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Abstract
Traditional methods for cancer treatment have been aimed at killing the cancer cells. Unfortunately this approach all too often is accompanied by harmful killing of normal cells. The present paper describes an experimental program in our laboratory in which cancer cells are treated so as to revert to normal cell behavior. This process, which we have named reverse transformation, appears to offer considerable hope in the treatment of a large number of malignancies.
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2
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Morrison RF, Seidel ER. Cell spreading and the regulation of ornithine decarboxylase. J Cell Sci 1995; 108 ( Pt 12):3787-94. [PMID: 8719885 DOI: 10.1242/jcs.108.12.3787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to investigate the effect of cell spreading on the induction of ornithine decarboxylase and the rate of putrescine uptake in anchorage-dependent and anchorage-independent cells. Plating non-transformed IEC-6 epithelial cells at high versus low cell density restricted cell spreading from 900 microns 2 to approximately 140 microns 2, blunted the transient induction of ornithine decarboxylase activity from 202 to 32 pmol 14CO2/mg protein per hour and reduced the rate of [14C] putrescine uptake from 46 to 23 pmol/10(5) cells per hour. The mean spreading area of the cell population was controlled by coating tissue culture dishes with the nonadhesive polymer, polyHEMA. Ornithine decarboxylase activity and putrescine uptake correlated with cell spreading with minimal spreading (263 microns 2) corresponding to an 83% decrease in ornithine decarboxylase activity and 51% decrease in the rate of putrescine uptake. Adding the RGD peptide, Gly-Arg-Gly-Glu-Ser-Pro to the medium of sparsely plated cells resulted in rapid reductions in cell spreading concomitant with dose-dependent decreases in ornithine decarboxylase activity and putrescine uptake. Finally, minimizing cell spreading by depriving cells of substratum contact completely abolished serum-induced increases in ornithine decarboxylase and reduced the rate of putrescine uptake by 47%. In contrast to IEC-6 cells, ornithine decarboxylase of neoplastic HTC-116 cells was constitutively expressed with basal and stimulated activity (193 and 982 pmol 14CO2/mg protein per hour, respectively) completely independent of cell adhesion. Putrescine uptake, however, was abolished in the absence of cell adhesion. These data suggest that the induction of ornithine decarboxylase activity and the rate of putrescine uptake correlate with spreading of anchorage-dependent IEC-6 cells and that ornithine decarboxylase activity but not putrescine uptake, appears to be independent of spreading of neoplastic HTC-116 cells.
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Affiliation(s)
- R F Morrison
- Department of Physiology, East Carolina University School of Medicine, Greenville, North Carolina 27858, USA
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3
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Robinson A. Encomium: Theodore Puck, a life in biophysics applied to medicine. AMERICAN JOURNAL OF MEDICAL GENETICS 1994; 53:264-73. [PMID: 7856663 DOI: 10.1002/ajmg.1320530312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- A Robinson
- University of Colorado Health Sciences Center, National Jewish Center for Immunology and Respiratory Medicine, Eleanor Roosevelt Institute, Denver
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Haag MM, Krystosek A, Arenson E, Puck TT. Reverse transformation and genome exposure in the C6 glial tumor cell line. Cancer Invest 1994; 12:33-45. [PMID: 8281464 DOI: 10.3109/07357909409021391] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Reexpression of growth control and differentiation in response to physiological inducers can be demonstrated in some malignant cell lines, showing that they are not irreversibly transformed. This switch in phenotype is likely to reflect a changing pattern of gene expression, but it has not been known whether such cellular transitions involve major or only minor modulation of chromatin structure. We have studied growth control and accessibility of chromatin to DNase I in C6 glioma cells subjected to different growth regimens using an in situ nick translation assay to label the most exposed regions of nuclear chromatin. In fibroblasts and primary glia, exposed chromatin was localized mainly at the nuclear lamina. This readily labeled DNA structure was largely lacking in the malignant C6 glioma. When C6 cells were treated with dibutyryl cyclic AMP, exposed chromatin was reestablished around the nuclear periphery. This restoration of a normal genome exposure pattern required cytoskeletal integrity. Thus large-scale nuclear reorganization events proceed in parallel with phenotypic normalization. The changes in cell morphology, growth control, cytoskeletal organization, and chromatin exposure and localization are similar to the reverse transformation reaction in CHO-K1 cells, which is also regulated by the cyclic nucleotide system. Hydrocortisone and dexamethasone also restored genome exposure in C6 but less markedly than cAMP derivatives. Diverse transformed cells can thus respond to growth control stimuli with similar nuclear restructuring events, which presumably underlie changes in gene expression. Reverse transformation and redifferentiation appear to be alternative terms describing essentially the same biological phenomenon.
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Affiliation(s)
- M M Haag
- Cytogenetics Laboratory, Children's Hospital, Denver, Colorado 80218
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5
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Abstract
The reverse transformation reaction whereby malignant cells are restored to a more normal phenotype has been reviewed. The primary causative action is ascribed to the genome exposure reaction in which a peripheral nuclear DNA region is restored to high sensitivity to DNase I, like that in normal cells. Various aspects of genome exposure around the nucleoli and the nuclear periphery are considered. The special role of the cytoskeleton in regulating exposure resulting in normal differentiation on the one hand and malignant transformation on the other is discussed. The action of the two-level system for regulation of the mammalian genome previously proposed is reviewed in relation to normal differentiation and malignancy with brief indication of roles played by various metabolites, transcription factors, protooncogenes, cell organelles, and processes like specific phosphorylation and dephosphorylation. Possible implications for cancer therapy and prevention and for the fields of genetic disease and toxicology are indicated.
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Affiliation(s)
- T T Puck
- Eleanor Roosevelt Institute, Denver, Colorado 80206
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Puck TT, Krystosek A. Role of the cytoskeleton in genome regulation and cancer. INTERNATIONAL REVIEW OF CYTOLOGY 1992; 132:75-108. [PMID: 1555922 DOI: 10.1016/s0074-7696(08)62454-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- T T Puck
- Eleanor Roosevelt Institute for Cancer Research, Denver, Colorado 80206
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Puck TT, Krystosek A, Chan DC. Genome regulation in mammalian cells. SOMATIC CELL AND MOLECULAR GENETICS 1990; 16:257-65. [PMID: 2193404 DOI: 10.1007/bf01233362] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A theory is presented proposing that genetic regulation in mammalian cells is at least a two-tiered effect; that one level of regulation involves the transition between gene exposure and sequestration; that normal differentiation requires a different spectrum of genes to be exposed in each separate state of differentiation; that the fiber systems of the cell cytoskeleton and the nuclear matrix together control the degree of gene exposure; that specific phosphorylation of these elements causes them to assume a different organizational network and to impose a different pattern of sequestration and exposure on the elements of the genome; that the varied gene phosphorylation mechanisms in the cell are integrated in this function; that attachment of this network system to specific parts of the chromosomes brings about sequestration or exposure of the genes in their neighborhood in a fashion similar to that observed when microtubule elements attach through the kinetochore to the centromeric DNA; that one function of repetitive sequences is to serve as elements for the final attachment of this fibrous network to the specific chromosomal loci; and that at least an important part of the calcium manifestation as a metabolic trigger of different differentiation states involves its acting as a binding agent to centers of electronegativity, in particular proteins and especially phosphorylated groups, so as to change the conformation of the fiber network that ultimately controls gene exposure in the mammalian cell. It would appear essential to determine what abnormal gene exposures and sequestrations are characteristic of each type of cancer; which agonists, if any, will bring about reverse transformation; and whether these considerations can be used in therapy.
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Affiliation(s)
- T T Puck
- Eleanor Roosevelt Institute for Cancer Research, Denver, Colorado 80206
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Chan D, Goate A, Puck TT. Involvement of vimentin in the reverse transformation reaction. Proc Natl Acad Sci U S A 1989; 86:2747-51. [PMID: 2539599 PMCID: PMC286995 DOI: 10.1073/pnas.86.8.2747] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
An organized cytoskeleton is required for the cAMP-induced reverse transformation reaction in CHO-K1 cells. In the course of the reaction a considerable fraction of the genome changes its nuclease sensitivity. The current paper presents the following evidence that cAMP-induced phosphorylation of vimentin is an early step in this reaction complex. (i) Vimentin is only slightly phosphorylated in transformed CHO-K1 cells but is heavily phosphorylated in normal fibroblasts. (ii) cAMP addition almost triples the vimentin phosphorylation of CHO-K1 cells but does not change that of normal cells. (iii) Vimentin phosphorylation is one of the earliest phenomena to occur after addition of cAMP to CHO-K1 cells, preceding the cell-stretching reaction and other manifestations of reverse transformation. (iv) Indirect immunofluorescence experiments demonstrate that vimentin appears as a condensed mass in transformed CHO-K1 cells but cAMP addition restores the filamentous structure characteristic of the normal fibroblast. (v) Other transformed cells unresponsive to reverse transformation by cAMP failed to demonstrate increased phosphorylation of vimentin on treatment with cAMP. These results support the proposed scheme that phosphorylation of cytoskeletal elements initiates a large-scale genetic regulatory action in which a substantial change in the spectrum of genome exposure and sequestration occurs. A function for intermediate filaments in reverse transformation is implied.
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Affiliation(s)
- D Chan
- Eleanor Roosevelt Institute for Cancer Research, Denver, CO 80206
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Ashall F, Sullivan N, Puck TT. Specificity of the cAMP-induced gene exposure reaction in CHO cells. Proc Natl Acad Sci U S A 1988; 85:3908-12. [PMID: 2836864 PMCID: PMC280329 DOI: 10.1073/pnas.85.11.3908] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Previous studies demonstrated that in the transformed CHO (Chinese hamster ovary) cell a substantial part of the genome behaves as though its genes are sequestered from effective contact with soluble constituents of the intracellular fluid. The reverse transformation reaction, initiated by cAMP derivatives, causes this cell to regain the morphology, growth regulation, surface characteristics, and sensitivity of its DNA to digestion by DNase I that are characteristic of normal fibroblasts. In this paper we show that this action of cAMP is gene specific. In examination of 47 different genetic loci, some, like ribosomal RNA genes, are found to be sensitive to DNase I hydrolysis both in the absence and in the presence of cAMP; some are resistant under both conditions; and some are resistant in the untreated cell but become sensitive after cAMP treatment. Unlike other gene exposure reactions, which are irreversible and connected with differentiation phenomena, that produced by cAMP is readily reversed when the reagent is removed. A sequence of events is observed after cAMP treatment, the first of which is reorganization of the cytoskeleton. Afterwards, metabolic changes occur over periods as long as 72 hr. The cAMP-induced cytoskeleton-mediated gene exposure reaction appears to be an important genetic regulatory mechanism in mammalian cells and to have special implications for cancer.
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Affiliation(s)
- F Ashall
- London School of Hygiene and Tropical Medicine, England
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Anderson HL, Puck TT, Shera EB. Apparatus for direct counting of beta-rays from two-dimensional protein gels: measurement of changes in protein synthesis due to changes in density of Chinese hamster ovary cells. Proc Natl Acad Sci U S A 1987; 84:4749-53. [PMID: 3474622 PMCID: PMC305182 DOI: 10.1073/pnas.84.14.4749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A method is described for scanning two-dimensional protein gels that utilizes direct counting of beta-rays instead of autoradiography. The methodology is compared with autoradiographic results and data are presented demonstrating changed patterns of protein synthesis accompanying changes in cell density. The method is rapid and permits identification of differences in protein abundance of approximately 10% for a substantial fraction of the more prominent proteins. A modulation effect of greater than 5 standard deviations is shown to occur for an appreciable number of the proteins that accompany the inhibition of cell growth due to contact inhibition. The method promises application to a variety of biochemical and genetic problems designed to delineate changes in protein synthesis accompanying changes in genome, molecular environment, history, and state of differentiation of the cell populations studied.
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Puck TT. Genetic regulation of growth control: role of cyclic AMP and cell cytoskeleton. SOMATIC CELL AND MOLECULAR GENETICS 1987; 13:451-7. [PMID: 2842878 DOI: 10.1007/bf01534947] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- T T Puck
- Lita Annenberg Hazen Laboratory for the Study of Human Development, Denver, Colorado
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Miyashita K. Inhibition by cytochalasin B of DNA synthesis in a thermosensitive anchorage-independent growth mutant. J Cell Physiol 1987; 131:99-106. [PMID: 2437133 DOI: 10.1002/jcp.1041310115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
After a shift from a nonpermissive to a permissive temperature, synchronized DNA synthesis and cell division were observed in a cold-sensitive anchorage-independent growth mutant (cs-17-25) of Chinese hamster lung cells in Methocel culture. Only 15 min exposure to the permissive temperature was sufficient for induction of DNA synthesis in the cells. A low dose of actinomycin D (0.02 micrograms/ml) or cytochalasin B (5 micrograms/ml) was able to inhibit the DNA synthesis when added at an early period after the temperature shift. The inhibitory effects of actinomycin D and cytochalasin B on RNA and protein synthesis were very similar at both temperatures. The degree of multinucleation caused by cytochalasin B was altered quickly depending on the incubation temperature. These results suggest that stimulation of this mutant involves an obligatory actin-mediated step closely correlated to transcription of early mRNAs.
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Affiliation(s)
- A M Otto
- Department of Biochemistry, St. George's Hospital Medical School, London, England
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Kempski O, Wroblewska B, Spatz M. Effects of forskolin on growth and morphology of cultured glial and cerebrovascular endothelial and smooth muscle cells. Int J Dev Neurosci 1987; 5:435-45. [PMID: 2845720 DOI: 10.1016/0736-5748(87)90021-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The present experiments were designed to evaluate the effectiveness of forskolin on cAMP production, growth and morphology on cell cultures of glia, endothelium and smooth muscle derived from brain microvessels. Forskolin significantly increased formation of cAMP and decreased incorporation of thymidine in all three cell types. The thymidine incorporation was reduced dose-dependently with maximal growth inhibition at 100 microM forskolin. A 1 hr preincubation with forskolin abolished thymidine incorporation by cells grown in fetal calf serum (FCS)-containing media over the following 24 hr. In cerebromicrovascular endothelium and smooth muscle, forskolin caused drastic and immediate changes of cell morphology and F-actin composition that were reversible. In glial cells, morphological changes were visible only after exposure to forskolin for more than 24 hr. These changes were accompanied by increased staining with antibodies against glial fibrillary acidic protein (GFAP). These findings support the contention of cAMP involvement in growth regulation of these cells and indicate that forskolin might be used as a tool to induce growth arrest and possible differentiation in cell cultures from mammalian brain.
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Affiliation(s)
- O Kempski
- LNNS, NINCDS, National Institutes of Health, Bethesda, MD 20892
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Perchellet JP, Posey TD, Owen MD. Comparison of the inhibitory effects of diverse amino acids and amino acid analogs on 12-O-tetradecanoylphorbol-13-acetate-induced ornithine decarboxylase activity in isolated epidermal cells. BIOCHIMICA ET BIOPHYSICA ACTA 1985; 844:182-92. [PMID: 3970979 DOI: 10.1016/0167-4889(85)90089-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
At a concentration of 1.25 mM, 14 amino acids were capable of inhibiting the induction of ornithine decarboxylase (L-ornithine carboxy-lyase, EC 4.1.1.17) activity by the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) in isolated epidermal cells. The greatest percentages of inhibition of TPA-induced epidermal ornithine decarboxylase activity were as follows: cysteine, 98%; tryptophan, 74%; methionine, 64%; phenylalanine, 51%; glycine, 44%; asparagine, 43%; glutamic acid, 42%; leucine, 40%; and arginine, 39%. These amino acid treatments did not alter the time- and concentration-response curves for induction of ornithine decarboxylase activity by TPA. Moreover, there was no difference between the rates at which [3H]arginine, [3H]leucine, [3H]phenylalanine, [3H]methionine, [3H]tryptophan and [14C]cysteine were taken up by freshly isolated epidermal cells or incorporated into epidermal proteins. Arginine, phenylalanine and methionine inhibited the induction of ornithine decarboxylase activity by the tumor promoter to degrees comparable to those elicited by their analogs canavanine and homoarginine, beta-2-thienyl-DL-alanine, and ethionine, respectively. These amino acids and amino acid analogs did not alter the overall rate of protein synthesis. In contrast, both the amino acids and their analogs increased the rates of proteolysis in isolated epidermal cells, an effect which correlated well with the abilities of these different compounds to inhibit TPA-induced ornithine decarboxylase activity. Moreover, both methionine and phenylalanine decreased the half-life and increased the rate of heat denaturation of the TPA-induced enzyme, a result identical to that obtained after treatment with the analogs ethionine and beta-2-thienyl-DL-alanine, respectively. Taken together, these results suggest that millimolar concentrations of exogenous amino acids might induce the synthesis of abnormal proteins and nonfunctional enzymes. Therefore, it is speculated that the uptake of unbalanced amounts of amino acids into the epidermal target cells might alter the stability and the ultrastructure of the TPA-stimulated enzyme just as the amino acid analogs do.
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Schulz WA, Gebhardt R, Mecke D. Dexamethasone restores hormonal inducibility of ornithine decarboxylase in primary cultures of rat hepatocytes. EUROPEAN JOURNAL OF BIOCHEMISTRY 1985; 146:549-53. [PMID: 2857644 DOI: 10.1111/j.1432-1033.1985.tb08686.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Induction of ornithine decarboxylase by various hormones was studied in quiescent primary cultures of adult rat hepatocytes maintained in a chemically defined medium. The following results were obtained: Enzyme activity rose transiently during the first day of cultivation in hormone-untreated cells. During this phase, insulin increased ornithine decarboxylase activity. Inducibility by insulin was maintained for more than 40 h only after pretreatment with 0.1 microM dexamethasone. Enzyme activity could be induced by 1 nM insulin and peaked after 7 h. Inducibility by glucagon and growth hormone required pretreatment with the glucocorticoid hormone. Ornithine decarboxylase activity was maximal 5 h after glucagon addition. Concentrations down to 0.1 nM were effective. Pretreatment with dexamethasone was most effective, when the hormone was present during the first 20 h of cultivation. The effect of the glucocorticoid during the pretreatment phase was diminished by colchicine and to a lesser extent by cytochalasine B. We suggest that part of the permissive effect of dexamethasone could be mediated by changes in the cytoskeleton and the function of hormone receptors. The fact that induction of ornithine decarboxylase was exerted by several hormones despite the absence of cell proliferation and DNA synthesis may indicate that polyamine biosynthesis has an important role in the quiescent hepatocyte.
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Ashall F, Puck TT. Cytoskeletal involvement in cAMP-induced sensitization of chromatin to nuclease digestion in transformed Chinese hamster ovary K1 cells. Proc Natl Acad Sci U S A 1984; 81:5145-9. [PMID: 6089178 PMCID: PMC391654 DOI: 10.1073/pnas.81.16.5145] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The cAMP-induced reverse transformation of CHO-K1 cells, which restores fibroblastic morphology, normal nuclear structure, specific membrane structures and biochemical activities, and cell growth regulation, also restores the sensitivity of nuclear chromatin digestion by DNase I to that resembling the normal fibroblast. All of these aspects of the reverse-transformation reaction require integrity of the cytoskeleton. The nuclease-sensitivity effect is achieved only when the entire cell rather than the isolated nucleus is incubated with cAMP derivatives, indicating linkage between the cytoskeleton and nuclear components. Evidence is presented to show that the DNA sensitization to digestion involves interaction between DNA and other chromatin components and affects different regions of the genome in specific ways. Normal fibroblasts display greater endogenous nuclease activity than the transformed cell. The data are interpreted in terms of a genetic regulatory system extending from the membrane to the nucleus and utilizing the cAMP-induced cytoskeleton.
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Abstract
The naturally-occurring polyamines exist in the free form, as N-acetyl derivatives and bound to protein. Their biosynthesis is subject to sensitive control, particularly of ornithine decarboxylase. This enzyme may be multifunctional and a key regulatory protein. Studies, principally with selective inhibitors, have elucidated the roles of polyamines in cell proliferation. Oxidized polyamines, in contrast, can be potent mitotic inhibitors. These effects are reviewed in terms of their chemistry and biochemistry. Their principal distinctions are that they can be made or degraded intracellularly, they can associate electrostatically with macromolecules by means of their spaced cationic groups, and these can be readily converted to covalent bonds.
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Abstract
Four members of a Gardner's syndrome family had rectal and colon polyposis treated with nonsteroid anti-inflammatory drugs. Three of these patients had had subtotal colectomy and ileoproctostomy and the residual polyps arose in the rectal mucosa. The polyps almost completely disappeared when sulindac was administered. Indomethacin therapy over the course of a preceding year was ineffective in one of these patients. One patient (case 4) had diffuse polyposis in an intact colon. After sulindac therapy for a year, only three small mucosal polyps could be identified by air contrast barium enema and colonoscopic examination. These observations confirm those of Pollard and Luckert [1,2] on rats with chemically induced polyposis of the intestinal tract.
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Otto AM, Jimenez de Asua L. Microtubule-disrupting agents can independently affect the prereplicative period and the entry into S phase stimulated by prostaglandin F2 alpha and fibroblastic growth factor. J Cell Physiol 1983; 115:15-22. [PMID: 6220020 DOI: 10.1002/jcp.1041150104] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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