Effect of omega-3 fatty acid supplementation on arterial elasticity in patients with familial hypercholesterolaemia on statin therapy

BACKGROUND AND AIMS

Increased arterial stiffness is closely linked with raised blood pressure that contributes substantially to enhanced risk of coronary heart disease in high risk individuals with familial hypercholesterolaemia (FH). Omega-3 fatty acid (ω3-FA) supplementation has been demonstrated to lower blood pressure in subjects with a high cardiovascular disease risk. Whether ω3-FA supplementation improves arterial stiffness in FH subjects, on background statin therapy, has yet to be investigated.

METHOD AND RESULTS

We carried out an 8-week randomized, crossover intervention trial to test the effect of 4 g/d ω3-FA supplementation (46% eicosapentaenoic acid and 38% docosahexaenoic acid) on arterial elasticity in 20 adults with FH on optimal cholesterol-lowering therapy. Large and small artery elasticity were measured by pulse contour analysis of the radial artery. ω3-FA supplementation significantly (P < 0.05 in all) increased large artery elasticity (+9%) and reduced systolic blood pressure (-6%) and diastolic blood pressure (-6%), plasma triglycerides (-20%), apoB concentration (-8%). In contrast, ω3-FAs had no significant effect on small artery elasticity. The change in large artery elasticity was not significantly associated with changes in systolic blood pressure or plasma triglyceride concentration.

CONCLUSIONS

ω3-FA supplementation improves large arterial elasticity and arterial blood pressure independent of statin therapy in adults with FH.

CLINICAL TRIAL REGISTRATION

https://www.clinicaltrials.com/NCT01577056.

Relationship of galectin-3 with obesity, IL-6, and CRP in women

PURPOSE

To evaluate the association of galectin-3 (Gal3) with obesity and inflammatory status in a cohort of metabolically healthy, predominantly African-American women with varying cardiovascular disease (CVD) risk as determined by CRP levels.

METHODS

We assessed the association between BMI and serum levels of Gal3, IL-6, CRP, and adiponectin in metabolically healthy women (N = 97) to determine the overall association between Gal3, obesity, and inflammation in groups at different CVD risk.

RESULTS

Obese women had significantly higher serum Gal3 compared to non-obese participants (P = 0.0016), although Gal3 levels were comparable among different classes of obesity. BMI (R ² = 0.1406, P = 0.0013), IL-6 (R ² = 0.0689, P = 0.035), and CRP (R ² = 0.0468, P = 0.0419), but not adiponectin, positively predicted the variance of Gal3 levels in the total study population. However, the predicting effect of BMI (R ² = 0.2923, P = 0.0125) and inflammation (R ² = 0.3138, P = 0.038) on Gal3 was only present in women at low/moderate risk of CVD (CRP ≤ 3 µg/mL).

CONCLUSIONS

Gal3 is positively correlated with obesity and inflammation in women, while the presence of elevated CVD risk may disturb the strength of Gal3 as a biomarker of inflammation.

[Transvesical single-site laparoscopic radical prostatectomy of 39 cases: technique and clinical outcomes]

Objectives: To present the surgical technique of transvesical single-site laparoscopic radical prostatectomy (TVSSLRP) and to evaluate its clinical efficacy. Methods: The clinical parameters of 39 patients who underwent transvesical single-site laparoscopic radical prostatectomy in Department of Urology, Third Affiliated Hospital of Sun Yat-Sen University from November 2010 to June 2015 were retrospectively reviewed. The age was (M(Q_R)) 64 (10) years (range 47 to 70 years). The median preoperative serum total prostate specific antigen (PSA) level was 7.9 (2.9) μg/L (range 4.2 to 9.8 μg/L). The clinical TNM stage comprised 24 cases of cT1c and 15 cases of cT2a. All the transrectal biopsy Gleason score ≤6. The International Index of Erectile Function (IIEF-5) was (21.7±1.6) points (range 18 to 24 points). The surgical procedures were performed through single-site transvesical approach. The postoperative serum PSA was regularly detected. The continence status were recorded at 1^st month, 3^rd month and 6^th month after catheter removal, and the potencies were evaluated at 3^rd month, 6^th month and 12^th month postoperative, respectively. Results: All the operations were successfully performed and there was no intraoperative complication or conversion to standard laparoscopic approach. The operation duration was (105±26) minuetes, the estimated blood loss was (100±56) ml and no blood transfusion was required. The pathological TNM stage comprised 30 cases of pT2a and 9 cases of pT2b, the Gleason score all ≤6 and no patient had positive surgical margins. The duration of urinary catheterization was (11.6±1.4) days and hospital stay was (12.9±4.3) days. The continence rates were 84.6%, 97.4%, 100% at 1^st month, 3^rd month and 6^th month after catheter removal, respectively. The potency rates were 48.7%, 64.1%, 76.9% at 3^rd month, 6^th month and 12^th month postoperative, respectively, with an IIEF-5 score≥18. Two cases demonstrated biochemical recurrence and one case presented vesico-urethral stricture during an average follow-up of 39 months (range 12 to 60 months). Conclusions: TVSSLRP is suitable for low-risk organ-confined prostate cancer. It can provide satisfactory continence and potency recovery, less complications and good oncological results.

Effect of niacin on triglyceride-rich lipoprotein apolipoprotein B-48 kinetics in statin-treated patients with type 2 diabetes

AIM

To investigate the effects of extended-release (ER) niacin on apolipoprotein B-48 (apoB-48) kinetics in statin-treated patients with type 2 diabetes (T2DM).

METHODS

A total of 12 men with T2DM were randomized to rosuvastatin or rosuvastatin plus ER niacin for 12 weeks and then crossed to the alternate therapy. Postprandial metabolic studies were performed at the end of each treatment period. D3-leucine tracer was administered as subjects consumed a high-fat liquid meal. ApoB-48 kinetics were determined using stable isotope tracer kinetics with fractional catabolic rates (FCRs) and secretion rates derived using a non-steady-state compartmental model. Area-under-the-curve (AUC) and incremental AUC (iAUC) for plasma triglyceride and apoB-48 were also calculated over the 10-h period after ingestion of the fat meal.

RESULTS

In statin-treated patients with T2DM, apoB-48 concentration was lower with ER niacin (8.24 ± 1.98 vs 5.48 ± 1.14 mg/l, p = 0.03) compared with statin alone. Postprandial triglyceride and apoB-48 AUC were also significantly lower on ER niacin treatment (-15 and -26%, respectively; p < 0.05), without any change to triglyceride and apoB-48 iAUC. ApoB-48 secretion rate in the basal state (3.21 ± 0.34 vs 2.50 ± 0.31 mg/kg/day; p = 0.04) and number of apoB-48-containing particles secreted in response to the fat load (1.35 ± 0.19 vs 0.84 ± 0.12 mg/kg; p = 0.02) were lower on ER niacin. ApoB-48 FCR was not altered with ER niacin (8.78 ± 1.04 vs 9.17 ± 1.26 pools/day; p = 0.79).

CONCLUSIONS

ER niacin reduces apoB-48 concentration by lowering fasting and postprandial apoB-48 secretion rate. This effect may be beneficial for lowering atherogenic postprandial lipoproteins and may provide cardiovascular disease risk benefit in patients with T2DM.

Abstract P6-13-22: Pharmacodynamics and consequences of PI3K inhibition in ER+ breast tumors

PI3K inhibitors have shown promise for the treatment of anti-estrogen-resistant ER+ breast cancers. Current PI3K inhibitor treatment regimens may incompletely and transiently inhibit the pathway in carcinomas, and are accompanied by significant adverse effects in patients. We hypothesized that short-term, complete inhibition of PI3K will have a greater anti-tumor effect and reduce systemic toxicity compared to chronic, partial inhibition.

Pharmacokinetic analysis of the orally available pan-PI3K inhibitor GDC-0941 at low (100 mg/kg) and high (800 mg/kg) doses in mice revealed that plasma levels peaked after 15-30 min, and decreased below the limit of detection within 24 h (low dose) and 72 h (high dose), respectively. Administering 2 doses at 100 mg/kg 12 h apart provided continuous drug exposure. Drug pharmacokinetics in MCF-7 tumors was similar.

Mice bearing s.c. MCF-7 tumors were treated with the anti-estrogen fulvestrant (fulv; 5 mg/wk) three days before GDC-0941 treatment to assess pharmacodynamic effects. Phospho-AKT and -S6 levels (markers of PI3K and mTORC1 activities, respectively) were inversely correlated with tumor drug concentrations. Mice bearing MCF-7, fulv-resistant T47D/FR, or HCC-003 patient-derived xenografts were treated with vehicle, fulv, GDC-0941 (100 mg/kg QD 5 d/wk; 100 mg/kg BID 3 d on/4 d off; 800 mg/kg QW), or combinations. Tumor growth curves indicated that different schedules of PI3K inhibition with fulv similarly induced tumor regression. Molecular analysis of MCF-7 tumors showed that fulv plus GDC-0941 QW induced 30.14% apoptosis (assessed by TUNEL) at 48 h, which dropped to baseline (2.72%) at 72 h. Fulv plus GDC-0941 BID induced 18.27% apoptosis at 24 h, and maintained apoptosis rate near 10% until 96 h (when GDC-0941 washed out), which is a rate similar to that observed with fulv plus GDC-0941 QD. Fulv plus GDC-0941 QW decreased cell proliferation (assessed by geminin and Ki67 staining) from 34.89% (baseline) to 11.46%, which rebounded to 60.54% at the time of GDC-0941 washout (at 96 h). Fulv plus GDC-0941 QD or BID modestly decreased cell proliferation to 28.84% and 24.32%, respectively, after 24 h, which returned to baseline after 36 h and 72 h, respectively, then maintained the level for a week. Temporal analysis of PI3K signaling revealed that fulv plus GDC-0941 QW and BID maximally decreased phospho-AKT levels after 3 h, which returned to baseline within 48 h and 72 h, respectively. With fulv + GDC-0941 QD, phospho-AKT levels decreased after 3 h, but rebounded to baseline within 24 h. These results indicate that 2 approaches to PI3K inhibition provide similar anti-tumor efficacy: 1) complete/intermittent (QW) PI3K inhibition induces a burst of apoptosis with a rebound in cell proliferation after drug clearance; and 2) metronomic/repeated (QD) PI3K inhibition repeatedly induces a smaller amount of apoptosis without significantly affecting cell proliferation. These findings may inform clinical testing of PI3K inhibitors to maximize therapeutic index.

Citation Format: Yang W, Bean J, Hosford S, Lloye D, Liu S, Salphati L, Pang J, Zhang X, Nannini M, Miller TW. Pharmacodynamics and consequences of PI3K inhibition in ER+ breast tumors. [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 P6-13-22.

Restoration of miR-101 suppresses lung tumorigenesis through inhibition of DNMT3a-dependent DNA methylation

The deregulation of miR-101 and DNMT3a has been implicated in the pathogenesis of multiple tumor types, but whether and how miR-101 silencing and DNMT3a overexpression contribute to lung tumorigenesis remain elusive. Here we show that miR-101 downregulation associates with DNMT3a overexpression in lung cancer cell lines and patient tissues. Ectopic miR-101 expression remarkably abrogated the DNMT3a 3′-UTR luciferase activity corresponding to the miR-101 binding site and caused an attenuated expression of endogenous DNMT3a, which led to a reduction of global DNA methylation and the re-expression of tumor suppressor CDH1 via its promoter DNA hypomethylation. Functionally, restoration of miR-101 expression suppressed lung cancer cell clonability and migration, which recapitulated the DNMT3a knockdown effects. Interestingly, miR-101 synergized with decitabine to downregulate DNMT3a and to reduce DNA methylation. Importantly, ectopic miR-101 expression was sufficient to trigger in vivo lung tumor regression and the blockage of metastasis. Consistent with these phenotypes, examination of xenograft tumors disclosed an increase of miR-101, a decrease of DNMT3a and the subsequent DNA demethylation. These findings support that the loss or suppression of miR-101 function accelerates lung tumorigenesis through DNMT3a-dependent DNA methylation, and suggest that miR-101-DNMT3a axis may have therapeutic value in treating refractory lung cancer.

Hybrid monitor for both beam position and tilt of pulsed high-current beams

A Hybrid beam monitor, integrated with both azimuthal and axial B-dot probes, was designed for simultaneous measurement of both beam position and beam angle for pulsed high-current beams at the same location in beam pipe. The output signals of axial B-dot probes were found to be mixed with signals caused by transverse position deviation. In order to eliminate the unwanted signals, an elimination method was developed and its feasibility tested on a 50-Ω coaxial line test stand. By this method, a waveform, shape-like to that of input current and proportional to the tilt angle, was simulated and processed by following integration step to achieve the tilt angle. The tests showed that the measurement error of displacement and tilt angle less than 0.3 mm and 1.5 mrad, respectively. The latter error could be reduced with improved probes by reducing the inductance of the axial B-dot probe, but the improvement reached a limit due to some unknown systemic mechanism.

EIF5A2 predicts outcome in localised invasive bladder cancer and promotes bladder cancer cell aggressiveness in vitro and in vivo

BACKGROUND

EIF5A2, eukaryotic translation initiation factor 5A2, is associated with several human cancers. In this study, we investigated the role of EIF5A2 in the metastatic potential of localised invasive bladder cancer (BC) and its underlying molecular mechanisms were explored.

METHODS

The expression pattern of EIF5A2 in localised invasive BC was determined by immunohistochemistry. In addition, the function of EIF5A2 in BC and its underlying mechanisms were elucidated with a series of in vitro and in vivo assays.

RESULTS

Overexpression of EIF5A2 was an independent predictor for poor metastasis-free survival of localised invasive BC patients treated with radical cystectomy. Knockdown of EIF5A2 inhibited BC cell migratory and invasive capacities in vitro and metastatic potential in vivo and reversed epithelial-mesenchymal transition (EMT), whereas overexpression of EIF5A2 promoted BC cells motility and invasiveness in vitro and metastatic potential in vivo and induced EMT. In addition, we found that EIF5A2 might activate TGF-β1 expression to induce EMT and drive aggressiveness in BC cells. EIF5A2 stabilized STAT3 and stimulated nuclear localisation of STAT3, which resulted in increasing enrichment of STAT3 onto TGF-β1 promoter to enhance the transcription of TGF-β1.

CONCLUSIONS

EIF5A2 overexpression predicts tumour metastatic potential in patients with localised invasive BC treated with radical cystectomy. Furthermore, EIF5A2 elevated TGF-β1 expression through STAT3 to induce EMT and promotes aggressiveness in BC.

Megaesophagus in a line of transgenic rats: a model of achalasia

Megaesophagus is defined as the abnormal enlargement or dilatation of the esophagus, characterized by a lack of normal contraction of the esophageal walls. This is called achalasia when associated with reduced or no relaxation of the lower esophageal sphincter (LES). To date, there are few naturally occurring models for this disease. A colony of transgenic (Pvrl3-Cre) rats presented with megaesophagus at 3 to 4 months of age; further breeding studies revealed a prevalence of 90% of transgene-positive animals having megaesophagus. Affected rats could be maintained on a total liquid diet long term and were shown to display the classic features of dilated esophagus, closed lower esophageal sphincter, and abnormal contractions on contrast radiography and fluoroscopy. Histologically, the findings of muscle degeneration, inflammation, and a reduced number of myenteric ganglia in the esophagus combined with ultrastructural lesions of muscle fiber disarray and mitochondrial changes in the striated muscle of these animals closely mimic that seen in the human condition. Muscle contractile studies looking at the response of the lower esophageal sphincter and fundus to electrical field stimulation, sodium nitroprusside, and L-nitro-L-arginine methyl ester also demonstrate the similarity between megaesophagus in the transgenic rats and patients with achalasia. No primary cause for megaesophagus was found, but the close parallel to the human form of the disease, as well as ease of care and manipulation of these rats, makes this a suitable model to better understand the etiology of achalasia as well as study new management and treatment options for this incurable condition.

Ovariectomy induces osteoporosis in the maxillary alveolar bone: an in vivo micro-CT and histomorphometric analysis in rats

OBJECTIVE

To investigate whether porotic changes occur in maxillary alveolar bone in ovariectomized rats.

METHODS

Thirty-two 6-week-old female Sprague-Dawley rats were divided into an ovariectomy group (OVX) and a sham-ovariectomy group (sham). Twelve weeks after surgery, maxillae of 16 rats (eight OVX and eight sham) were analyzed by micro-CT. Inter-radicular alveolar bone of the maxillary first molar was reconstructed and analyzed. The remaining 16 maxillae were used for histochemistry, including hematoxylin-eosin staining and tartrate-resistant acid phosphatase enzyme staining.

RESULTS

Three-dimensional reconstructed images of the irregular alveolar bone showed an intuitive view of porotic changes in the OVX group. The alveolar bone in OVX rats had a porous microarchitecture including lower bone mass and a looser structure of more widely separated trabeculae. Bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular thickness (Tb.Th.) were significantly lower in the OVX group than those in the sham group (P < 0.05). Trabecular separation (Tb.Sp.) increased significantly in the OVX rats compared to the sham rats (P < 0.05). Histomorphometric analysis of alveolar bone also revealed porotic changes in the OVX rats. Bone area ratio significantly decreased in the OVX group compared with the sham group (P < 0.01). There were also more osteoclasts present in the alveolar bone of OVX rats compared to sham rats (P < 0.05).

CONCLUSION

Ovariectomy induces osteoporosis in maxillary alveolar bone in rats, which may be related to the increased number of osteoclasts.