Production of S-adenosyl-L-methionine by Saccharomyces cerevisiae cells carrying a gene for ethionine resistance

A gene for ethionine resistance isolated from the yeast Saccharomyces cerevisiae DKD-5D-H conferred on the yeast cells resistance to seleno-L-methionine and capability to produce S-adenosyl-L-methionine in the cells. An enzymatic study of the L-methionine synthetic pathway of L-methionine proto- and auxotrophs and in dried yeast cells with or without the gene suggested that the cloned gene for ethionine resistance is responsible for the activity of S-adenosyl-L-methionine synthase. To produce S-adenosyl-L-methionine by yeast cells transformed with the ethionine resistance gene, some culturing conditions were determined.

Ros production by endogenously generated Protoporphyrin IX in murine leukemia cells

Endogenous production of Protoporphyrin IX (PpIX) is successfully exploited for photodynamic therapy (PDT) on malignant cells, following 5-aminolevulinic acid (ALA) administration and light irradiation. This treatment kills cancer cells by damaging organelles and impairing metabolic pathways via cellular reactive oxygen species (ROS) generation. We studied the efficiency of PpIX synthetized from ALA on ROS generation, in the Vincristine resistant (LBR-V160), Doxorubicin resistant (LBR-D160) and sensitive (LBR-) murine leukemia cell lines. Cells were incubated 4 hr with 1 mM ALA and then irradiated during different times with fluorescent light. One hour later, production of ROS was analyzed by flow cytometry using different fluorescent probes: Hydroethidine (HE) for superoxide anion, 2',7' Dichlorodihydrofluorescein diacetate (DCFH-DA) for hydrogen peroxide; mitochondrial damage was examined with 3,3' Dihexyloxacarbocyanine iodide (DiOC6). We found that superoxide anion production in the three cell lines increased with irradiation time whereas no peroxide hydrogen was detected. Mitochondrial damage also increased in an irradiation time dependent manner, being higher in the Vincristine resistant line. Previous studies have demonstrated that apoptotic cell death increased with irradiation time, which is consistent with these results, indicating that ROS are critical in ALA-PDT efficiency to kill malignant cells.

Endogenous and exogenous porphyrins as photosensitizers in the Hep-2 human carcinoma cell line

The photodynamic activity of three photosensitizers (PS): AL-induced PPIX, the porphyrin derivative 5-(4-trimethylammoniumphenyl)-10, 5, 20-tris (2,4,6- trimethoxyphenyl) porphyrin (CP) and the molecular dyad porphyrin-C(60) (P-C(60)), the last two incorporated into liposomal vesicles, was evaluated on Hep-2 human larynx carcinoma cell line. ALA-induced accumulation of the endogenous PS PPIX, reached saturation values between 5 and 24 h incubation time; the maximal PPIX content was 5.7 nmol/106 cells. The same intracellular level was accumulated when the cationic porphyrin CP was used, while the amount of P-C(60) attained was 1.5 nmol/106 cells. Under violet-blue exciting light, the fluorescence of PPIX and P-C(60) was found in the cytoplasm showing a granular appearance indicating lysosomal localization. CP was mainly detected as a filamentous pattern characteristic of mitochondrial localization. No dark cytotoxicity was observed using 1mM ALA, 5 microM CP and 1 microM P-C(60) after 24 h incubation. Cell morphology was analyzed using Hoechst-33258, toluidine blue staining, TUNEL assay and DNA fragmentation, 24 h after irradiation with 54 J/cm2. When photosensitized with ALA and P-C(60), chromatine condensation characteristic of apoptotic cell death was found; instead, 58 % of necrotic cells were observed with CP. The results show that in the Hep-2 cells, of the three PS analyzed, the molecular dyad P-C(60) was more efficient than CP and PPIX, and confirm that PDT can induce different mechanisms of cell death depending on the PS and the irradiation dose.

Effects of aerobic exercise training on brain structure and psychological well-being in young adults

AIM

There is convergent evidence that exercise increases psychological well-being; however, the mechanism of this psychological effect of exercise is not yet completely understood. The purpose of this study was to examine the effects of aerobic exercise training on brain structure and psychological well-being in young adults.

METHODS

University students who had not regularly exercised were divided into training group (N.=15) and control group (N.=15). The training group performed a total 30 periods of aerobic exercise training, while the control group never performed. Whole-brain magnetic resonance imaging scans and mental health questionnaire examinations were performed before and after the exercise training period for all of the participants. A voxel-based morphometry (VBM) analysis was used to compare the changes in gray-matter volumes in the two groups. VBM is an objective whole-brain technique for characterization of regional cerebral volume and tissue concentration differences in structural magnetic resonance images.

RESULTS

The results of VBM analysis revealed no change in gray-matter volume in the training group, although the gray-matter volume of the left insula was significantly decreased in the control group after the exercise training period. The training group exhibited significant improvement in some scores on the mental health questionnaire after the exercise training period, compared with the control group.

CONCLUSIONS

These findings suggest that aerobic exercise training may inhibit gray-matter volume loss in the insula, and that a relationship may exist between preservation of insula gray-matter and improvement of psychological well-being by aerobic exercise training.

Cisplatin + irinotecan versus cisplatin + etoposide in extensive stage small cell lung cancer (E-SCLC): Final “common arm”: Comparative outcomes analysis of JCOG 9511 and SWOG 0124

8027

Background: S0124 was a large North American phase III trial (n=651) that failed to confirm a survival benefit for cisplatin/irinotecan over cisplatin/etoposide in patients with E-SCLC, contrary to the results of J9511, a phase III trial exclusively in Japanese patients (n=154). As S0124 and J9511 protocols used identical treatment regimens and similar eligibility criteria, we compared demographics, toxicity, and outcomes using patient-level data and a “common arm” analysis to explore potential reasons for the divergent results. Methods: In both trials, patients with documented E-SCLC and adequate end-organ function were randomized to receive either cisplatin 60 mg/m2 day 1 + irinotecan 60 mg/m2 days 1, 8, & 15 Q 4 weeks or cisplatin 80 mg/m2 day 1 + etoposide 100 mg/m2 days 1–3 Q 3 weeks. Demographics and outcomes data were compared among 805 patients enrolled in J9511 and S0124 receiving identical treatment using a logistic model adjusted for age, sex, and performance status. Results: Of 671 patients in S0124, 651 were eligible. Patient characteristics (J9511 & S0124, respectively): Mean age - 61 & 62 years; Male sex - 132 (86%) & 370 (57%), p<0.001; Performance status 0 - 19 (12%) & 211 (32%), p<0.001. Efficacy and toxicity comparisons are summarized below. Conclusions: Significant differences in patient demographics, toxicity, and efficacy exist between J9511 and S0124 populations. These results, relevant in the current era of clinical trials globalization, warrant 1) consideration of differential patient characteristics and outcomes amongst populations receiving identical therapy; 2) utilization of the “common arm” model in prospective trials; and 3) inclusion of pharmacogenomic correlates in cancer trials where ethnic/racial differences in drug disposition are expected.

[Table: see text]

[Table: see text]

Phase II study of gemcitabine chemotherapy alone for locally advanced pancreatic carcinoma: JCOG 0506

e15578

Background: Fluorouracil (5-FU) chemoradiotherapy has been accepted as standard care for locally advanced pancreatic cancer (LAPC); however, it has not been shown to be superior to chemotherapy alone in gemcitabine (Gem) era. The present multicenter phase II study was conducted to evaluate the efficacy and the safety for the screening of Gem monotherapy against LAPC. Methods: Eligibility criteria included the following: patients (pts) with histologically or cytologically proven pancreatic adenocarcinoma or adenosquamous carcinoma, pts with UICC clinical stage III (T4N0–1 and M0), all lesions are assumed to be included in the radiation field of 15 cm square, age 20 or older, no prior treatment for LAPC, ECOG performance status of 0, 1 or 2, and adequate organ function. Gem was given intravenously at a dose of 1,000 mg/m2 over 30 minutes on days 1, 8 and 15, repeated every 4 weeks until disease progression. The primary endpoint was %1-year overall survival. A sample size of 50 was required with one-sided alpha of 0.20, beta of 0.10, expected %1-year survival of 40% and threshold %1-year survival of 25%. Results: Between Jan. 06 and Feb. 07, 50 pts from 14 institutions were registered. Patient characteristics were: median age; 67.5 (45–80), male/female; 35/15, PS 0/1/2; 30/20/0, pancreatic head/body-tail; 26/24. The major grade 3–4 adverse events were neutropenia (62%), leucopenia (32%), thrombocytopenia (18%), fatigue (12%), infection-biliary tree (10%), anorexia (8%), and nausea (6%). Hematological toxicity was mostly transient and there was no episode of infection with grade 3–4 neutropenia. There were no treatment-related deaths during the study. Serum CA 19–9 level was reduced by >50% in 37.5% of 40 pts with baseline CA19–9 >100U/ml. Up to the final follow-up in Apr. 08, the median overall survival was 1.25 years (95% CI, 1.06–1.71 years) with a %1-year survival of 64.8% (95% CI, 49.6–76.4%), and the null hypothesis (%1-y survival=25%) was rejected (p<0.0001). Conclusions: Gem monotherapy demonstrated far better survival than historical data of 5-FU chemoradiotherapy in LAPC pts with mild toxicities. In future randomized trial, we will select Gem chemotherapy as a referential arm to compare with the chemoradiotherapy regimen which is under phase II evaluation for LAPC.

No significant financial relationships to disclose.

Treatment-related deaths (TRD) in investigator-initiated cancer cooperative group trials: From the datasets of 44 studies (4,964 patients) by the Japan Clinical Oncology Group (JCOG)

6632

Background: The proportion of Serious Adverse Events (SAE) including TRDs has a critical impact on choosing a new standard therapy as well as the efficacy of treatment in clinical trials. The proportion of TRD (%TRD) has been reported in a single clinical trial, but an overall % TRD in plural clinical trials has merely been evaluated so far. Methods: The JCOG trials which met both of the following criteria were included in this analysis: i) started after 1995 by 2008, ii) primary analysis was completed. In JCOG, attribution of all reported SAE are classified by Data and Safety Monitoring Committee into 5 categories (definite, probable, possible, unlikely, not related) according to causality to protocol treatment, and the death with causality judged as definite, probable, or possible is defined as TRD. The total number of any deaths and TRD were counted in all included trials and the incidences (%) of TRD were calculated. The association between %TRD and the following trial profiles was evaluated: arm (standard vs. testing), phase, modality and median survival time of each arm. Results: In total, 44 JCOG trials (67 arms) with 4,964 patients were included in the analysis. The number of all deaths and TRD were 2,974 and 60. Thus, the overall %TRD for all enrolled patients was 1.2% (95%CI, 0.9–1.6%), and %TRD among all deaths was 2.0% (95%CI, 1.5–2.6%). Major results of the association between %TRD and trial profiles are shown in the table. The later phase trials showed the lower %TRD, and the trials with shorter MST tended to have higher %TRD. Conclusions: When the trial is in earlier phase and includes more advanced disease, the trial should be planned and performed more carefully about minimization of patient risk.

[Table: see text]

No significant financial relationships to disclose.

Updated results of randomized phase III study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG 9912)

4514

Background: We reported the primary results of JCOG9912 in ASCO 2007. In the planning, this study with 230 patients (pts) per arm had 80% power to demonstrate 10% superiority of CP and non-inferiority with 5% margin (HR=1.16) of S-1 at 6 months in overall survival (OS) and 0.05 study-wise 1-sided alpha. Primary analysis was conducted in Feb 2007, one year after the last patient accrual with 601 deaths (85%) of all randomized 704 pts. S-1 showed statistically significant non-inferiority to 5-FU (p<0.001), but after adjusting for multiplicity either S-1 or CP failed to show statistically significant superiority to 5-FU (CP, hazard ratio (HR)=0.85 (95% CI, 0.70–1.04), p=0.055 and S-1, HR=0.83 (0.68–1.01), p=0.034). Methods: The survival information of all surviving 103 pts at the primary analysis was updated in Apr 2008 when 660 pts (94%) were dead. An updated analysis and multivariate analyses with Cox proportional hazard model were conducted. The multivariate analysis model included arms, sex, age, tumor status (unresectable/recurrent), PS, the number of metastatic sites, target lesion (TL), macroscopic type, histological type and peritoneal dissemination. Results: The updated results are shown in Table . OS curves and HRs remained almost identical to the previous report. Multivariate analyses showed that number of metastatic sites (≥2), PS (≥1), presence of TL were associated with worse survival, and that the adjusted HRs of CP and S-1 were 0.79 (0.65–0.95, p=0.014) and 0.80 (0.66–0.96, p=0.017), respectively. There was no significant interaction among baseline factors and treatment arms. Conclusions: The updated results reconfirmed the primary conclusion that S-1 monotherapy can be a new standard regimen for advanced gastric cancer, and suggest that CP is still worthy for further clinical investigation.

[Table: see text]

[Table: see text]

Randomized phase III study of 5-fluorouracil continuous infusion (5FUci) versus methotrexate and 5-FU sequential therapy (MF) in gastric cancer with peritoneal metastasis (JCOG0106)

4545

Background: Gastric cancer (GC) with peritoneal metastasis (PM) often complicates ascites or intestinal stenosis and the prognosis is still poor. Anti-cancer drugs generally can not be administered for such patients (pts) due to the risk of serious and prolonged adverse events. However, 5FU-based chemotherapy is reportedly relatively safe for PM. We conducted a phase III study to investigate the superiority of MF over 5FUci for GC with PM with a primary endpoint of overall survival (OS) and secondary endpoints of toxicities, ingestion-possible survival (IPS) in pts with initially possible ingestion and proportion of ingestive improvement (%II) in pts requiring nutrition support. Methods: Eligibility criteria included pts with histologically proven gastric adenocarcinoma; inoperable or recurrent GC; PM with radiologically confirmed intestinal stenosis or ascites; 20–75 years old; PS 0–2; no prior treatment except surgery or adjuvant chemotherapy. Treatment with 5FUci (800mg/m2/d, civ, d1–5, q4w) or MF (methotrexate, 100mg/m2, iv, followed 3 h later by 5FU, 600mg/m2, iv, with leucovorin rescue, q1w) were continued until disease progression or unacceptable toxicities. Projected sample size was 236 in total, which had 80% power to detect 40% increase of median OS in MF with 1-sided alpha 0.05. Results: A total of 237 pts were randomized between Oct 2002 and Apr 2007. Final analysis was performed in Dec 2008 when 224 pts (95%) were dead. Results of OS are shown in Table . Median IPS was 8.1M for 5FUci(n=102) and 9.0M for MF(n=103) (p=0.60). %II was 41%(7/17) for 5FUci and 57%(8/14) for MF (p=0.48). Frequencies (%) of grade 4 neutropenia, grade >3 febrile neutropenia, infection with neutropenia, anemia, anorexia, diarrhea, abdominal pain within 6M, and treatment related death (5-FUci/MF) were 0/9, 0/3, 0/5, 10/16, 27/34, 1/10, 5/10 and 2/1, respectively. Conclusions: MF could not become new standard therapy for GC with PM.

[Table: see text]

No significant financial relationships to disclose.

Stress assessment in acute care department nurses by measuring interleukin-8

BACKGROUND

Cytokines, such as interleukin (IL)-8, have been shown to be related to depressive symptoms or inflammatory diseases and may be useful as stress biomarkers.

AIM

This study was to assess whether urinary IL-8 levels were reliable indicators of stress among acute care department (AD) nurses.

METHODS

A total of 118 nurses participated in the study. Urinary IL-8 levels of 49 AD nurses were compared with levels of a control group of 69 chronic care department (CD) nurses.

RESULTS

The urinary IL-8 levels of AD nurses, who reported a higher level of professional stress, were higher than the levels of CD nurses (P < 0.01).

CONCLUSION

Measurement of urinary IL-8 may be an appropriate biomarker for stress assessment in nurses.

Histologic examination of two cases of cystosarcoma phylloaes with pulmonary metastases

BACKGROUND

Cystosarcoma phyllodes (CP) is a rare neoplasm of the breast. Many studies of the histology of CP have been reported. However, few reports have included an evaluation of the histologic appearance of pulmonary metastases, or the change in histologic grade as a function of time in patients with recurrent tumors.

METHODS

We treated two patients with pulmonary metastases, CP from 1973 to 1995. One patient died of respiratory failure. The other underwent six operations for CP. We evaluated the histologic characteristics of these metastases and changes in the histologic grade of recurrent tumors.

RESULTS

The primary lesions in these two cases were typical high-grade malignant tumors. Case 1 had multiple pulmonary metastases and histologic findings indicated typical malignant CP. Case 2 had a solitary pulmonary metastasis and histologic findings showed low-grade malignant CP, which could be resected. The first patient died of respiratory failure ten months after surgery. The second had no further pulmonary metastases although she had frequent local recurrences, and the histologic features of these tumors became progressively worse.

CONCLUSION

We suggest that patients with malignant CP be followed closely and that when pulmonary metastases are detected, they should be resected if possible, because pulmonary metastatic tumors may represent lower-grade malignant CP.