Treatment of Eyelid Epithelial Neoplasm by Targeting Sonic Hedgehog Signaling: An Experimental Study

Targeting the sonic hedgehog pathway in keratocystic odontogenic tumor

Keratocystic odontogenic tumors (KCOT) may occur sporadically or associated with the nevoid basal cell carcinoma syndrome. It is a benign aggressive tumor of odontogenic epithelial origin with a high rate of recurrence. A primary human keratocystic odontogenic tumor cell population, KCOT-1, has been established from a tumor explant culture. The KCOT-1 cells were characterized by growth rate, gene expression profiles of major tooth enamel matrix proteins (EMPs), amelogenin (AMELX), enamelin (ENAM), ameloblastin (AMBN), amelotin (AMTN), tumor-related proteins enamelysin (MMP-20), kallikrein-4 (KLK-4), and odontogenic ameloblast-associated protein (ODAM) using quantitative real-time reverse transcription-polymerase chain reaction. Cytokeratin 14 (CK14) was examined by immunohistochemistry. In addition, expression of the members of the sonic hedgehog (SHH) pathway, SHH, patched (PTCH-1), smoothened (SMO), GLI-1, and GLI-2 and of the NOTCH signaling pathway, NOTCH-1, NOTCH-2, NOTCH-3, JAG-2 (Jagged-2), and Delta-like-1 (DLL-1) were evaluated. KCOT-1 cells were treated with SMO antagonist cyclopamine. We found that cyclopamine significantly arrested the growth of KCOT-1 cells in a dose-dependent manner and that the effects of cyclopamine were abolished by adding SHH protein. The protein expression of the SHH pathway was down-regulated by cyclopamine, further confirming that cyclopamine inhibits the SHH signaling pathway; SHH down-regulation correlated with the down-regulation of the NOTCH signaling pathway as well. In conclusion, using an established KCOT-1 cell population, we characterized the gene expression profiles related to the EMPs, SHH, and NOTCH signaling pathway and confirmed that cyclopamine significantly arrested the growth of KCOT-1 cells and may be a viable agent as a novel therapeutic.

Sonic hedgehog expression and its role in form-deprivation myopia in mice

PURPOSE

To investigate whether sonic hedgehog (Shh) plays a role in postnatal eye development and the development of experimentally induced myopia.

METHODS

Expression of Shh, Patched-1 (Ptc-1), and Gli3 was evaluated in the eyes of 13- to 14-day-old C57B/L6 mice with form-deprivation myopia (FDM) (n = 100) and controls (n = 100) using real-time PCR and Western blot analysis. In a second experiment, 336 mice were divided into two groups: the first wore a unilateral translucent diffuser to induce myopia and the second served as a control. Both groups received four intravitreal injections of either Shh-N (Sonic hedgehog amino-terminal peptide) or cyclopamine (a specific inhibitor of the Shh pathway) every other day. Retinoscopic refraction and axial length measurements were performed on the 11th day of form deprivation. Sections of the eyes were observed using a light microscope.

RESULTS

Inducing myopia caused a significant increase in expression of Shh mRNA (7 days: t = 6.09, p = 0.004; 14 days: t = 3.48, p = 0.025) and protein (7 days: t = 4.06, p = 0.015; 14 days: t = 4.25, p = 0.013). Expression of both Gli3 mRNA (t = 7.61, p = 0.002) and protein (t = 2.89, p = 0.045) increased after 7 days of occlusion. Administration of Shh-N stimulated the development of myopia and axial growth in both occluded (refraction: F = 7.49, p = 0.001; axial length: F = 9.89, p < 0.001) and non-occluded eyes (refraction: F = 14.20, p < 0.001; axial length: F = 20.37, p < 0.001). Cyclopamine reduced myopic refractive error and axial elongation in occluded eyes (refraction: F = 27.91, p < 0.001; axial length: F = 15.18, p < 0.001). It also influenced non-occluded eyes, reducing axial growth and shifting the refraction toward hyperopia (refraction: F = 14.81, p < 0.001; axial length: F = 3.99, p = 0.024). No difference in retinal thickness was found between experimental and control eyes.

CONCLUSIONS

The Shh signaling pathway may influence both form-deprivation myopia and the postnatal growth of eyes with normal visual input.

[Precancerous and early invasive carcinomas: non-surgical treatment of head and facial skin]

Chronic exposure to sunlight with its high proportion of high energy ultraviolet light is the main cause of the common cutaneous precancerous lesions and carcinomas of the head and neck. This causes a field cancerization effect frequently with multiple actinic keratoses (AKs), basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). Although demonstrating the best cure rates and lowest recurrence rates, surgical excision rapidly progresses to its limits. Field cancerization requires field therapy. Non-specific caustic agents may remove superficial lesions, however, the modern therapeutic modalities such as topical cytotoxic treatment with 5-fluorouracil, photodynamic therapy with 5-aminolevulinic acid (ALA) or its methyl ester (MeALA), the topical immune response modifier imiquimod or the local application of the cyclooxygenase inhibitor diclofenac are more specific and effective. Intralesional and perilesional injections of cytotoxic agents and interferons as well as the new targeted anti-cancer drugs are further alternatives. The most important aspect, however, is the prophylaxis of chronic photodamage.