PI3 Kinase Pathway Analysis in Tissue Microarrays Using Laser Capture Microdissection and Immunohistochemistry

Background. During the performance of the BCIRG trials primary patient tumor samples were obtained from paraffin blocks and assembled into 15 tissue microarrays, including 3000 samples from trial 005 (adjuvant taxol in Her2- node positive patients), 2200 in 006 (adjuvant herceptin in Her2+ high risk patients) and 300 in 007 (addition of platinum in Her2+ first line therapy). This array set was prepared prospectively, in anticipation of molecular epidemiologic studies of a variety of targets in relation to outcome. In order to address the potentially important role of the PIK3CA pathway in modulating outcome in different clinical situations we assessed components of the PIK3CA pathway by various methods.Methods. We analysed the expression of PTEN, Cyclin D1, p53 and Stathmin by immunohistochemistry using standard methods. All markers were scored by histoscore. Phospho S6 240 and phospho Akt 473 were assessed simultaneously by quantum dot immunofluorescence using automated image capture and segmentation. PIK3CA mutations were evaluated using SnaPshot analysis of laser captured TMA spots in a subset of approximately 2000 samples.Results. In the samples analyzed PIK3CA mutation had an incidence of 23%, with 9% being mutations in exon 9 and 13% in exon 20, with 0.5% being mutant in both exons. Initial analysis of the results prior to outcome analysis indicated that Stathmin expression, while being a robust marker with good dynamic range, did not appear to correlate with PTEN loss by IHC or with PIK3CA mutation.Conclusions. PIK3CA mutational analysis is feasible from TMA cores and gives mutation incidences similar to the published literature for archival material. Relationships of markers with outcome will be presented.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4043.

Abstract A4: Phase I clinical trial evaluating the safety, pharmacokinetics and biological effect of intravenous bevacizumab (avastin) in combination with escalating doses of AZD2171 (cediranib) administered orally for 21 consecutive days to patients with advanced malignancies (NCI protocol #7534)

Background: Angiogenesis inhibitors may be classified as direct or indirect inhibitors. Direct inhibitors like bevacizumab (B) that target the microvascular endothelial cells and prevent them from responding to different endothelial mitogens. Conversely, indirect inhibitors like cediranib (C), target growth-factor tyrosine kinases and its VEGF receptors on tumor endothelium. We hypothesized that maximizing VEGF inhibition with a combination therapy consisting of a direct angiogenesis inhibitor (B) and an indirect inhibitor (C) with different VEGF blocking mechanisms may result in increased anti-tumor activity and a safe toxicity profile. As a first step, we conducted a phase I study of the combination of bevacizumab and cediranib in advanced cancer patients.

Methods: Pts with advanced solid tumors refractory to standard therapy were eligible. The trial is a conventional phase I 3+3 dose-escalation design. Cediranib was administered orally continuously for 21 days. Bevacizumab was given every two weeks (days 1 and 15) at escalating doses. Correlative studies including pharmacokinetic studies of cediranib, DCE-MRI, and circulating tumor (CTCs) and endothelial cells (CECs).

Results: A total of 27 pts have been treated. Dose level 3 (C-30 mg/day and B-5mg/kg/2 weeks) was determined to be the MTD with the major dose-limiting toxicity of hypertension. The most common drug related toxicities include hypertension (66%), fatigue (41%), and anorexia (33%). Currently, of the 17 evaluable pts by RECIST, 7 pts had SD for >4 cycles (months). One confirmed PR was noted in a metastatic basal cell carcinoma pt (−33%) and one unconfirmed PR (−31%) in ovarian cancer pt. Several notable minor responses by RECIST have also been observed in the SD pts; 2 pts with RCC (−21%, −23%), an alveolar soft tissue sarcoma pt (−24%), and a prostate cancer pt (−21%). Overall, immature CECs (CD105+) enumerated by CellSearch™ revealed a dose-dependent significant decrease (1,290% to 93%; p=0.0001). A 3-fold induction in apoptosis was observed at 24 hrs compared to baseline in the CD105-positive CECs. Overall, mature CECs (CD31+) assessed for VEGFR2 activity revealed an 83% and 1.9% significant (p=0.019) inhibition in pVEGFR2 expression at low (B;3mg/kg) and high (B;5mg/kg) doses, respectively. In the non-responders, mature CECs revealed a dose-dependent (C;20mg/kg–30mg/kg) significant increase (−6.8% to 63%;p=0.031) in pERK/ERK expression levels. PK and DCE-MRI analysis is pending.

Conclusions: The MTD was determined to be cediranib 30mg/day and bevacizumab 5mg/kg/2weeks. Activity has been seen in a diverse number of tumor types. Inhibition of pVEGFR2 and induction of apoptosis in CECs shows target effect by the combination.

Grant support: National Cancer Institute grant and 2 UO1 CA062461-15

Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A4.

Assessment of the effects of subthalamic stimulation in Parkinson disease patients by artificial neural network

This study aims at using a probabilistic neural network (PNN) for discriminating between normal and Parkinson disease (PD) subjects using as input the principal components (PCs) derived from vertical component of the ground reaction force (vGRF). The trained PNN was further used for evaluating the effects of deep brain stimulation of the subthalamic nucleus (STN DBS) on PD, with and without medication. A sample of 45 subjects (30 normal and 15 PD subjects who underwent STN DBS) was evaluated by gait analysis. PD subjects were assessed under four test conditions: without treatment (mof-sof), only with stimulation (mof-son) or medication (mon-sof), and with combined treatments (mon-son). PC analysis was applied on vGRF, where six PC scores were chosen by the broken stick test. Using a bootstrap approach for the PNN model, and the area under the receiver operating characteristic curve (AUC) as performance measurement, the first three and fifth PCs were selected as input variables. The PNN presented AUC = 0.995 for classifying controls and PD subjects in the mof-sof condition. When applied to classify the PD subjects under treatment, the PNN indicated that STN DBS alone is more effective than medication, and further vGRF enhancement is obtained with combined therapies.

Single Molecule Measurements of Interaction Free Energies Between the Proteins Within Binary and Ternary SNARE Complexes

We use an Atomic Force Microscope based single molecule measurements to evaluate the activation free energy in the interaction of SNARE proteins syntaxin 1A, SNAP25B and synaptobrevin 2 which regulate intracellular fusion of vesicles with target membranes. The dissociation rate of the binary syntaxin-synaptobrevin and the ternary syntaxin-SNAP25B-synaptobrevin complex was measured from the rupture force distribution as a function of the rate of applied force. The temperature dependence of the spontaneous dissociation rate was used to obtain the activation energy to the transition state of 19.8 +/- 3.5 kcal/mol = 33 +/- 6 k(B)T and 25.7 +/- 3.0 kcal/mol = 43 +/- 5 k(B)T for the binary and ternary complex, respectively. They are consistent with those measured previously for the ternary complex in lipid membranes and are of order expected for bilayer fusion and pore formation. The DeltaG was 12.4-16.6 kcal/mol = 21-28 k(B)T and 13.8-18.0 kcal/mol = 23-30 k(B)T for the binary and ternary complex, respectively. The ternary complex was more stable by 1.4 kcal/mol = 2.3 k(B)T, consistent with the spontaneous dissociation rates. The higher adhesion energies and smaller molecular extensions measured with SNAP25B point to its possible unique and important physiological role in tethering/docking the vesicle in closer proximity to the plasma membrane and increasing the probability for fusion completion.

Oleanolic Acid, a plant triterpenoid, significantly improves survival and function of islet allograft

BACKGROUND.: Oleanolic acid (OA) is a ubiquitous triterpenoid, with potent antioxidant and anti-inflammatory properties. Here, we tested whether these combined properties of OA can prevent nonimmunologic primary nonfunctioning and immunologic phenomena ascribed to graft rejection hence prolong islet allograft survival. METHODS.: Islet transplants were performed under kidney capsule of streptozotocin-induced diabetic C57BL/6 mice with BALB/c islets. Recipients were treated with 0.5 mg/day of OA intraperitoneally, and serum samples were collected once in 2 days and used for luminex, ELISA, and donor-specific antibody screening. Transplanted mice were killed at different time intervals to obtain splenocytes and kidney samples for ELISPOT, mixed leukocyte reaction, and immunohistochemical studies. RESULTS.: After transplantation, the decrement of blood glucose was significantly faster in mice receiving OA less than 2+/-1 days compared with untreated (4+/-2 days). OA prolonged survival of transplanted islets up to 23+/-3 days and reversed diabetes even with 250 islets. Treatment group showed increased serum interleukin (IL)-10 (twofold) and decreased inducible protein-10 and IL-4 (threefold) in luminex. Significantly reduced frequency of interferon-gamma (4.5-fold), IL-4 (3.5-fold), IL-2 (2.3-fold), and IL-17 (fourfold) producing T-cell populations were found in ELISPOT. OA-treated grafts had significant reduced and delayed infiltration of CD4+ and CD8+ T cells. OA also delayed donor-specific antibody generation up to 19 days after transplantation. Combined treatment with cyclosporine A, OA further prolonged the islet allograft survival to 34+/-3 days. CONCLUSIONS.: In conclusion, OA is an attractive, dietary nontoxic plant triterpenoid, which suppresses the production of proinflammatory cytokines and delays graft-specific immune responses to prolong islet allograft survival.

Generation of Janus alginate hydrogel particles with magnetic anisotropy for cell encapsulation

A microfluidic approach for fabrication of Janus hydrogel particles with magnetic anisotropy is demonstrated. Using this technique, cells and magnetic beads (MBs) can be separately embedded in one hydrogel particle to maintain optical performance, and reduce the contact between cells and magnetic beads (nano- or submicron-particles). Alginate cell capsules prepared by this method can be easily controlled and manipulated by external magnetic fields and require no specific surface modification. Bio-degradability and super-paramagnetic properties of these hydrogel particles were also demonstrated experimentally.

Heterogeneity of class I and class II MHC sequences in Schistosoma japonicum from different endemic regions in mainland China

The present study examined sequence variation in class I and class II major histocompatibility complex (MHC) genes among Schistosoma japonicum isolates from different endemic regions in mainland China and assessed the level of horizontal gene transfer and sequence similarity between parasites and their hosts. S. japonicum cercariae were used to infect male adult rabbits to obtain adult S. japonicum samples. A portion of the class I MHC gene (pMHC I) and class II MHC genes (pMHC II) were amplified separately from individual adult trematodes by polymerase chain reaction and sequenced. Among all the examined isolates of S. japonicum, sequence differences between male and female parasites were 0.0-26.6% for pMHC I and 0.0-7.0% for pMHC II. Sequence variations between male and female parasites among different geographical locations from the mountainous areas were 1.1-26.6% for pMHC I and 1.5-3.0% for pMHC II. Sequence variations between samples from Yunnan and those from Sichuan were 2.7-23.5% for pMHC I and 1.1-3.7% for pMHC II. In the lake/marshland areas, sequence variations between male and female parasites among different geographical locations were 0.0-25.0% for pMHC I and 0.0-7.0% for pMHC II. Sequence variations between S. japonicum isolates from mountainous areas, and those from lake/marshland areas were 0.0-26.1% for pMHC I and 0.4-6.1% for pMHC II. BLASTN analysis indicated that all the pMHC II sequences showed high homology to a portion of exon 3 in rabbit MHC class II DP beta gene with more than 89% similarity, and all the pMHC I sequences except isolates in Yunnan (Eryuan) revealed high homology to the portion of exon 2 in rabbit MHC I gene with more than 81% similarity. Phylogenetic analysis showed no specific clustering comprising parasites from single geographical or endemic regions, and the paired parasites were even found in different clusters. These results demonstrated that pMHC I and II of S. japonicum isolates in mainland China existed heterogeneity, but the pMHC I, II, or combined sequences were not suitable markers for examining genetic relationship among different isolates from endemic regions in mainland China.

The evaluation of whitening efficacy of cosmetic products using a human skin pigmentation spot model

BACKGROUND

To establish a pigmentation spot model on human skin and to assess whitening efficacy for whitening products by this established pigmentation spot model.

METHODS

Twenty subjects between 20 and 45 years old with skin phototype III or IV were selected. Three consecutive daily UV exposures were performed on buttocks of the subjects as follows: Day 1=1 minimal erythema dose (MED), Day 2=0.5 MED and Day 3=0.5 MED. After the first UV exposure, a selected whitening product was applied to the subjects twice a day on UV exposure area. The application of the whitening product to subjects on the exposed areas was continued till Day 27. CM2500d chromameter, Maxmeter MX18 and visual evaluation were used to assess changes of skin color.

RESULTS

A pigmentation spot model after UV exposure was established. The measurement of the pigment spot showed that L* value declined abruptly at Day 3 and then slowly reached to a lowest point at Day 6. L* value of the pigment spot almost remained at the same level until Day 20, thereafter increased slowly. The a* value showed an abrupt increase at Day 3 and slowly reached to a maximal level at Day 6. The a* value slowly declined toward its baseline level. Likewise, the erythema index also increased significantly at Day 3, and reached to a maximal level at Day 6 and then slowly declined. However, L*, a* and erythema indices did not return to their baseline levels during the 27-day period of this study. On the other hand, b* value started to increase from Day 3 and such increase was observed continuously to Day 27. Melanin index also showed a slow increase during the first 3 days. It started to increase rapidly from Day 3 and a to maximal level at Day 9 and maintain at a plateau till Day 27 (with an exception at Day 13). To assess the whitening product by this pigmentation spot model, DeltaL, Deltab*, and DeltaM values were analyzed. It showed that absolute DeltaL value and Deltab*value of whitening products were lower than those values of the vehicle of the whitening product at each checkpoint, while DeltaM value of the whitening product was lower only at Day 9 and Day 20, although no statistically significant differences was found. The visual results also strongly supported that the whitening product enhanced the decrease of pigmentation.

CONCLUSION

This study showed that repeated UV exposure was able to induce a long extensive period of pigment formation. The resulted pigmentation spot was able to maintain at an elevated level till Day 20. Clinical subjective evaluations together with combined objective instrument measurements were still important to assess whitening and spot-removing ability of a material due to the instrument limitation for color differentiations. This kind of pigmentation spot model can be used to assess whitening efficacy for whitening or spot-removing products. In addition, the combinations of subjective and objective methods were able to serve as advisable references to assess the whitening efficacy of products.

Comparison of native E. coli and PEG asparaginase pharmacokinetics and pharmacodynamics in pediatric acute lymphoblastic leukemia

Asparaginase (ASP) is used routinely in frontline clinical trials for the treatment of childhood acute lymphoblastic leukemia (ALL). The goals of this study were to assess the pharmacokinetics and pharmacodynamics of ASP and to mathematically model the dynamics between ASP and asparagine (ASN) in relapsed ALL. Forty children were randomized to receive either native or polyethylene glycolated (PEG) Escherichia coli ASP during reinduction therapy. Serial plasma ASP and ASN, cerebrospinal fluid (CSF) ASN, and serum anti-ASP antibody samples were collected. The ASP clearance was higher (P = 0.001) for native vs. PEG ASP. Patients with antibodies to PEG ASP had faster PEG ASP clearance (P = 0.004) than did antibody-negative patients. Patients who were positive for antibodies had higher CSF ASN concentrations than did those who were negative (P = 0.04). The modeling suggests that by modifying dosages, comparable ASN depletion is achievable with both preparations. At relapse, there were significant pharmacokinetic and pharmacodynamic differences attributable to ASP preparation and antibody status.

Insulin receptor substrate 2 plays important roles in 17beta-estradiol-induced bone formation

BACKGROUND

Discovering the mechanisms of the estrogen effects on the osteoblasts is very important for the development of new agents which have the clear-cut beneficial effects of estrogen while free of adverse effect.

AIM

The aim of this study was to investigate the differential gene expression of 17beta-estradiol (E2)-treated osteoblast-like cells, and the effect of E2 on the insulin receptor substrate 2 (IRS- 2) expression in human cultured osteoblast-like cells and the osteoblasts of ovariectomized (OVX) rats.

MATERIAL AND METHODS

The differential gene expression of E2-treated osteoblast- like cells was analyzed by cytokine expression array and validated by RT-PCR and Western blot analysis. The protein expression and phosphorylation of one of the differentially expressed gene, IRS-2, treated at different times with E2 were analyzed. The Sprague-Dawley rats were ovariectomized and then treated with E2, the IRS-2 expression was analyzed by immunohistochemistry analysis.

RESULTS

E2 upregulated the mRNA expression of IRS-2, bone morphogenetic protein 9, and connective tissue growth factor expression, down-regulated the mRNA expression of matrix metalloproteinase 15 and some tumor suppressor genes. Peak expression of IRS-2 was observed at 12-24 h of treatment by 10-8M E2. E2 can also increase the phosphorylation of IRS-2. The IRS-2 expression was down-regulated in the osteoblasts and bone marrow cells of the OVX rats, which had lower bone mineral density (BMD) than the normal rats. However, both BMD and IRS-2 expression can be rescued by 10-8M E2 in the OVX rats.

CONCLUSION

IRS-2 in osteoblast is up-regulated by E2 and plays important roles in the estrogen- induced bone formation.

Impact of hypertension on health-related quality of life in a population-based study in Shanghai, China

OBJECTIVES

The purpose of this study was to examine the relationship between hypertension and health-related quality of life (HRQL) in a general representative Chinese population, and to explore the impacts of comorbidity on people with hypertension.

STUDY DESIGN

Population-based cross-sectional survey.

METHODS

A self-administered questionnaire survey including demographic questions and the Mandarin version of 36-item Short Form (SF-36) was conducted in a general population in Shanghai, China. In total, 1034 subjects participated. The SF-36 dimension scores of hypertensive subjects were compared with those of normotensive subjects. Independent association of hypertension with each quality-of-life domain was analysed using a multiple linear regression model, so were the effects of comorbidity on the HRQL of hypertensive subjects.

RESULTS

Nine hundred and nineteen respondents were included in the analysis, and 16.97% reported hypertension. Respondents with hypertension scored lower than those without hypertension in at least five SF-36 dimensions. The dimension of role limitations due to physical problems was the most affected, whereas the mental health dimension was the least affected. Hypertensive subjects with comorbidity experienced lower SF-36 scores than hypertensive subjects without comorbidity.

CONCLUSIONS

Hypertension markedly impairs quality of life in terms of both physical and mental health. Comorbidity further deteriorates HRQL among people with hypertension. The findings suggest that people with hypertension represent a vulnerable population, and it is important to prevent and treat comorbidity of hypertension.

Comparison of Hyperbolic and Constant Width Simultaneous Confidence Bands in Multiple Linear Regression under MVCS Criterion

A simultaneous confidence band provides useful information on the plausible range of the unknown regression model, and different confidence bands can often be constructed for the same regression model. For a simple regression line, it is proposed in Liu and Hayter (2007) to use the area of the confidence set that corresponds to a confidence band as an optimality criterion in comparison of confidence bands; the smaller is the area of the confidence set, the better is the corresponding confidence band. This minimum area confidence set (MACS) criterion can clearly be generalized to the minimum volume confidence set (MVCS) criterion in study of confidence bands for a multiple linear regression model. In this paper the hyperbolic and constant width confidence bands for a multiple linear regression model over a particular ellipsoidal region of the predictor variables are compared under the MVCS criterion. It is observed that whether one band is better than the other depends on the magnitude of one particular angle that determines the size of the predictor variable region. When the angle and so the size of the predictor variable region is small, the constant width band is better than the hyperbolic band but only marginally. When the angle and so the size of the predictor variable region is large the hyperbolic band can be substantially better than the constant width band.

Infusion of mesenchymal stem cells and rapamycin synergize to attenuate alloimmune responses and promote cardiac allograft tolerance

The inherent immunosuppressive properties and low immunogenicity of mesenchymal stems cells (MSCs) suggested their therapeutic potential in transplantation. We investigated whether MSCs could prolong allograft survival. Treatment involving infusion of MSCs into BALB/c recipients 24 hours after receiving a heart allograft from a C57BL/6 donor significantly abated rejection and doubled graft mean survival time compared to untreated recipients. Furthermore, combination therapy of MSCs and low-dose Rapamycin (Rapa) achieved long-term heart graft survival (>100 days) with normal histology. The treated recipients readily accepted donor skin grafts but rejected third-party skin grafts, indicating the establishment of tolerance. Tolerant recipients exhibited neither intragraft nor circulating antidonor antibodies, but demonstrated significantly high frequencies of both tolerogenic dendritic cells (Tol-DCs) and CD4(+)CD25(+)Foxp3(+)T cells in the spleens. Infusion of GFP(+)C57BL/6-MSCs in combination with Rapa revealed that the GFP-MSCs accumulated in the lymphoid organs and grafts of tolerant recipients. Thus, engraftment of infused MSCs within the recipient's lymphoid organs and allograft appeared to be instrumental in the induction of allograft-specific tolerance when administered in combination with a subtherapeutic dose of Rapamycin. This study supports the clinical applicability of MSCs in transplantation.

Effects of adenovirus-mediated gene transfer of ICOSIg and CTLA4Ig fusion protein on experimental autoimmune myocarditis

OBJECTIVE

To explore the therapeutic alliance effects of adenovirus vector-mediated gene transfer of ICOSIg and CTLA4Ig fusion protein on experimental autoimmune myocarditis (EAM).

METHODS

Expression vector pAdeno-CTLA4Ig and pAdeno-ICOSIg was constructed and transfected into HEK293 cells. Adenovirus expresses CTLA4Ig and ICOSIg was produced. Ad-CMV-GFP was used as controls. EAM was induced in Lewis rats by injection of procine cardiac myosin. All the immunized rats were divided into four groups. Group A (n = 15) received adenovirus containing CTLA4Ig and ICOSIg from day 14-28; group B (n = 15), group C (n = 15) and group D (n = 15) received adenovirus containing CTLA4Ig, ICOSIg and GFP, respectively. Group E (n = 10) was normal controls never received immunization. On day 28, all the rats were killed after echocardiography examination. Histopathological examination was used to observe inflammation in the myocardium. Western blot was used to detect CTLA4, ICOS, ICOSL and competitive RT-PCR for B7-1, B7-2 expression. T lymphocyte proliferation assay was performed and ELISPOT was used to detect the Th1 and Th2 production.

RESULTS

Alliance application of CTLA4Ig and ICOSIg exerts therapeutic effects on EAM. After a treatment duration of 14 days, cardiac function and myocardial inflammation improved significantly compared to group D. Expression of CTLA-4, ICOS and ICOSL, B7-1 was statistically decreased in group A, B and C compared with group D. T-cell proliferation was inhibited by costimulatory blockade in a dose-dependent style. ICOSIg blockade significantly augments IL-4 and IL-10 production while diminished IFN-gamma production.

CONCLUSIONS

Blockade of costimulatory pathway with alliance therapy of CTLA4Ig and ICOSIg alleviated autoimmune damage in EAM and improved cardiac function. The mechanisms may be downregulation of costimulatory molecules and anti-inflammation.

High glucose attenuates insulin-induced VEGF expression in bovine retinal microvascular endothelial cells

PURPOSE

To investigate the effect of high glucose on insulin-induced vascular endothelial growth factor (VEGF) expression in bovine retinal microvascular endothelial cells (BRECs) and to probe into related mechanisms.

METHODS

BRECs were isolated as primary cultures and identified by immunostaining. Passage cells were initially exposed to normal (5 mM) or high glucose (30 mM) for 3 days, and equimolar L-glucose was supplemented for osmotic equation. BRECs were then treated with 100 nM insulin for 24 h or not, and cells were prepared for the determination of VEGF mRNA expression by real-time PCR. VEGF protein was determined by human umbilical vein endothelial cell proliferation assay, immunofluorescence, and ELISA. BRECs were treated with 5 or 30 mM glucose for 3 days and then cells cultured with 5 mM glucose were exposed to the PI3-K inhibitor wortmannin (100 nM), the P42/44 mitogen-activated protein kinase (MAPK) inhibitor U0126 (50 microM), or to the protein kinase C (PKC) inhibitor GF109203X (2 microM) 1 h before addition of 100 nM insulin. Twenty-four hours after incubation with insulin, the cells were subjected to real-time PCR and ELISA analyses.

RESULTS

Insulin or high glucose alone markedly increased VEGF mRNA and protein levels in BRECs (P<0.05, two-way ANOVA). However, the combination of insulin and high glucose displayed a weaker effect in promoting VEGF expression than did insulin alone (P<0.05, t-test). Pretreatment of cells with PI3-K inhibitor significantly (P<0.05, one-way ANOVA) suppressed the insulin-induced VEGF expression; neither pretreatment with the PKC inhibitor nor with the P42/p44 MAPK inhibitor showed an effect on the expression of VEGF at the mRNA or protein level (P>0.05, one-way ANOVA).

CONCLUSIONS

Both insulin and high glucose can markedly increase VEGF expression in BRECs at the mRNA and protein level. We propose that insulin may upregulate VEGF expression through the PI3-K signalling pathway in BRECs, and high glucose may attenuate insulin-induced VEGF expression by impairing PI3-K signalling pathways.

Expression of cathepsin L in nasopharyngeal carcinoma and its clinical significance

AIM

To study the expression of cathepsin L in nasopharyngeal carcinoma (NPC), and analyze its relationship with clinicopathologic factors.

METHODS

The expression of cathepsin L was determined immunohistochemically in NPC, adjacent normal nasopharyngeal tissues and metastatic cervical lymph nodes. The correlation between its protein expression and clinicopathologic parameters as well as with long term follow-up data in NPC was analyzed.

RESULTS

The protein of cathepsin L was overexpressed in 47% primary tumor tissues, and in 89% metastatic cervical lymph node samples. Overexpression of cathepsin L was found to correlate with lymph node metastasis ( P = 0.04) and distant metastasis ( P = 0.01), and marginally with clinical stage and T classification, but not with patient age, gender and histological classification of tumor. Patients with overexpression of cathepsin L in tumor tissue had worse 5-year survival than those without such expression pattern ( P = 0.033). Multivariate survival analysis showed that cathepsin L protein expression level had a marginal significant correlation with prognosis of NPC.

CONCLUSION

Cathepsin L is a potential biomarker for prognosis of NPC and contributes to NPC metastasis.