Effect of rapamycin treatment during post-activation and/or in vitro culture on embryonic development after parthenogenesis and in vitro fertilization in pigs

This study investigated the effects of early induction of autophagy on embryonic development in pigs. For this, oocytes or embryos were treated with an autophagy inducer, rapamycin (RP), during post-activation (Pa), in vitro fertilization (IVF) and/or in vitro culture (IVC). When parthenogenesis (PA) embryos were untreated (control) or treated with various concentrations of RP for 4 hr during Pa, 100 nm RP showed a higher blastocyst formation (48.8 ± 2.7%) than the control (34.6 ± 3.0%). When PA embryos were treated during the first 24 hr of IVC, blastocyst formation was increased (p < .05) by 1 and 10 nm RP (61.9 ± 3.0 and 59.6 ± 3.0%, respectively) compared to the control (43.2 ± 1.8%) and 100 nm RP (47.8 ± 3.2%), with a higher embryo cleavage in response to 10 nm RP (87.3 ± 2.4%) than the control (74.1 ± 3.2%). RP treatment during IVC and Pa + IVC showed increased blastocyst formation (44.7 ± 2.5 and 44.1 ± 2.0%, respectively) compared to the control (33.2 ± 2.0%). In addition, RP treatment during Pa and/or IVC increased glutathione content and inversely reduced reactive oxygen species. In IVF, RP treatment for 6 hr during IVF significantly increased embryonic development (34.0 ± 2.6%) compared to the control (24.8 ± 1.6%), but treatment during IVC for 24 hr with RP did not (23.0 ± 3.8%). Autophagy was significantly increased in PA oocytes by the RP treatment during Pa but not altered by the treatment during the first 24 hr of IVC. Overall, RP treatment positively regulated the pre-implantation development of pig embryos, probably by regulating cellular redox state and stimulating autophagy.

Ondansetron in acute food protein-induced enterocolitis syndrome, a retrospective case-control study

BACKGROUND

Therapy for moderate to severe acute food protein-induced enterocolitis syndrome (FPIES) typically consists of intravenous fluids and corticosteroids (traditional therapy). Ondansetron has been suggested as an adjunctive treatment. We aimed to evaluate the efficacy of the parenteral (intravenous or intramuscular) ondansetron vs traditional therapy to resolve the symptoms of acute FPIES.

METHODS

Cases of FPIES who had a positive oral food challenge (OFC) were retrospectively examined at two major hospitals over a two-year period (Rome, Italy; and Sydney, Australia). The efficacy of therapy, based on the percentage of cases who stopped vomiting, was compared in cases who received parenteral ondansetron and in cases who received traditional therapy or no pharmacological therapy.

RESULTS

A total of 66 patients were included: 37 had parenteral ondansetron, 14 were treated with traditional therapy, and 15 did not receive any pharmacological therapy. Nineteen percentage of children treated with ondansetron continued vomiting after the administration of the therapy vs 93% of children who received traditional therapy (P < 0.05, relative risk = 0.2). Children who received ondansetron or no therapy were less likely to require an admission overnight compared with those who received traditional therapy (P < 0.05).

CONCLUSIONS

Parenteral ondansetron is significantly more effective than traditional therapy in resolving acute symptoms of FPIES. The relative risk = 0.2 greatly reduces the bias linked to the lack of randomization. These findings suggest an effective treatment for vomiting in positive FPIES OFCs and allow for more confidence in performing OFCs.

Abstract P6-11-18: A novel subgroup of estrogen receptor positive breast cancer may benefit from super-enhancer guided patient selection for retinoic acid receptor α agonist treatment

Endocrine-resistance remains a major challenge for treatment of breast cancer. Multiple mechanisms for endocrine resistance have been proposed, including altered expression of ER co-regulators such as Retinoic Acid Receptor Alpha (RARα). Furthermore, crosstalk between estradiol and RA signaling is known and upregulation of RARα has been observed in tamoxifen resistance. We propose a novel treatment paradigm for a newly-defined subset of HR+ patients based on our discovery of a super-enhancer (SE) associated with the RARA locus. SEs are large, highly active chromatin regions that pinpoint cancer vulnerabilities. The RARA SE-identified vulnerability can be targeted using the potent, selective, and metabolically stable RARα agonist SY-1425 (tamibarotene). SY-1425 is approved in Japan to treat Acute Promyelocytic Leukemia, has a well-established efficacy and safety profile, and may enhance response to hormonal therapy (HT) in this newly-defined subset of HR+ patients potentially delaying the need for alternate treatment.

Tumor samples from 42 breast cancer patients were analyzed across a range of molecular subtypes. We identified an SE linked to the RARA gene in 54.5% of the hormone positive patient samples. RARA SEs predicted sensitivity to SY-1425 in 12 breast cancer cell lines confirming their functional role, and showed a correlation with RARA gene expression. A panel of 37 breast cancer cell lines was tested for SY-1425 anti-proliferative activity and gene expression levels, and identified RARA as the single best predictor of response. Proliferation of RARA-high cells was inhibited by SY-1425 with low nanomolar EC50s. Transcriptional profiling was performed on 4 HR+ and 3 HER2+/HR- breast cancer cell lines and analyzed by GSEA to examine the molecular response to SY-1425. Signatures for growth including E2F, MYC, DNA replication, and cell cycle were significantly downregulated while retinol metabolism and luminal signaling were upregulated. Estrogen signaling was also significantly altered by SY-1425, supporting known crosstalk between RARα and ER. Consistent with differentiation, CYP26A1 and VE-Cadherin were induced and Actin and Ki67 were diminished at relevant concentrations of SY-1425 and could serve as pharmacodynamic markers of response.

To test responses to SY-1425 in vivo, two cell line-derived models and two patient-derived breast cancer models (one RARA-high, and one RARA-low each) were treated with SY-1425. SY-1425 inhibited tumor growth in the RARA-high models, but not the RARA-low models (43% versus 0% TGI). Consistent with the observed changes in transcription, SY-1425 in combination with tamoxifen synergistically inhibited proliferation of RARA-high breast cancer cell lines.

Although a few clinical studies have investigated the use of ATRA in HR+ breast cancer without success, our results suggest that patient selection based on the RARA SE may predict which HR+ breast cancer patients could derive benefit by adding an RARα agonist to HT. The potential to prolong or increase the clinical effect of anti-estrogen therapy with SY-1425, which has improved potency, selectivity, and PK stability versus ATRA, would be an attractive strategy to explore.

170 SUPPLEMENT OF GROWTH DIFFERENTIATION FACTOR 8 ON PORCINE OOCYTE DURING IN VITRO MATURATION ACTIVATES SMAD2 AND cAMP RESPONSIVE ELEMENT BINDING PROTEIN SIGNALING

Growth differentiation factor 8 (GDF8) is a member of the transforming growth factor-β family that has been identified as a strong physiological regulator. The purpose of this study is to investigate the effects of GDF8 on porcine oocytes during in vitro maturation (IVM). We investigated reactive oxygen species (ROS) levels, specific gene transcription levels in oocytes and cumulus cells (CC) after IVM, and specific protein expression and activation levels in matured CC by Western blotting. Each concentration (0, 1, 10, and 100 ng mL−1) of GDF8 was added in maturation medium (TCM199) during process of IVM. Data were analysed by ANOVA followed by Duncan using SPSS (IBM Corp., Armonk, NY). Data are presented as the mean (replicate numbers) and differences were considered significant at P < 0.05. After 44 h of IVM, oocytes are mechanically denuded from CC with 0.1% hyaluronidase and only metaphase II stage oocytes are counted as nuclear matured oocytes. Each group of matured oocytes are stained by 2′,7′-dichlorodihydrofluorescein diacetate and the fluorescence was captured as graphic files under an epifluorescence microscope. The fluorescence intensities of oocytes were measured using Image J software (National Institutes for Health, Bethesda, MD). The groups treated with 10 and 100 ng mL−1 of GDF8 showed significantly more than 10% decrease in intracellular ROS levels compared with other groups (5 times). To assess the effect of GDF8 on specific gene transcription level changes as a dose response during IVM, real-time PCR was performed. In matured oocytes, the developmental competence marker POU5F1, antioxidant enzymes regulator NRF2, and antiapoptosis gene BCL-2 mRNA transcription levels were significantly increased in the 10 ng mL−1 treatment group compared with control (4 times). In CC, the 10 ng mL−1 treatment groups showed significantly higher PCNA and NRF2 mRNA levels, and the 1 and 10 ng mL−1 treatment groups observed significantly increased cumulus expansion-related genes HAS2, PTX3, and TNFAIP6 mRNA expression levels after IVM (4 times). To determine effect of GDF8 treatment during IVM, GDF8 downstream effector and oocyte ovulation-related protein expression and activation levels were analysed in CC after IVM by Western blotting. The 1 and 10 ng mL−1 treatment groups showed significantly increased phosphorylated (P)-SMAD2 (1.25 and 1.23 times increased compared with the control) and cyclic adenosine monophosphate responsive element binding protein (CREB; 1.31 and 1.32 times increased compared with the control) activation levels (4 times). In conclusion, supplementation of 10 ng mL−1 of GDF8 during IVM effectively increased the oocytes cytoplasmic maturation by reducing of intracellular ROS, and it seems correlated with significantly increased P-SMAD2, which is possibly related with induction of the cumulus cell expansion related genes expression and P-CREB while process of IVM. This work was supported by a grant from the Cooperative Research Program for Agriculture Science & Technology Development (Project No. PJ011288), Rural Development Administration, Republic of Korea.

Interferon-inducible T-cell alpha chemoattractant (ITAC) induces the melanocytic migration and hypopigmentation through destabilizing p53 via histone deacetylase 5: a possible role of ITAC in pigment-related disorders

BACKGROUND

Cell migration plays a major role in the immune response and in tumorigenesis. Interferon-inducible T-cell alpha chemoattractant (ITAC) elicits a strong chemotactic response from immune cells.

OBJECTIVES

To examine the effect of ITAC on melanocyte migration and pigmentation and its involvement in related disorders, and to investigate potential key players in these processes.

METHODS

Human melanocytes or melanoma cells were treated with ITAC and a migration assay was carried out. Global gene expression analysis was performed to find genes regulated by ITAC treatment. The function of key players involved in ITAC-induced cellular processes was addressed using knockdown or overexpression experiments in combination with ITAC treatment. ITAC expression in the inflammation-associated hypopigmentary disorder, vitiligo, was examined.

RESULTS

Among CXCR3 ligands, only ITAC induced melanocyte migration. ITAC treatment upregulated the expression of histone deacetylase 5 (HDAC5) and downregulated that of p53, a known target of HDAC5. Through knockdown or overexpression of HDAC5 and p53, we confirmed that HDAC5 mediates ITAC-induced migration by decreasing levels of p53 via deacetylation. In addition, ITAC treatment could decrease pigmentation in a p53- and HDAC5-dependent manner. Finally, the increased migration of human melanoma cells by ITAC treatment and the increased ITAC expression in the epidermis of vitiligo skin were verified.

CONCLUSIONS

This study provides in vitro evidence for the migratory and hypopigmentation effects of ITAC on melanocytic cells, gives translational insights into the roles of ITAC in pathological conditions, and suggests that HDAC5 and its substrate p53 are potent targets for regulating ITAC-induced cellular processes.

Comparison of pollutant concentrations from weekly discrete versus composite samples for residential dry-weather runoff

As urbanization has increased, so has degradation of urban streams. Urban water quality monitoring has focused on storm runoff sampling, but in arid climates, dry-weather runoff is a significant contributor of pollutants to aquatic systems. The majority of dry-weather runoff studies sample a small window of the entire dry-season. For this study constituent concentrations were compared using two sampling protocols. The first protocol repeatedly collected samples on the same day of the week at the same time of day. The second protocol collected samples during two week-long intensive sampling events consisting of sample collection every hour for 24 h for seven consecutive days. The two protocols were compared to determine if sampling at the same time of the week was representative of the entire week. For nitrate, total phosphorous, fipronil, permethrin, total organic carbon, and total suspended solids, sampling at the same time was not representative of the weekly mean; however, variability was observed between sites and constituents. For those constituent concentrations with significant differences seen between the two protocols, load adjustment factors (LAF) were determined, using a ratio of treatment means, and employed to adjust dry-season load estimates. Future work should include determining if LAF values can be used at similar sites excluded from the study or for similar constituents from the current sampling sites.

Meditation and vacation effects have an impact on disease-associated molecular phenotypes

Meditation is becoming increasingly practiced, especially for stress-related medical conditions. Meditation may improve cellular health; however, studies have not separated out effects of meditation from vacation-like effects in a residential randomized controlled trial. We recruited healthy women non-meditators to live at a resort for 6 days and randomized to either meditation retreat or relaxing on-site, with both groups compared with 'regular meditators' already enrolled in the retreat. Blood drawn at baseline and post intervention was assessed for transcriptome-wide expression patterns and aging-related biomarkers. Highly significant gene expression changes were detected across all groups (the 'vacation effect') that could accurately predict (96% accuracy) between baseline and post-intervention states and were characterized by improved regulation of stress response, immune function and amyloid beta (Aβ) metabolism. Although a smaller set of genes was affected, regular meditators showed post-intervention differences in a gene network characterized by lower regulation of protein synthesis and viral genome activity. Changes in well-being were assessed post intervention relative to baseline, as well as 1 and 10 months later. All groups showed equivalently large immediate post-intervention improvements in well-being, but novice meditators showed greater maintenance of lower distress over time compared with those in the vacation arm. Regular meditators showed a trend toward increased telomerase activity compared with randomized women, who showed increased plasma Aβ42/Aβ40 ratios and tumor necrosis factor alpha (TNF-α) levels. This highly controlled residential study showed large salutary changes in gene expression networks due to the vacation effect, common to all groups. For those already trained in the practice of meditation, a retreat appears to provide additional benefits to cellular health beyond the vacation effect.

Targeting the SIN3A-PF1 interaction inhibits epithelial to mesenchymal transition and maintenance of a stem cell phenotype in triple negative breast cancer

Triple negative breast cancer (TNBC) is characterized by a poorly differentiated phenotype and limited treatment options. Aberrant epigenetics in this subtype represent a potential therapeutic opportunity, but a better understanding of the mechanisms contributing to the TNBC pathogenesis is required. The SIN3 molecular scaffold performs a critical role in multiple cellular processes, including epigenetic regulation, and has been identified as a potential therapeutic target. Using a competitive peptide corresponding to the SIN3 interaction domain of MAD (Tat-SID), we investigated the functional consequences of selectively blocking the paired amphipathic α-helix (PAH2) domain of SIN3. Here, we report the identification of the SID-containing adaptor PF1 as a factor required for maintenance of the TNBC stem cell phenotype and epithelial-to-mesenchymal transition (EMT). Tat-SID peptide blocked the interaction between SIN3A and PF1, leading to epigenetic modulation and transcriptional downregulation of TNBC stem cell and EMT markers. Importantly, Tat-SID treatment also led to a reduction in primary tumor growth and disseminated metastatic disease in vivo. In support of these findings, knockdown of PF1 expression phenocopied treatment with Tat-SID both in vitro and in vivo. These results demonstrate a critical role for a complex containing SIN3A and PF1 in TNBC and provide a rational for its therapeutic targeting.

Novel effects of sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture: the national survey

This study compared the effects sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture. By using national survey data, we suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.

INTRODUCTION

Sarcopenia and osteoarthritis are known risk factors for metabolic syndrome. However, their combined effects on metabolic syndrome, insulin resistance and osteoporosis remain uncertain.

METHODS

We used data from the fifth Korean National Health and Nutrition Examination Survey using a total of 3158 adults (age >50 years). Sarcopenia was defined as a skeletal muscle index score (appendicular skeletal muscle mass/body weight) within the fifth percentile of sex-matched younger reference participants. Radiographic knee osteoarthritis was defined as a Kellgren-Lawrence (K-L) grade of 2 or greater. Metabolic syndrome was diagnosed using the National Cholesterol Education Program criteria. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). Osteoporosis was defined using the World Health Organization T-score criteria.

RESULTS

In multivariable logistic regression analysis, the sarcopenic osteoarthritis group had a higher odds ratio (OR) for metabolic syndrome (OR = 11.00, 95 % confidential interval (CI) = 2.12-56.99, p = 0.013) than the non-sarcopenic osteoarthritis (OR = 1.02, 95 % CI = 0.65-1.62, p = 0.972) and sarcopenic non-osteoarthritis groups (OR = 7.15, 95 % CI = 1.57-32.53, p = 0.027). Similarly, sarcopenic osteoarthritis had a greater OR of highest HOMA-IR quartiles (OR = 8.19, 95 % CI = 2.03-33.05, p = 0.003) than the other groups. Overall, the association between the K-L grade and body mass index was significant; however, this significance was lower in individuals with sarcopenia and was lost in those with sarcopenic osteoarthritis. Additionally, osteoporosis and bone fracture were not associated to sarcopenic osteoarthritis (p > 0.05).

CONCLUSIONS

These results suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.

Atopic dermatitis phenotype with early onset and high serum IL-13 is linked to the new development of bronchial hyperresponsiveness in school children

BACKGROUND

Atopic dermatitis (AD) is characterized by a heterogeneous clinical spectrum, and some forms of AD are associated with the initial steps of allergic march. The aims of this study were to determine AD phenotypes in school-age children and investigate their associations with the allergic march in each cluster.

METHODS

We included 242 children (6-8 years) with current AD from the Children's HEalth and Environmental Research study, a 4-year prospective follow-up study with 2-year survey intervals. Latent class analysis was used. Serum IL-13 and thymic stromal lymphopoietin (TSLP) levels at the time of enrollment were measured using ELISA.

RESULTS

We identified four current AD phenotypes in children, characterized as 'early onset with low atopy' (26.4% of the sample; group 1), 'early onset with high atopy and high eosinophil percentages' (48.3%; group 2), 'late onset with low atopy' (9.9%; group 3), and 'late onset with high atopy and normal eosinophils' (15.3%; group 4). Although groups 2 and 4 demonstrated high atopic burden, children in group 2 showed the persistence of AD and eosinophilia associated with a high prevalence of new cases of bronchial hyper-responsiveness and asthma symptoms during follow-up. The serum IL-13 level was significantly increased in the early-onset AD groups, but there was no significant difference in the serum TSLP levels across all four groups.

CONCLUSION

An allergic march-associated AD phenotype exists that is characterized by early onset of AD with its persistence, increased serum IL-13 levels, high atopy, and a persistently increased blood eosinophil percentage.

Creatine kinase enzyme level correlates positively with serum creatinine and lean body mass, and is a prognostic factor for survival in amyotrophic lateral sclerosis

BACKGROUND AND PURPOSE

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative condition for which there is no single diagnostic test or biomarker. The level of the creatine kinase (CK) enzyme in serum may be mild to moderately elevated in some patients with ALS, the precise cause of which and its behaviour with disease progression is unknown. The aim of this study was to examine the usefulness of monitoring CK serially during the ALS disease trajectory and to determine whether CK levels mirror disease progression.

METHODS

This was a prospective observational cohort study, using the clinical database of the olesoxime (TRO19622) investigational medicinal product trial.

RESULTS

The baseline CK was raised in 52% of the trial participants with the mean CK ± SD being 257 ± 239 U/l. The mean CK was significantly higher in male participants than in female participants (P < 0.001) and amongst participants with limb onset ALS compared to participants with bulbar onset ALS (P < 0.001). There was no significant difference in the CK levels between upper limb and lower limb onset disease (P = 0.746). The CK level co-related positively with serum creatinine and estimated lean body mass but there was no relationship between CK and muscle scores and limb function. A higher CKlog was associated with significantly better survival, even when adjusted for prognostic co-variants (P = 0.013).

CONCLUSIONS

The serum CK level seems to be an independent prognostic factor for survival in ALS. The cellular mechanism of CK enzyme suggests that it may be upregulated to provide energy in the face of metabolic stress in ALS.

Calcium and Vitamin D Use among Older Adults in U.S.: Results from National Survey

OBJECTIVE

This study was conducted to describe a 10-year trend of the supplement from 2000 to 2009 and to evaluate age, gender and racial disparities using a national level health data.

DESIGN

Cross-sectional observational study.

SETTING AND PARTICIPANTS

Data collected from patient visit records to stand-alone US ambulatory care clinics. Visits made by men and women who were 40 years of age and older were included (n=175,830).

MEASUREMENTS

Overall prevalence of recorded calcium and vitamin D use for osteoporosis prevention and treatment, and annual visit rates were estimated by age, gender, race, insurance types, physician specialties, geographical regions, and metropolitan status using chi square test. Multivariate logistic regression was conducted to determine potential predictive factors for calcium and vitamin D supplements.

RESULTS

An increase in yearly trend of calcium and vitamin D supplements was observed. The increase was proportional to patients' age (p<0.05) and female gender was a strong predictor of calcium and vitamin D supplement (p<0.0001).Visits made by blacks were significantly less likely to be associated with the supplement (<0.05). Visits associated with self-pay and Medicaid was less likely to be recorded with vitamin D (p<0.05) but not calcium supplements. Osteoporosis diagnosis was an independent predictor of calcium and vitamin D records (p<0.0001).

CONCLUSIONS

In spite of the observed increases in the trend of visits associated with calcium and vitamin D supplements, variability in the access to the medications was observed. More focused strategies targeting elderly, men, or black population are needed to maintain and improve adequate calcium and vitamin D supplements.

Abstract P1-09-08: Does adverse tumour biology contribute to inferior outcomes for Indigenous Australians diagnosed with breast cancer?

Background: Analyses across multiple Australian states have consistently demonstrated significantly inferior breast cancer survival for Indigenous patients (IPs). Studies compensating for increased remoteness, socioeconomic disadvantage and later presentation demonstrate a residual unexplained detriment. This survival disadvantage is confined to the first five years, akin to the inferior outcomes demonstrated by higher risk biological breast cancer subtypes. We postulated that a preponderance of such higher risk subtypes could explain the disparate mortalities.

Methods: The distribution of breast cancer subtypes in Western Australian IPs diagnosed between 2001 and 2010 was assessed to explore the contribution of adverse prognostic subtypes to poorer outcome. This was a retrospective cohort study of Indigenous women (n=114) and 3:1 age and remoteness matched non-Indigenous women (n=310) diagnosed with invasive, non-metastatic, unilateral breast cancer, who underwent definitive local treatment. Subtypes were assigned as luminal A, B, HER2 enriched and triple negative by ER, PR, HER2 and tumour grade comparisons. Differences in basic tumour demographics and biological sub-types were analysed and racial survival discrepancies explored within biological subtype cohorts.

Results: Hazards for overall and breast cancer-specific mortality in IPs were 4.07 (95% CI 2.55-6.49) and 4.19 (95% CI 2.42-7.25). IPs were significantly more likely to have grade 3 tumours (41 v 25%, p&lt;0.001), LN positive disease (39 v 27%, p&lt;0.001) and larger tumours (median 20 v 10 mm, p&lt;0.001). No significant differences in proportions of classical histological sub-types (ductal v lobular) or in tumours showing ER, PR or HER2 positivity were observed. There were no significant differences in biological sub-type proportions although IPs were diagnosed with numerically more non-Luminal A subtypes (56 v 44%, p=0.08), accounted for by increased Luminal B (21 v 15%) and HER2 enriched (10 v 5%) sub-types. The significant relative five-year survival deficit for IPs noted overall (94 v73%, p&lt;0.0001) was observed for each sub-type with the exception of HER2 positive patients. This extended from the relatively low risk luminal A sub-type where oral anti-estrogens are the mainstay of treatment (98 v 82%, p=0.0002) to the high risk triple negative sub-type where intravenous chemotherapy is the standard adjuvant therapy (94 v 50%, p=0.0014).

Conclusions: The contribution of adverse tumour biological subtype to poorer outcomes for Indigenous women is modest. Indigenous women with almost all biological subtypes fare significantly worse than their non-Indigenous contemporaries. Ongoing work includes more detailed biological comparisons of RNA expression and DNA mutation between groups as well as an exploration of potentially disparate treatment patterns.

Citation Format: Redfern A, Lee E, Bulsara M, Threlfall T, Harvey J, Cordell D. Does adverse tumour biology contribute to inferior outcomes for Indigenous Australians diagnosed with breast cancer?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-08.

Abstract P2-02-12: Association of inflammatory and tumor markers with circulating tumor cells in metastatic breast cancer

Background: Circulating tumor cells (CTCs) are associated with prognosis in metastatic breast cancer (BC). We evaluated the association of inflammatory/tumor markers and CTCs in women with progressing metastatic breast cancer prior to commencing a new line of systemic therapy.

Methods: From February 2013 to April 2015, 96 patients with metastatic BC about to start a new treatment (due to progression), without current diabetes or use of anti-inflammatory agents, were recruited from four Ontario cancer hospitals. Women provided fasting blood for inflammatory and tumor markers and CTC measurement; CTCs were assayed within 72 hours of collection using CellSearch. Blood was frozen at -80C until assays were performed in a single batch (C-reactive protein (CRP), IL-6, PAI-1, Ca15-3, Ca125, VEGF, TNFa). Associations of CTCs with blood factors were evaluated using Pearson correlation coefficients after transforming the variables to normality. For CTCs the transformation log(x+0.5) was used. Associations with categorical variables were tested using one-way analysis of variance. P values &lt;0.05 were significant.

Results: Median age of patients was 60.5 years, 87 (90.6%) were post-menopausal, 83 (86.5%) had hormone receptor positive BC, 16 (16.7%) HER2 positive BC, 10 (10.4%) triple negative; 75 (78.1%) grade II/III. At the time of CTC measurement, bone, lung, liver and brain metastases were present in 79%, 44%, 40% and 6% of patients respectively, with 54%, 37%, 35% and 3% having progression at these sites respectively. PAI-1 and CA15-3 exceeded the limit of the assay in 11 and 5 cases respectively (the upper limit of the assay was used in the analysis). 33.4% of patients were starting first line therapy, 25% second line and 16.7% third line. CTC counts (per 7.5cc) ranged from 0 to 1238 (median 2, geometric mean 3.63); none were detected in 29 (30.2%) patients, 1 to 4 in 25 (26%) and 5 or more in 42 (43.8%) patients. CTCs were not associated with age, estrogen receptor, progesterone receptor, HER2, line of treatment, lymph-vascular invasion or tumor grade. Compared to metastatic disease at other sites, CTCs were higher in the presence of bone (p=0.027) and liver metastases (p=0.002) and with progressing bone (p=0.018) and liver (p=0.012) metastases. CTCs were significantly associated with CRP (R =0.25, p=0.014), IL-6 (R=0.31, p=0.002), PAI-1 (R=0.31, p=0.002), Ca15-3 (R=0.44, p=&lt;0.0001) and Ca 125 (R=0.21, p=0.04) but not with VEGF and TNFa (R = 0.11, p= 0.29 and R = 0.16, p=0.11, respectively).

Conclusion: CTCs were associated with bone and liver metastases and with higher levels of inflammatory and tumor markers, potentially reflecting tumor burden. Additional inflammatory marker assays are underway. Future studies are warranted to confirm these findings.

Citation Format: Lohmann AE, Chang M, Dowling RJO, Ennis M, Amir E, Elser C, Brezden-Masley C, Vandenberg T, Lee E, Fazae K, Stambolic V, Goodwin PJ. Association of inflammatory and tumor markers with circulating tumor cells in metastatic breast cancer. [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 P2-02-12.

Abstract P2-02-09: Obesity associated factors are inversely associated with circulating tumor cells in metastatic breast cancer

Background: Elevated levels of circulating tumor cells (CTCs) are associated with adverse outcomes in metastatic breast cancer (BC). However, relationships between CTCs and various patient-related factors that may impact outcome remain undefined. Consequently, associations of CTC counts with obesity and metabolic factors were evaluated in order to gain insight into potential interactions between patient physiology and disease burden. We hypothesized that obesity and associated metabolic factors would be associated with higher CTC counts.

Methods: Non-diabetic women with metastatic BC beginning a new line of treatment due to progressive disease were recruited from four Ontario cancer hospitals between February 2013 and April 2015. Patients provided blood for CTC analysis, which was completed within 72 hours of collection using the Janssen CellSearch platform. Fasting serum was also collected for assessment of metabolic factors including glucose (mmol/L), insulin (pmol/L), leptin (ng/mL) and adiponectin (ng/mL). Associations of CTC counts with these factors, as well as anthropometric measurements (height (cm), weight (kg), BMI (kg/m2)) were evaluated using Pearson correlation coefficients after transforming the variables involved to normality. For CTC counts, the log transformation with half integer correction was used.

Results: 96 patients with a median age of 60.5 years completed the study. Most were post-menopausal (87, 90.6%) and exhibited grade II/III tumors (75, 78.1%). The majority of patients had hormone receptor positive disease (83, 86.5%), but 16.7% (16) were HER2 positive and 10.4% (10) were triple negative. The number of CTCs observed ranged from 0 to 1238 (median 2, geometric mean 3.63). No CTCs were detected in 29 patients (30.2%), whereas 25 patients (26 %) exhibited counts of 1 to 4 CTCs and 42 (43.8%) had 5 or more CTCs. CTCs were not significantly associated with tumor characteristics including ER/PgR, HER2, grade, stage (T/N) or lymphovascular invasion. The number of CTCs inversely correlated with BMI (r=-0.26, p=0.01), leptin (r=-0.29, p=0.004), and leptin-adiponectin ratio (r=-0.3, p=0.004). A similar trend that approached significance was noted for body weight (r=-0.19, p=0.07), insulin (r=-0.19, p=0.06) and homeostatic model assessment (HOMA, an estimate of insulin resistance, r=-0.2, p=0.055). Conversely, adiponectin (r=0.18, p=0.07) and height (r=0.18, p=0.07) were positively associated with CTC counts in correlations that neared significance. No associations were observed for age (r=0.09, p=0.4) or glucose (r=-0.09, p=0.4).

Conclusions: Obesity associated metabolic factors including weight, BMI, insulin, HOMA and leptin were inversely associated (and adiponectin and height positively associated) with CTC counts. These patterns are consistent with weight loss and/or cachexia in women with elevated CTC counts who have higher disease burden. Additional analyses are underway to further characterize these associations and include assessment of serum albumin, free fatty acids, creatine kinase and hepcidin.

Citation Format: Dowling RJO, Chang MC, Lohmann AE, Ennis M, Amir E, Elser C, Brezden-Masley C, Vandenberg T, Lee E, Fazaee K, Stambolic V, Goodwin PJ. Obesity associated factors are inversely associated with circulating tumor cells in metastatic breast cancer. [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 P2-02-09.

Cilostazol Improves Developmental Competence of Pig Oocytes by Increasing Intraoocyte Cyclic Adenosine Monophosphate Level and Delaying Meiotic Resumption

Cilostazol (CLZ) is a cyclic adenosine monophosphate (cAMP) modulator that influences the steady state of the meiotic stage. This study was conducted to determine the effects of CLZ treatment during in vitro maturation (IVM) on developmental competence of pig oocytes. Immature oocytes were exposed to 0 (control), 0.5, 2 and 4 μm CLZ during the first 22 h of IVM. Nuclear maturation, intraoocyte glutathione content and embryo cleavage after parthenogenesis (PA) and somatic cell nuclear transfer (SCNT) were not influenced by CLZ at any concentrations. However, 4 μm CLZ significantly (p < 0.05) improved blastocyst formation after PA (52.1% vs 38.7-46.0%) and SCNT relative to other concentrations (40.8% vs 25.0-30.7%). The mean cell numbers of SCNT blastocysts were significantly increased by 4 μm CLZ compared to the control (42.6 cells vs 35.3 cells/blastocyst). CLZ treatment significantly increased the intraoocyte cAMP level and effectively arrested oocytes at the germinal vesicle (GV) and GV break down stages compared to the control (74.5% vs 45.4%). Our results demonstrated that improved developmental competence of PA and SCNT pig embryos occurred via better synchronization of nuclear and cytoplasmic maturation induced by increased cAMP and delayed meiotic resumption after CLZ treatment.

58 EFFECT OF LYSOPHOSPHATIDIC ACID ON PORCINE OOCYTE IN VITRO MATURATION AND SUBSEQUENT EMBRYONIC DEVELOPMENT AFTER PARTHENOGENETIC ACTIVATION AND IVF

Lysophosphatidic acid (LPA) is a signalling molecule derived from phospholipid, known to have biological activities such as stimulating cell proliferation, differentiation, and migration. The purpose of this study was to investigate the effect of LPA on in vitro maturation (IVM) of porcine oocytes and subsequent embryonic development after in vitro fertilization (IVF) and parthenogenetic activation (PA). We examined nuclear maturation, intracellular glutathione (GSH), and reactive oxygen species (ROS) levels and subsequent embryonic development after IVF in porcine oocytes matured in TCM-199 media containing either 0, 10, 30, or 60 μM LPA (No. of cultured oocytes 225, 225, 230, and 226, respectively). All data were compared for all groups using one-way ANOVA, followed by Duncan’s multiple range test. After 44 h of IVM, no significant difference was observed for nuclear maturation from the different (0, 10, 30, and 60 μM) LPA treatment groups (86.61, 87.48, 92.97, and 88.69%, respectively) compared with the control (P < 0.05). The 30 μM LPA treated group exhibited a significant (P < 0.05) increase in intracellular GSH levels and decrease in intracellular ROS levels compared with other LPA-treated groups. Oocytes matured with 30 μM LPA during IVM had significantly (P < 0.05) higher cleavage rates after PA (88.50%) than other LPA-treated groups (79.42, 83.87, and 83.65%, respectively). Blastocyst formation rates following PA increased up to 30 μM LPA, but the rates decreased in the 60 μM LPA-treated group (49.64, 53.28, 57.00, and 51.09%, respectively). However, a statistical difference was not observed (P < 0.05). Upon evaluation of embryonic competence following IVF, treatment with 30 μM LPA during IVM significantly increased cleavage rates (70.44%; P < 0.05) compared with 0 and 60 μM LPA-treated groups (61.51 and 65.27%, respectively). Blastocyst formation rates improved with increasing concentrations of LPA up to 30 µM; however, the rates decreased in the 60 μM LPA-treated group (26.34, 30.10, 33.26, and 27.77%, respectively). However, like the preceding PA blastocyst formation rates, a statistical difference was not observed (P < 0.05). In conclusion, treatment with 30 μM LPA during IVM improved the developmental potential of PA and IVF porcine embryos by increasing the intracellular GSH level, thereby decreasing the intracellular ROS level during oocyte maturation. This work was supported, in part, by a grant from the Cooperative Research Program for Agriculture Science & Technology Development (Project No. PJ011077, PJ011288), Rural Development Administration, and the National Research Foundation of Korea Grant funded by the Korean Government (NRF-2013R1A2A2A04008751). These are the results of a study from the Leaders INdustry-University Cooperation Project 2015-B-0013–010118, supported by the Ministry of Education, Republic of Korea.

208 EFFECT OF GDF8 AND SB-431542 ON PORCINE OOCYTE DURING IN VITRO MATURATION AND SUBSEQUENT EMBRYONIC DEVELOPMENT

Growth differentiation factor-8 (GDF8) is a member of the transforming growth factor-β that has been identified as a strong physiological regulator. SB-431542 (SB) is a specific inhibitor of transforming growth factor-β superfamily type I activin receptor-like kinase (ALK) receptors such as ALK4, ALK5, and ALK7. The purpose of this study is investigation of the effects of GDF8 and SB on porcine oocytes during in vitro maturation and subsequent embryonic development. We first performed ELISA to detect GDF8 concentrations in follicular fluid for each size of follicle; sizes were as follows: small (<3 mm), medium (>3 mm and <6 mm), and large (>6 mm) follicle. After detection of the GDF8 concentration in follicular fluid, we investigated the effect of GDF8 and SB treatment during in vitro maturation (IVM) on nuclear maturation, intracellular glutathione (GSH), and reactive oxygen species (ROS) levels, and embryonic development after IVF and parthenogenetic activation (PA). Data were analysed by ANOVA followed by Duncan using SPSS (Statistical Package for Social Science, IBM, New York, NY, USA) mean ± SEM. The ELISA result showed different concentrations of GDF8 for each grade of follicular fluid: small, 0.479 ng mL–1; medium, 0.668 ng mL–1; and large, 1.318 ng mL–1. During the IVM process, 1.318 ng mL–1 of GDF8 and 5 ng mL–1 of SB were added to the maturation medium as control, SB, SB+GDF8, and GDF8 treatment groups. After 44 h of IVM, GDF8 group (90.4%) showed a significantly higher nuclear maturation rate than control and SB+GDF8 groups (85.4 and 81.7%). The SB group (78.9%) showed significantly reduced nuclear maturation rate compared with control (P < 0.05). The GDF8 treatment group showed a significant decreased intracellular ROS and increased GSH levels compared with other groups (P < 0.05). The SB+GBF8 treatment group showed a significantly better cytoplasmic maturation than the SB treatment group. In the PA embryonic development analysis, the GDF8 treatment group showed a significantly higher blastocyst formation rate compared with other groups (47.9, 37.2, 46.4, and 58.7% respectively; P < 0.05). In the IVF embryonic development analysis, the GDF8 treatment groups showed significantly higher blastocyst formation rate compared with the SB group (28.2 and 42.2%, respectively; P < 0.05). In conclusion, treatment with GDF8 during porcine oocyte IVM improved the embryonic developmental competence via increased cytoplasmic maturation and led to better oocyte maturation from the ALK receptor inhibition by SB.