Leukemia cell infiltration causes defective erythropoiesis partially through MIP-1α/CCL3

Leukemia often results in severe anemia, which may significantly contribute to patient mortality and morbidity. However, the mechanisms underlying defective erythropoiesis in leukemia have not been fully elucidated. In this study, we demonstrated that insufficient erythropoiesis in an immunocompetent acute myeloid leukemia (AML) murine model was due to reduced proliferation of megakaryocyte erythroid progenitors and increased apoptosis of erythroblasts. Colony-forming cell assays indicated that the leukemic bone marrow (BM) plasma inhibited erythroid colony formation, whereas they had no inhibitory effect on other types of colonies. Cytokine array analysis demonstrated that the chemokine CCL3 was elevated in the plasma of AML mice and patients. CCL3 inhibited erythroid differentiation of hematopoietic stem cells, common myeloid progenitors and especially megakaryocytic-erythroid progenitors. Administration of the CCR1 antagonist partially recovered the yield of erythroid colonies in the presence of CCL3 or leukemic BM plasma. Mechanistically, we observed an increase of p38 phosphorylation and subsequent downregulation of GATA1 after CCL3 treatment. Furthermore, knockdown of CCL3 attenuated leukemic progression and alleviated anemia. Therefore, our results demonstrate that elevated CCL3 in the leukemic environment suppresses erythropoiesis via CCR1-p38 activation, suggesting a novel mechanism for the erythroid defects observed in leukemia.

Melatonin Pathway and Atenolol-Related Glucose Dysregulation: Is There a Correlation?

Lower melatonin level, melatonin receptor gene variations, and atenolol treatment are associated with glucose dysregulation. We investigated whether atenolol‐related glucose and melatonin changes are correlated, and whether single nucleotide polymorphisms (SNPs) in melatonin candidate genes contribute to interindividual variation in glucose change. Hypertensive Caucasians (n = 232) from the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) study treated with atenolol for 9 weeks were studied. Urinary 6‐sulfatoxymelatonin (aMT6s) was measured pre‐ and posttreatment and normalized to urinary creatinine. Pharmacogenetic effects on glucose change of 160 SNPs in 16 melatonin candidate genes were assessed with multiple linear regression. Atenolol was associated with increased glucose (1.8 ± 10.1mg/dl, P = 0.02) and decreased aMT6s (–4.5 ± 10.1 ng/mg, P < 0.0001). However, the aMT6s change was not correlated with post‐atenolol glucose change. SNP rs11649514 in PRKCB was associated with glucose change (P = 1.0×10⁻⁴). PRKCB is involved in the melatonin‐insulin regulatory pathway, and may be important in mediating clinically meaningful atenolol‐related hyperglycemia.

Abstract P5-07-08: The clinical utility of alternative chromosome 17 probes in equivocal HER2 results

Background

Acurrate assessment of HER2 status in patients with breast cancer is critical in selecting patients for targeted therapy. In 2013, the American Society of Clinical Oncology-/College of American Pathologists (ASCO/CAP) released new guidelines for HER2 testing in an attempt to more acurately identify all breast cancer patients who are eligible for HER2 targeted therapy; these guidelines included new cutoff points for HER2/CEP17 ratio by in situ hybridization (ISH) or average HER2 copy number/cell and recommended the use of a reflex test with alternative ISH chromosome 17 probe for resolving cases with equivocal HER2 ISH results. We sought to determine the clinical utility of alternative chromosome 17 probes in such equivocal cases.

Patients and Methods

Our institution's database of HER2 dual- probe ISH results was searched for cases of invasive breast cancer with a HER2/CEP17 ratio of &lt;2 and an average HER2 copy number of &gt;4 and &lt;6 signals/cell (i.e., cases meeting the new ASCO/CAP definition of equivocal). Of these, 30 consecutive cases with available corresponding sections were selected for additional chromosome 17 studies using probes for Smith-Magenis syndrome (SMS) and retinoic acid receptor alpha (RARA) genes. A eusomic copy number exhibited in one or both of these loci was used to calculate a revised HER2/chromosome-17 ratio by using the eusomic gene locus as the reference.

Results

Of 5489 cases of invasive breast cancer tested by dual-probe ISH for HER2 gene status, 316 (5.7%) cases were found to have equivocal results according to the 2013 ASCO/CAP guidelines. Further analysis of the 30 equivocal consecutive cases using the alternative chromosome 17 probes (SMS/RARA), 17 cases were upgraded from equivocal to positive HER2 status, and 13 cases remained unchanged.

Conclusion

The use of alternative chromosome 17 probes effectively determines true HER2 status in most equivocal HER2 ISH cases. Equivocal results are common; therefore, we advocate testing for alternative chromosome 17 genes to better categorize equivocal cases under the new ASCO/CAP guidelines. Additional analysis of the remaining equivocal cases and their relation to disease progression is underway and will be presented at the meeting.

Citation Format: Sneige N, Gong Y, Multani AS, Ibrahim NK. The clinical utility of alternative chromosome 17 probes in equivocal HER2 results. [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 P5-07-08.

Genetic and Nongenetic Factors Affecting Clopidogrel Response in the Egyptian Population

Aspirin and clopidogrel are the mainstay oral antiplatelet regimens, yet a substantial number of major adverse cardiac events (MACE) still occur. Herein, we investigated genetic and nongenetic factors associated with clopidogrel response in Egyptians. In all, 190 Egyptians with acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI), treated with clopidogrel (75 mg/day) for at least a month, were genotyped for CYP2C19 *2, *3, *6, *8, *10, and *17, CES1 G143E and ABCB1*6 and *8. These variants along with nongenetic factors were tested for association with the risk of having MACE in clopidogrel‐treated patients. CYP2C19 loss‐of‐function (LOF) alleles carriers had increased risk of MACE vs. noncarriers (odds ratio 2.52; 95% confidence interval 1.23–5.15, P = 0.011). In a logistic regression, CYP2C19 LOF variants (P = 0.011), age (P = 0.032), and body mass index (BMI, P = 0.039) were significantly associated with the incidence of MACE in patients taking clopidogrel. CYP2C19 genetic variants, age, and BMI are potential predictors associated with variability to clopidogrel response in Egyptians.

Nickel-responsive regulation of two novel Helicobacter pylori NikR-targeted genes

Nickel is an essential transition metal for the survival of Helicobacter pylori in the acidic human stomach. The nickel-responsive transcriptional regulator HpNikR is important for maintaining healthy cytosolic nickel concentrations through the regulation of multiple genes, but its complete regulon and role in nickel homeostasis are not well understood. To investigate potential gene targets of HpNikR, ChIP sequencing was performed using H. pylori grown at neutral pH in nickel-supplemented media and this experiment identified HPG27_866 (frpB2) and HPG27_1499 (ceuE). These two genes are annotated to encode a putative iron transporter and a nickel-binding, periplasmic component of an ABC transporter, respectively. In vitro DNA-binding assays revealed that HpNikR binds both gene promoter sequences in a nickel-responsive manner with affinities on the order of ∼10(-7) M. The recognition sites of HpNikR were identified and loosely correlate with the HpNikR pseudo-consensus sequence (TATTATT-N11-AATAATA). Quantitative PCR experiments revealed that HPG27_866 and HPG27_1499 are transcriptionally repressed following growth of H. pylori G27 in nickel-supplemented media, and that this response is dependent on HpNikR. In contrast, iron supplementation results in activation of HPG27_1499, but no impact on the expression of HPG27_866 was observed. Metal analysis of the Δ866 strain revealed that HPG27_866 has an impact on nickel accumulation. These studies demonstrate that HPG27_866 and HPG27_1499 are both direct targets of HpNikR and that HPG27_866 influences nickel uptake in H. pylori.

Visualizing surface plasmons with photons, photoelectrons, and electrons

Multidimensional imaging of surface plasmons via hyperspectral dark field optical microscopy, tip-enhanced Raman scattering, nonlinear photoemission electron microscopy, and electron energy loss spectroscopy.

Effect of lipoic acid combined with paclitaxel on breast cancer cells

Breast cancer is the most common gynecologic tumor globally that threatens women's health. Lipoic acid is a type of antioxidant that can alleviate oxidative stress damage. Studies showed that lipoic acid could inhibit the proliferation of tumor cells in cervical cancer and colon cancer. This paper intends to explore the combined effect of lipoic acid and paclitaxel on breast cancer cells. Breast cancer MCF-7 cells were divided into four groups: control group, lipoic acid group, paclitaxel group, and a combination group. MTT was applied to detect the drugs' influence on breast cancer cell proliferation. A colony formation test was used to determine the effects on breast cancer cell clone formation rate. Western blot was performed to detect the effects on nuclear factor (NF)-κB. Lipoic acid alone can inhibit tumor cell proliferation and clone formation with time dependence. Compared with the control, paclitaxel alone can significantly suppress tumor cell proliferation and clone formation (P < 0.05). Lipoic acid and paclitaxel in combination obviously strengthened their individual inhibitory effects on tumor cells (P < 0.05). Compared with the paclitaxel alone group, the combination group exhibited more remarkable inhibitory effect (P < 0.05). Lipoic acid alone or combined with paclitaxel can inhibit NF-κB expression and inhibit breast cancer cell proliferation.

Pharmacometabolomic Assessments of Atenolol and Hydrochlorothiazide Treatment Reveal Novel Drug Response Phenotypes

Achieving hypertension (HTN) control and mitigating the adverse health effects associated with HTN continues to be a global challenge. Some individuals respond poorly to current HTN therapies, and mechanisms for response variation remain poorly understood. We used a nontargeted metabolomics approach (gas chromatography time-of-flight/mass spectrometry gas chromatography time-of-flight/mass spectrometry) measuring 489 metabolites to characterize metabolite signatures associated with treatment response to anti-HTN drugs, atenolol (ATEN), and hydrochlorothiazide (HCTZ), in white and black participants with uncomplicated HTN enrolled in the Pharmacogenomic Evaluation of Antihypertensive Responses study. Metabolite profiles were significantly different between races, and metabolite responses associated with home diastolic blood pressure (HDBP) response were identified. Metabolite pathway analyses identified gluconeogenesis, plasmalogen synthesis, and tryptophan metabolism increases in white participants treated with HCTZ (P < 0.05). Furthermore, we developed predictive models from metabolite signatures of HDBP treatment response (P < 1 × 10(-5)). As part of a quantitative systems pharmacology approach, the metabolites identified herein may serve as biomarkers for improving treatment decisions and elucidating mechanisms driving HTN treatment responses.

Identification and profiling of microRNAs associated with white and black plumage pigmentation in the white and black feather bulbs of ducks by RNA sequencing

MicroRNAs (miRNAs) play important roles in many biological processes by regulating gene expression at the post-transcriptional level. However, the mechanism by which specific miRNAs may regulate plumage pigmentation has remained largely elusive. In this study, we sequenced miRNAs using Solexa sequencing and then performed a detailed analysis of their expression profiles between the black and white feather bulbs of ducks from Cui Hei, Kaiya, Liancheng pure breeds and a Kaiya-Liancheng F2 population. mirdeep2 software identified 121 conserved and eight novel miRNAs. Five differentially expressed miRNAs between the two tissues types were also identified by degseq software. Notably, miR-204 was predominantly expressed in black feather bulbs. To further validate the sequencing data, we applied stem-loop quantitative PCR of ten known miRNAs based on the identified sequences. Furthermore, in exploring the temporal expression pattern of miR-204, we performed profiling in nine duck tissues. The targets of these miRNAs were predicted using a PITA algorithm and were later grouped based on Gene Ontology and KEGG pathway analysis using the DAVID website. The melanogenesis pathway was among the identified signalling pathways, implying key roles of these miRNAs in plumage pigmentation. Expression analysis of the target genes in the melanogenesis pathways was also performed. This study provides the foundation for subsequent studies on the prospective practical role for such miRNAs in post-transcriptional gene regulation linked to plumage pigmentation.

Estrogen receptor variant ER-α36 is involved in estrogen neuroprotection against oxidative toxicity

It is well known that estrogen exerts neuroprotective effect against various neuronal damages. However, the estrogen receptor (ER) that mediates estrogen neuroprotection has not been well established. In this study, we investigated the potential receptor that mediates estrogen neuroprotection and the underlying molecular mechanisms. Hydrogen peroxide (H2O2) was chosen as an agent in our study to mimic free radicals that are often involved in the pathogenesis of many degenerative diseases. We found that in human SY5Y and IMR-32 cells, the estrogen neuroprotection against H2O2 toxicity was abrogated by knockdown of a variant of estrogen receptor-α, ER-α36. We also studied the rapid estrogen signaling mediated by ER-α36 in neuroprotective effect and found the PI3K/AKT and MAPK/ERK1/2 signaling mediated by ER-α36 is involved in estrogen neuroprotection. We also found that GPER, an orphan G protein-coupled receptor, is not involved in ER-α36-mediated rapid estrogen response. Our study thus demonstrates that ER-α36-mediated rapid estrogen signaling is involved in the neuroprotection activity of estrogen against oxidative toxicity.

Patient-Centred Coordinated Care in Times of Emerging Diseases and Epidemics. Contribution of the IMIA Working Group on Patient Safety

OBJECTIVES

In this paper the researchers describe how existing health information technologies (HIT) can be repurposed and new technologies can be innovated to provide patient-centered care to individuals affected by new and emerging diseases.

METHODS

The researchers conducted a focused review of the published literature describing how HIT can be used to support safe, patient-centred, coordinated care to patients who are affected by Ebola (an emerging disease).

RESULTS

New and emerging diseases present opportunities for repurposing existing technologies and for stimulating the development of new HIT innovation. Innovative technologies may be developed such as new software used for tracking patients during new or emerging disease outbreaks or by repurposing and extending existing technologies so they can be used to support patients, families and health professionals who may have been exposed to a disease. The paper describes the development of new technologies and the repurposing and extension of existing ones (such as electronic health records) using the most recent outbreak of Ebola as an example.

Conduction Mechanisms in CVD-Grown Monolayer MoS2 Transistors: From Variable-Range Hopping to Velocity Saturation

We fabricate transistors from chemical vapor deposition-grown monolayer MoS2 crystals and demonstrate excellent current saturation at large drain voltages (Vd). The low-field characteristics of these devices indicate that the electron mobility is likely limited by scattering from charged impurities. The current-voltage characteristics exhibit variable range hopping at low Vd and evidence of velocity saturation at higher Vd. This work confirms the excellent potential of MoS2 as a possible channel-replacement material and highlights the role of multiple transport phenomena in governing its transistor action.

All optical mode controllable Er-doped random fiber laser with distributed Bragg gratings

An all-optical method to control the lasing modes of Er-doped random fiber lasers (RFLs) is proposed and demonstrated. In the RFL, an Er-doped fiber (EDF) recoded with randomly separated fiber Bragg gratings (FBG) is used as the gain medium and randomly distributed reflectors, as well as the controllable element. By combining random feedback of the FBG array and Fresnel feedback of a cleaved fiber end, multi-mode coherent random lasing is obtained with a threshold of 14 mW and power efficiency of 14.4%. Moreover, a laterally-injected control light is used to induce local gain perturbation, providing additional gain for certain random resonance modes. As a result, active mode selection of the RFL is realized by changing locations of the laser cavity that is exposed to the control light.

Investigating the effect of silver coating on the solubility, antibacterial properties, and cytocompatibility of glass microspheres

Silver (Ag) coatings have been incorporated into many medical materials due to its ability to eradicate harmful microbes. In this study, glass microspheres (SiO2–Na2O–CaO–Al2O3) were synthesized and employed as substrates to investigate the effect Ag coating has on glass solubility and the subsequent biological effects. Initially, glasses were amorphous with a glass transition point (Tg) of 605℃ and microspheres were spherical with a mean particle diameter of 120 µm (±27). The Ag coating was determined to be crystalline in nature and its presence was confirmed using scanning electron microscopy and X-ray photoelectron spectroscopy. Ion release determined that Ag-coated ( Ag-S) microspheres increased the Na+ release rate but slightly reduced the Ca2+ and Si4+ release compared to an uncoated control ( UC-S). Additionally, the Ag-S reduced the pH to just above neutral (7.3–8.5) compared to the UC-S (7.7–9.1). Antibacterial testing determined significant reductions in planktonic Escherichia coli ( p = 0.000), Staphylococcus epidermidis ( p = 0.000) and Staphylococcus aureus ( p = 0.000) growth as a function of the presence of Ag and with respect to maturation (1, 7, and 30 days). Testing for toxicity levels using L929 Fibroblasts determined higher cell viability for the Ag-S at lower concentrations (5 µg/ml); in addition, no significant reduction in cell viability was observed with higher concentrations (15, 30 µg/ml).

Sonic hedgehog through Gli2 and Gli3 is required for the proper development of placental labyrinth

Sonic hedgehog (Shh) functions as a conserved morphogen in the development of various organs in metazoans ranging from Drosophila to humans. Here, we have investigated the potential roles and underlying mechanisms of Shh signaling in murine placentation. Immunostaining revealed the abundant expression of the main components of Shh pathway in both the trophectoderm of blastocysts and developing placentas. Disruption of Shh led to impaired vascularogenesis of yolk sac, less branching and malformation of placental labyrinth, thereby leading to a robust decrease in capacity of transplacental passages. Moreover, placenta-specific gene incorporation by lentiviral transduction of mouse blastocysts and blastocyst transplantation robustly knocked down the expression of Gli3 and Gli2 in placenta but not in embryos. Finally, Gli3 knockdown in Shh^−/− placentas partially rescued the defects of both yolk sac and placental labyrinth, and robustly restored the capacity of transplacental passages. Gli2 knockdown in Shh^+/− placentas affected neither the capacity of tranplacental passages nor the vascularogenesis of yolk sac, however, it partially phenocopied the labyrinthine defects of Shh^−/− placentas. Taken together, these results uncover that both Shh/Gli2 and Shh/Gli3 signals are required for proper development of murine placentas and are possibly essential for pregnant maintenance.

Evaluating two new Schiff bases synthesized on the inhibition of corrosion of copper in NaCl solutions

An AND or DSM organic film can be formed onto a copper surface in 3% NaCl solution and acts as a barrier to copper dissolution and O₂reduction.

Systematic investigation of the synthesis and light-absorption broadening of a novel diketopyrrolopyrrole conjugated polymer of low and high molecular weight with thermo-labile groups

Removal of the thermo-labilet-Boc groups in a DPP-carbazole copolymer leads to the broadening of light-absorption and increased π–π stacking.

Serum uric acid and non-alcoholic fatty liver disease in non-hypertensive Chinese adults: the Cardiometabolic Risk in Chinese (CRC) study

OBJECTIVE

The causal relationship between serum uric acid (SUA) level and non-alcoholic fatty liver disease (NAFLD) has not yet been clarified. The objective of the study was to determine the association between SUA and NAFLD, as well as assess the interactions between SUA and other metabolic risk factors regarding NAFLD.

PATIENTS AND METHODS

The study samples related to a community-based health examination survey conducted in Central China. Initially, a total of 24,878 patients with medical examination were included. After excluding the individuals with confounding factors, the remaining 21,798 subjects with biomarkers available were included in the present study.

RESULTS

The data show that the risk of NAFLD significantly increased with the elevated SUA levels. Further adjustments for sex, age, and other confounding metabolic factors did not change the increasing trend of NAFLD risk. The odds ratios [ORs, 95% confidence interval (CI)] of NAFLD across the increasing quintiles of SUA were 1.00, 1,530 (1.174-1.995), 2.24 (1.714-2.886), 2.636 (2.019-3.441), and 3.714 (2.828-4.877) (p for trend < 0.0001). Also, significant interaction was found between SUA and prehypertension in relation to the NAFLD risk (p for interaction < 0.05).

CONCLUSIONS

SUA was significantly associated with NAFLD risk, independent of other metabolic risk factors, and SUA also had significant interaction with prehypertension regarding the risk of NAFLD.

Crystallization and characterization of cocrystals of piroxicam and 2,5-dihydroxybenzoic acid

Two cocrystals of piroxicam (PRX) and 2,5-dihydroxybenzoic acid (HBA) were found using a microfluidic cocrystal screening approach; one crystal contained an acetone (ACT) impurity.

Graphene enhanced evanescent field in microfiber multimode interferometer for highly sensitive gas sensing

Graphene based new physics phenomena are leading to a variety of stimulating graphene-based photonic devices. In this study, the enhancement of surface evanescent field by graphene cylindrical cladding is observed, for the first time, by using a graphene-coated microfiber multi-mode interferometer (GMMI). It is found theoretically and experimentally that the light transmitting in the fiber core is efficiently dragged by the graphene, hence significantly enhancing the evanescent fields, and subsequently improving the sensitivity of the hybrid waveguide. The experimental results for gas sensing verified the theoretical prediction, and ultra-high sensitivities of ~0.1 ppm for NH(3) gas detection and ~0.2 ppm for H(2)O vapor detection are achieved, which could be used for trace analysis. The enhancement of surface evanescent field induced by graphene may pave a new way for developing novel graphene-based all-fiber devices with compactness, low cost, and temperature immunity.

Hydrochlorothiazide-induced hyperuricaemia in the pharmacogenomic evaluation of antihypertensive responses study

OBJECTIVE

Elevations in uric acid (UA) and the associated hyperuricaemia are commonly observed secondary to treatment with thiazide diuretics. We sought to identify novel single nucleotide polymorphisms (SNPs) associated with hydrochlorothiazide (HCTZ)-induced elevations in UA and hyperuricaemia.

METHODS

A genome-wide association study of HCTZ-induced changes in UA was performed in Caucasian and African American participants from the pharmacogenomic evaluation of antihypertensive responses (PEAR) study who were treated with HCTZ monotherapy. Suggestive SNPs were replicated in Caucasians and African Americans from the PEAR study who were treated with HCTZ add-on therapy. Replicated regions were followed up through expression and pathway analysis.

RESULTS

Five unique gene regions were identified in African Americans (LUC7L2, ANKRD17/COX18, FTO, PADI4 and PARD3B), and one region was identified in Caucasians (GRIN3A). Increases in UA of up to 1.8 mg dL(-1) were observed following HCTZ therapy in individuals homozygous for risk alleles, with heterozygotes displaying an intermediate phenotype. Several risk alleles were also associated with an increased risk of HCTZ-induced clinical hyperuricaemia. A composite risk score, constructed in African Americans using the 'top' SNP from each gene region, was strongly associated with HCTZ-induced UA elevations (P = 1.79 × 10(-7) ) and explained 11% of the variability in UA response. Expression studies in RNA from whole blood revealed significant differences in expression of FTO by rs4784333 genotype. Pathway analysis showed putative connections between many of the genes identified through common microRNAs.

CONCLUSION

Several novel gene regions were associated with HCTZ-induced UA elevations in African Americans (LUC7L2, COX18/ANKRD17, FTO, PADI4 and PARD3B), and one region was associated with these elevations in Caucasians (GRIN3A).

Graphene-based D-shaped fiber multicore mode interferometer for chemical gas sensing

In this Letter, a graphene-coated D-shaped fiber (GDF) chemical gas sensor is proposed and demonstrated. Taking advantage of both the graphene-induced evanescent field enhancement and the in-fiber multimode interferometer, the GDF shows very high sensitivity for polar gas molecule adsorptions. An extinction ratio of up to 28 dB within the free spectrum range of ~30  nm in the transmission spectrum is achieved. The maximum sensitivities for NH₃ and H₂O gas detections are ~0.04 and ~0.1  ppm, respectively. A hybrid sensing scheme with such compactness, high sensitivity, and online monitoring capabilities may pave the way for others to explore a series of graphene-based lab-on-fiber devices for biochemical sensing.

Graphene Bragg gratings on microfiber

Graphene Bragg gratings (GBGs) on microfiber are proposed and investigated in this paper. Numerical analysis and simulated results show that the mode distribution, transmission loss, and central wavelength of the GBG are controllable by changing the diameter of the microfiber or the refractive index of graphene. Such type of GBGs with tunability may find important applications in optical fiber communication and sensing as all-fiber in-line devices.

Link between obesity and cancer: role of triglyceride/free fatty acid cycling

Obesity has long been suspected to be a risk factor for cancer. The relationship between body fat deposition and the pathogenesis of cancer has been the subject of many studies, however, no clear consensus has emerged linking these two biological processes. Recent epidemiological studies showed a strong association between cancer-related deaths and increased body-mass index. In fact, obesity has been identified as a cause for oesophageal, colon, uterine, kidney and post-menopausal breast cancers and also as a significant risk factor for the cancers of prostate, pancreas and non-Hodgkin lymphoma. Approximately 16-20% of cancer deaths in women and 14% of cancer deaths in men were found to be due to obesity. It is also recognized that there is a positive relationship between type-2 diabetes associated hyperinsulinemia and cancer incidence. Though the recent annual report in US finds that the incidence and mortality rates for many cancers have dropped in 2003 since 1975, this decline is mostly due to a substantial decrease in tobacco use among men. However, during the same period the rise in the prevalence of obesity might have contributed to the increased risk and incidence of prostate, liver, kidney, oesophageal and breast cancers. Whether the elevated cancer risk in obesity arises from similar modulation of parallel signaling/metabolic pathways during adipogenesis and oncogenesis has not been hitherto addressed. In this Review we would like to bring out the similarities between adipogenesis and oncogenesis and how this relationship at molecular level may be relevant for the development of effective therapeutics for obesity, diabetes and cancer. While adipogenesis is the process of formation of mature adipocytes or fat cells under normal physiological conditions, oncogenesis is a pathological process, which results in the uncontrolled growth of cells leading to cancer. Though, both these processes at surface seem to be totally different, we believe that there are important common denominators for these processes that need to be recognized. We will discuss the role of two such underlying factors - (1) malonyl-CoA, an important regulator of fatty acid metabolism and (2) triglyceride/free fatty acid (TG/FFA) cycling which is central to the generation of multiple signals for controlling various metabolic, physiological and signaling pathways in the cell.

Linagliptin treatment in subjects with type 2 diabetes with and without mild-to-moderate renal impairment

AIMS

Renal disease is a frequent comorbidity of type 2 diabetes mellitus (T2DM) and an important factor complicating the choice of glucose-lowering drugs. The aim of this analysis was to evaluate the efficacy and safety of the dipeptidyl peptidase (DPP)-4 inhibitor linagliptin (5 mg/day) in mono, dual or triple oral glucose-lowering regimens in subjects with T2DM and mild or moderate renal impairment (RI).

METHODS

In this pooled analysis of three 24-week, placebo-controlled, phase 3 trials, subjects with mild (estimated glomerular filtration rate (eGFR) 60-<90 ml/min/1.73 m(2) , n = 838) or moderate RI (30-<60 ml/min/1.73 m(2), n = 93) were compared with subjects with normal renal function (≥90 ml/min/1.73 m(2), n = 1212).

RESULTS

Subjects with RI were older, had longer duration of diabetes, and increased prevalence of diabetes-related comorbidities. After 24 weeks, linagliptin achieved consistent placebo-corrected mean glycated haemoglobin (HbA1c) changes across the three renal function categories: normal (-0.63%; p < 0.0001), mild RI (-0.67%; p < 0.0001) and moderate RI (-0.53%; p < 0.01), with no inter-group difference (p = 0.74). Renal function with linagliptin remained stable across all categories. In linagliptin-treated subjects, overall adverse event (AE) rates and serious AE rates were similar to placebo. The incidence of hypoglycaemia with linagliptin and placebo was 11.1 versus 6.9%, 11.9 versus 9.0% and 15.9 versus 12.0% in the normal, mild RI and moderate RI categories, respectively.

CONCLUSIONS

This pooled analysis provides evidence that linagliptin is an effective, well-tolerated and convenient treatment in subjects with T2DM and mild or moderate RI.

Text prediction on structured data entry in healthcare: a two-group randomized usability study measuring the prediction impact on user performance

BACKGROUND

Structured data entry pervades computerized patient safety event reporting systems and serves as a key component in collecting patient-related information in electronic health records. Clinicians would spend more time being with patients and arrive at a high probability of proper diagnosis and treatment, if data entry can be completed efficiently and effectively. Historically it has been proven text prediction holds potential for human performance regarding data entry in a variety of research areas.

OBJECTIVE

This study aimed at examining a function of text prediction proposed for increasing efficiency and data quality in structured data entry.

METHODS

We employed a two-group randomized design with fifty-two nurses in this usability study. Each participant was assigned the task of reporting patient falls by answering multiple choice questions either with or without the text prediction function. t-test statistics and linear regression model were applied to analyzing the results of the two groups.

RESULTS

While both groups of participants exhibited a good capacity of accomplishing the assigned task, the results were an overall 13.0% time reduction and 3.9% increase of response accuracy for the group utilizing the prediction function.

CONCLUSION

As a primary attempt investigating the effectiveness of text prediction in healthcare, study findings validated the necessity of text prediction to structured date entry, and laid the ground for further research improving the effectiveness of text prediction in clinical settings.

Effects of progesterone and its metabolites on human granulosa cells

The corpus luteum (CL) is under control of gonadotrophic hormones and produces progesterone, which is necessary for endometrial receptivity. Recent studies have shown that progesterone and its metabolites are involved in cell proliferation and apoptosis of cancer cells. Here weanalyzed the role of progesterone and its meta-bolites on luteinized granulosa cells (LGC) by FACS analysis and quantitative Real-Time PCR. We detected the mRNA of the progesterone metabolizing genes SRD5A1, AKR1C1, and AKR1C2 in LGC. The stimulation of LGC with progesterone or progesterone metabolites did not show any effect on the mRNA expression of these genes. However, a downregulation of Fas expression was found to be accomplished by progesterone and human chorionic gonadotropin. Our findings do not support the concept of an effect of progesterone metabolites on LGCs. However, it suggests an antiapoptotic effect of hCG and progesterone during corpus luteum development by downregulation of Fas.

Metabolic signaling of insulin secretion by pancreatic β-cell and its derangement in type 2 diabetes

Pancreatic beta-cell is responsible for insulin secretion in response to the availability of nutrients. Type 2 diabetes mellitus (T2D) is the result of pancreatic b-cell failure to supply sufficient amount of insulin accompanied with decreased sensitivity of the body tissues to respond to insulin. The insulin secretion apparatus of beta-cell is uniquely equipped with multiple metabolic and signaling steps that are under rigorous control. The metabolic machinery of beta-cell is designed to sense the fluctuations in blood glucose level and supply insulin accordingly to the needs of body. Besides glucose, amino acids including glutamine and leucine and also fatty acids are known to either stimulate the beta-cell directly or potentiate the glucose stimulated insulin secretion (GSIS) response. Glucose metabolism dependent GSIS is linked with the production of ATP that is needed for K+ATP channel inhibition and influx of calcium, necessary for insulin granule exocytosis. Besides glucose metabolism, amino acid metabolism and lipid metabolism derived metabolites mediate the optimal glucose response of beta-cells to secrete insulin. Metabolites derived from nutrient secretagogues that directly or indirectly participate in the enhancement of GSIS are considered as metabolic coupling factors. In this review, we will discuss the regulation of insulin secretion by b-cell keeping the recent developments in metabolic signaling in focus. The relevant metabolic pathways in pancreatic beta-cell and their role in the control of fuel-stimulated insulin secretion will be reviewed to arrive at a consensus picture with respect to the metabolic signaling of insulin secretion.

Abstract P6-12-09: Targeting deregulated cyclin E in inflammatory breast cancer via sequential combination therapy

Inflammatory breast cancer (IBC) is a rare, highly aggressive form of breast cancer, accounting for 2-5% of all breast cancers in the US and 10% of breast cancer deaths. Unfortunately, until recently this disease has not been studied extensively at the molecular/cellular level despite the compelling unmet need to develop more effective therapies. In spite of receiving aggressive multidisciplinary therapy (anthracycline-taxane-based neoadjuvant chemotherapy, modified-radical-mastectomy and adjuvant radiation therapy), only about 40% of IBC patients survive 5 years. The goal of this project is to identify new targets that can be exploited pharmacologically either in combination with current therapies or with other novel agents.

Previous work has identified tumor-specific low molecular weight forms of cyclin E, termed LMW-E, that are preferentially found in triple negative breast cancers (TNBC) and serve as a poor prognostic biomarker. As a result of cleavage, LMW-E preferentially accumulates in the cytoplasm where it exerts its pleiotropic oncogenic functions including deregulating the cell cycle. Furthermore, we have shown that TNBC cells harboring LMW-E are sensitive to CDK inhibitors.

To establish the clinical relevance of targeting the cyclin E/CDK2 axis in IBC, a pilot study was performed to determine the incidence of LMW-E. We performed IHC on 11 post-chemotherapy surgical specimens from MDACC. All tumors expressed cyclin E, 8 of which had predominantly cytoplasmic staining, indicative of LMW-E expression. These results are now being validated in a larger cohort of samples. These promising preliminary results led us to perform in vitro experiments to determine sensitivity to CDK2 inhibitors and characterize cell cycle profiles.

Similar to non-IBC breast cancers, IBC tumors can be ER-positive, TNBC or HER2-overexpressing; however, there are only TN-IBC or HER2+ cell lines. We utilized 2 cell lines for these studies, one of which is TN-IBC, the other of which is ER-negative and HER2-overexpressing. These cell lines were treated with a panel of CDK inhibitors to evaluate their sensitivity in both short-term and long-term assays. The long-term assay we developed called the high-throughput survival assay was used to examine combinations of agents for potential synergies using isobologram analysis. We have demonstrated chemotherapy-specific synergistic cell death when cells are first treated with CDK inhibitor in IBC and non-IBC cell lines.

Using flow cytometry, we have demonstrated that CDK inhibitors induce a G2/M arrest, which is further increased by sequential treatment with chemotherapy. Furthermore, combination treatment leads to cell death, as measured by sub-G1 DNA content.

Taken together, these studies provide solid evidence that targeting CDK2 is a promising strategy in treating IBC tumors that express cyclin E. Beyond these early pre-clinical advances, however, we demonstrated clear sequence-specificity for certain pairs of drugs, implying that future clinical studies should be designed taking into account the mechanism of action of cell cycle targeting drugs.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-12-09.

HMGB3 characterization in gastric cancer

Gastric cancer is a major health problem worldwide; it is the second most common cause of cancer death in the world. Recent studies indicate that the high-mobility group (HMG) of chromosomal proteins is associated with cancer progression. However, HMGB3 has been little studied. We analyzed the co-expression network between HMGB3 and differentially-expressed genes in the GSE17187 database, identifying the relevant transcription factors, and the conserved domain of HMGB3 to understand the underlying regulation mechanisms involved in gastric cancer. Thirty-one relationships between 11 differentially-expressed genes were included in a co-expression network; many of these genes have been identified as related to cancer, including TBX5 and TFR2. Further analysis identified nine transcription factors, these being GATA3, MZF1, GATA1, GATA2, SRY, REL, NFYB, NFYC, and NFYA, which could interact with HMGB3 to regulate target gene expression and consequently regulate gastric cancer cell proliferation, migration and invasion. The HMG-box domain was very similar in various species, with only a few amino acid changes, indicating conserved functions in HMG-box. This information helps to provide insight into the molecular mechanisms of HMGB3 in human gastric cancer.