcitabine sensitivity of cancer tissues. Next, expression ratios of multiple proteins (transporters and enzymes) that were present in cancer tissues were calculated for the cell lines. dCK/(MRP1+MRP4), dCK/(MRP1+MRP4+Purine-5NT), dCK/(MRP1+MRP4+CTPS1) and dCK/(MRP1+MRP4+Purine-5NT+CTPS1) showed high correlation with IC50 values. For all four combinations, the protein expression ratio in the RS group was significantly higher than those in NR and SE groups.

Conclusion: Applying these equations, we can predict GEM sensitivity and tailor-made chemotherapy can be implemented.

Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2705.

Overexpression of adenovirus-mediated p27kip1 lacking the Jab1-binding region enhances cytotoxicity and inhibits xenografted human cholangiocarcinoma growth

The cyclin-dependent kinase inhibitor (CDK1) p27(kip1) is a negative regulator of cell cycling and has antitumor effects. In our previous study, the recombinant adenovirus expressing wild-type p27(kip1) (Adp27-wt) induced cell cycle arrest and apoptosis, and proved that p27 is a tumor suppressor gene like p53. Another adenovirus vector expressing mutant p27(kip1) (Adp27-mt), which inhibited degradation by the ubiquitin-proteasome system, showed increased protein stability and caused a stronger induction of apoptosis. Recently, the p27(kip1) protein binding with Jab1 (Jun activating binding protein 1) was found to translocate from the nucleus into the cytosol, and then become degraded by the 26S proteasome system. The inhibition of nuclear-cytoplasmic translocation increases the protein stability of p27(kip1) and p27(kip1) with a deletion of the Jab1-binding region (p27-jab-d) is not translocated and not degraded. Therefore, a new recombinant adenovirus (Adp27-jab-d) expressing p27-jab-d was made which was able to induce greater cytotoxicity. Adp27-jab-d inhibited the growth of human cholangiocarcinoma cell line (TFK-1) cells in vitro at 3.3 times (IC(50)) lower concentration than Adp27-wt. Moreover, in a xenografted severe combined immuno-deficient (SCID) mouse model injected with TFK-1 cells in the subcutaneous tissue, treatment by intratumor injection of Adp27-jab-d once a day for 3 days after the tumor was established, inhibited tumor growth more strongly than Adp27-wt or Adp27-mt and even induced tumor regression. However, the flow cytometric TUNEL assay showed little enhancement of apoptosis. Adp27-jab-d was thought to induce not only apoptosis but also necrosis, which was due to a specific effect of the Adp27-jab-d. Thus, by enhancing the cytotoxicity through inhibiting the translocaton of p27(kip1), p27(kip1) lacking the Jab1-binding region might be useful for cancer therapy. The control protein localization might also be a new target not only for cancer treatment, but also other diseases.

Use of a dual priming oligonucleotide system to detect multiple sexually transmitted pathogens in clinical specimens

AIMS

To evaluate a new dual priming oligonucleotide (DPO)-based multiplex polymerase chain reaction (PCR) assay for detection of six sexually transmitted pathogens, including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum and Trichomonas vaginalis.

METHODS AND RESULTS

Using 130 clinical specimens, the results obtained by the multiplex PCR, previously established in-house PCR and COBAS Amplicor PCR assays were compared. The specimens frequently contained multiple pathogens (34/130 specimens). The multiplex PCR assay had an overall sensitivity of 96% and specificity of 100% compared to the in-house PCR assay at >20 microg ml(-1) of DNA concentrations in samples and there was no cross-reaction with nonpathogenic Neisseria species that cause the majority of false-positive results with the COBAS Amplicor PCR assay.

CONCLUSIONS

The DPO-based multiplex PCR assay detected the six sexually transmitted pathogens in clinical specimens with a high sensitivity and specificity, although its sensitivity was dependent on the DNA content of the samples.

SIGNIFICANCE AND IMPACT OF THE STUDY

It is the first report about the new DPO-based technique to detect multiple sexually transmitted pathogens in a single assay, which has considerable potential to diagnose the infections accurately and rapidly.

Comparison of one-year outcomes between 23- and 20-gauge vitrectomy for preretinal membrane

PURPOSE

To compare the outcomes of transconjunctival sutureless 23-gauge vitrectomy and conventional 20-gauge vitrectomy 1 year after removal of preretinal membrane.

DESIGN

Retrospective, consecutive, comparative case series.

METHODS

One hundred consecutive eyes with a preretinal membrane underwent either 23- and 20-gauge vitrectomy. The rate of improvement of the logarithm minimum angle of resolution visual acuity (VA) was calculated by the formula: (various postoperative values-preoperative values) x 100/ (1 year postoperative values-preoperative values).

RESULTS

No significant differences were found between the groups in the preoperative and postoperative VAs. The VA improvement was higher and the surgically induced corneal astigmatism was lower 1 week postoperatively in the 23-gauge group compared with the 20-gauge group (P = .006 and P = .001, respectively). The flare values in the anterior chamber measured by laser flare meter preoperatively and 1 week postoperatively did not differ between the groups. The surgical time was significantly (P = .023) shorter in the 23-gauge group than in the 20-gauge group. No apparent complications developed in either group.

CONCLUSION

Transconjunctival sutureless 23-gauge vitrectomy appears effective for preretinal membrane surgery with an acceptable safety profile. Transconjunctival sutureless 23-gauge vitrectomy may be a treatment option for preretinal membranes.

Clock gene mouse period2 overexpression inhibits growth of human pancreatic cancer cells and has synergistic effect with cisplatin

Circadian rhythms are the daily oscillations of multiple biological processes regulated by an endogenous clock. The Period2 gene is essential in controlling the circadian rhythm and plays an important role in tumor suppression. We examined whether the overexpression of the mouse Period2 gene (mPer2) in cultured tumor cells from human tissues inhibits cell growth, using the recombinant adenovirus vector AdmPer2. The overexpression of mPer2 in human pancreatic cancer cells (Panc1, Aspc1) reduced cellular proliferation and induced apoptotic cell death. Infection with AdmPer2 also inhibited cell-cycle progression, inducing arrest at the G(2)-M phase. Western blotting analyses confirmed that infection with AdmPer2 reduced Bcl-X(L), Cdc2 and cyclin B1 protein, whereas it increased Bax protein in Aspc1 cells. The overexpression of mPer2 suppressed Cdc2 kinase activity. Moreover, infection with AdmPer2 resulted in dose-dependent synergic cell killing effects with the anticancer agent cisplatin (CDDP) in human pancreatic cancer cells. This synergic effect might be related to the reduction of Bcl-X(L) induced by infection with AdmPer2. Our results suggest that the circadian gene Period2 may play an important role in suppression of cell proliferation in human cancer, and additionally Period2 gene expression level may influence the sensitivity to cisplatin depending on Bcl-X(L) expression level.

Peroxisome proliferator-activated receptor alpha activates cyclooxygenase-2 gene transcription through bile acid transport in human colorectal cancer cell lines

BACKGROUND

Evidence is accumulating that bile acids are involved in colon cancer development, but their molecular mechanisms remain unexplored. Bile acid has been reported to be associated with induction of the cyclooxygenase-2 (COX-2) gene. Because the human liver-specific organic anion transporter-2 (LST-2/OATP8/OATP1B3) is expressed in gastrointestinal cancers and might transport bile acids to the intracellular space, we studied the molecular mechanisms by which bile acids induce the transcription of COX-2, and the role of LST-2 in colonic cell lines.

METHODS

Transcriptional activity of COX-2 was measured using a human COX-2 promoter-luciferase assay under various concentrations of bile acids. Electrophoresis mobility shift assays (EMSAs) for peroxisome proliferators-activated receptor (PPAR) alpha and cyclic AMP responsive element (CRE) were performed.

RESULTS

The COX-2 promoter was induced by lithocholic acid (LCA), deoxycholic acid (DCA), and chenodeoxycholic acid (CDCA). Deletion and site-directed mutation analyses showed that CRE is the responsive element for LCA. An adenovirus expression system revealed that LST-2 is responsible for induction of COX-2. By EMSA using oligonucleotides of CRE, we observed formation of a specific protein-DNA complex, which was inhibited by a specific antibody against PPARalpha and CRE. A PPARalpha-specific agonist induced transcription of COX-2.

CONCLUSION

These results indicate that COX-2 is transcriptionally activated by the addition of LCA, CDCA, and DCA and that LST-2 plays an important role by transporting bile acid to the intracellular space. Moreover, LCA-dependent COX-2 gene activation consists of a transcriptional complex including PPARalpha and CRE-binding protein. Thus, this induction of COX-2 may participate in carcinogenesis and progression of colorectal cancer cells.

[Adult Bochdalek hernia with volvulus of the stomach]

We report a rare case of Bochdalek hernia, congenital posterolateral diaphragmatic hernia with volvulus of the stomach, in an adult A 74-year-old man was admitted to our hospital complaining of sudden abdominal pain and vomiting. Roentgenologic examination of the chest showed air above the left diaphragm, and the mediastinum was displaced to the right. Upper gastrointestinal series revealed volvulus of the stomach in which the pylorus was displaced to the left. The surgical repair was done through left thoracotomy with combining laparoscopy and thoracoscopy without surgical complications, 1 year later the patient is asymptomatic.

Bile acids repress E-cadherin through the induction of Snail and increase cancer invasiveness in human hepatobiliary carcinoma

Although some kinds of bile acids have been implicated in colorectal cancer development, the mechanism of cancer progression remains unexplored in hepatobiliary cancer. From our personal results using complementary DNA microarray, we found that chenodeoxycholic acid (CDCA) induced Snail expression in human carcinoma cell lines derived from hepatocellular carcinoma and cholangiocarcinoma. Snail expression plays an important role in the regulation of E-cadherin and in the acquisition of invasive potential in many types of human cancers including hepatocellular carcinoma. We found that CDCA and lithocholic acid (LCA) induced Snail expression in a concentration-dependent manner and down-regulated E-cadherin expression in hepatocellular carcinoma and cholangiocarcinoma cell lines. Moreover, Snail short interference RNA (siRNA) treatment reduced the down-regulation of E-cadherin by CDCA or LCA. Luciferase analysis demonstrated that the promoter region from -111 to -24 relative to the transcriptional start site was necessary for this induction and, at least in part, nuclear factor Y (NF-Y) and stimulating protein 1 (Sp1) might be an inducer of Snail expression in response to bile acids. In addition, using an in vitro wound healing assay and invasion assay, we observed that CDCA and LCA induced cell migration and invasion. These results suggest that bile acids repress E-cadherin through the induction of transcription factor Snail and increase cancer invasiveness in human hepatocellular carcinoma and cholangiocarcinoma. Inhibition of this bile acid-stimulated pathway may prove useful as an adjuvant in the therapy of hepatocellular carcinoma.

Up-regulated p27Kip1 reduces matrix metalloproteinase-9 and inhibits invasion of human breast cancer cells

BACKGROUND

p27Kip1 is a cyclin-dependent kinase inhibitor which has been reported to be associated with invasion, metastasis and angiogenesis in malignant tumors, but its mechanism of action remains unknown. Here, it was examined whether p27Kip1 has an inhibitory effect on cancer cell invasion and correlates with matrix metalloproteinase expression (MMPs).

MATERIAL AND METHODS

The human breast cancer cell line MDA-MB-231 and MDA-MB-231 transfectedp27Kip1 MDA-MB-p27 were used for the invasion assay, Western blotting and real-time quantitative RT-PCR.

RESULTS

In the invasion assay, the invasion of MDA-MB-p27 was significantly less than that of the parent cell line. In Western blotting analyses, the protein level of MMP-9 was also reduced in MDA-MB-p27. Furthermore, the activity of MMP-9 in cell culture supernatants was lower in MDA-MB-p27 as compared with enzyme-linked immunosorbent assays. In real-time quantitative RT-PCR, the mRNA level of MMP-9 was lower in MDA-MB-p27 cells.

CONCLUSION

Up-regulation of p27Kip1 remarkably inhibited the invasion of the breast cancer cells, in part due to the reduced expression of MMP-9. This is the first report of p27Kip1 modulating MMP-9 and indicating that p27Kip1 might play a key role in tumor cell invasion.

[Combined intravitreal triamcinolone and photodynamic therapy for retinal angiomatous proliferation after photodynamic therapy]

PURPOSE

To investigate the 1-year results of treatment for retinal angiomatous proliferation (RAP), especially focused on the combination therapy of intravitreal injection of tiamcinolone acetonide with photodynamic therapy (IVTA-PDT).

METHODS

Between July 2004 and July 2005, IVTA-PDT was performed in 7 patients (9 eyes) with RAP at the Ohtsuka Eye Hospital. We reviewed the records of 4 of these patients (5 eyes) who had received IVTA-PDT during follow-up.

RESULTS

PDT was effective in only 1 of the 9 eyes. During IVTA-PDT, leakage from neovascularization was observed on angiography, and retinal edema and retinal pigment epithelial detachment (RPED) were observed on optical coherence tomography (OCT), even though PDT had been performed several times in all 5 eyes receiving IVTA-PDT. Complete resolution of angiographic leakage and improvement of retinal edema and RPED were observed at the examination 3 months after IVTA-PDT. At 1 year after IVTA-PDT, the fundus findings remained stable in 4 eyes, but angiographic leakage and RPED had progressed slightly in one eye. Visual acuity 1 year after IVTA had decreased compared with that at the primary PDT, but was almost the same as that at the beginning of IVTA-PDT.

CONCLUSIONS

IVTA-PDT for eyes with RAP, in which PDT had been performed several times, may be effective for improvement or elimination of retinal edema, achieving rapid regression of neovascularization, and stabilizing visual acuity.