Serum hyaluronic acid and laminin as potential tumor markers for upper gastrointestinal cancers

Inverted Pyramid Nanostructures Coupled with a Sandwich Immunoassay for SERS Biomarker Detection

Cancer diagnostics often faces challenges, such as invasiveness, high costs, and limited sensitivity for early detection, emphasizing the need for improved approaches. We present a surface-enhanced Raman scattering (SERS)-based platform leveraging inverted pyramid SU-8 nanostructured substrates fabricated via nanoimprint lithography. These substrates, characterized by sharp apices and edges, are further functionalized with (3-aminopropyl)triethoxysilane (APTES), enabling the uniform self-assembly of AuNPs to create a highly favorable configuration for enhanced SERS analysis. Performance testing of the substrates using malachite green (MG) as a model analyte demonstrated excellent detection capabilities, achieving a limit of detection as low as 10-12 M. Building on these results, the SERS platform was adapted for the sensitive and specific detection of hyaluronic acid (HA), a key biomarker associated with inflammation and cancer progression. The system employs a sandwich immunoassay configuration, with substrates functionalized with antibodies to capture HA molecules and 4-MBA-labeled SERS tags for detection. This setup achieved an ultra-sensitive detection limit of 10-11 g/mL for HA. Comprehensive characterization confirmed the uniformity and reproducibility of the SERS substrates, while validation in complex biological matrices demonstrated their robustness and reliability, highlighting their potential in cancer diagnostics and biomarker detection.

The diagnostic utility of glycosaminoglycans (GAGs) in the early detection of cancer: a systematic review

Background

Glycosaminoglycans (GAGs) are a family of polysaccharides found abundantly in the extracellular matrix (ECM) of tissues. Research has indicated that the dysregulation of ECM, including changes and disruptions in GAGs, contributes to various cancer hallmarks such as metabolic reprogramming, persistent growth signals, immunosuppression, angiogenesis, tumor invasion, and metastasis.

Objective

This systematic review aims to evaluate the diagnostic accuracy of GAGs, including heparan sulfate (HS), chondroitin sulfate (CS), and hyaluronic acid (HA), in early detection of cancer.

Method

Four databases (PubMed, Scopus, EBSCO, and Ovid) were searched for studies in English within the last 15 years, involving at least 50 human participants. Using a two-stage process: identification and screening, 11 articles were selected and critically appraised using Critical Appraisal Skills Programme (CASP) checklists and Newcastle-Ottawa Scale (NOS) appropriate for each study design.

Result

Eleven studies met the inclusion criteria, encompassing various cancers like renal cell carcinoma (RCC), upper GI cancer (UGI), ovarian cancer, prostate cancer, breast cancer, lung cancer, colorectal cancer and oral cancer. Methodological quality was assessed using two established tools, with no studies exhibiting a high risk of bias. Heparan sulfate levels showed diagnostic potential in renal cancer with a maximum accuracy of 98.9%, achieving 94.7% specificity and 100% sensitivity. Chondroitin sulfate disaccharides emerged as a promising diagnostic marker in ovarian cancer and showed potential as diagnostic markers in renal cancer. However, there were no statistically significant differences in urinary chondroitin sulfate levels between patients and controls in prostate cancer. In breast cancer, hyaluronic acid showed moderate accuracy (AUC = 0.792) in distinguishing metastatic from non-metastatic disease, and a composite score incorporating multiple markers, including HA, showed even higher accuracy (AUC = 0.901) in detecting metastatic breast cancer. HA demonstrated moderate diagnostic accuracy for UGI cancers. Serum HA levels were significantly elevated in patients with oral cancer and pleural malignant mesothelioma and associated with tumor progression in patients with lung cancer. Elevated low molecular weight form of hyaluronan (~6 k Da HA) levels were found in colorectal cancer tissues.

Conclusion

GAGs hold potential as early cancer detection biomarkers. Further validation with larger, diverse populations is needed to validate their diagnostic accuracy and clinical utility.

Predictive value of peripheral blood leukocytes-based methylation of Long non-coding RNA MALAT1 and H19 in the chemotherapy effect and prognosis of gastric cancer

BACKGROUND

The predictive value of the methylation of Long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and H19 promoters in peripheral blood leukocytes as a non-invasive biomarker for the chemotherapy effect and prognosis gastric cancer (GC) is unclear.

METHODS

The DNA methylation of H19 and MALAT1 between chemotherapy-sensitive and non-sensitive groups and between groups with better and worse survival of GC was compared using regression analyses. Several predictive nomograms were constructed. The genetic alteration of MALAT1 and H19 and the association between gene expression and immune status in GC were also investigated using bioinformatics analysis.

RESULTS

Higher genetic methylations in peripheral blood were noticed in GC groups with poorer survival. The constructed nomograms presented strong predictive values for the chemotherapy effect and 3-year survival of disease-free survival, progression-free survival, and overall survival, with the area under the curve as 0.838, 0.838, 0.912, and 0.925, respectively. Significant correlations between MALAT1 or H19 expression and marker genes of immune checkpoints and immune pathways were noticed. The high infiltration of macrophages in H19-high and low infiltration of CD8+ T cells in MALAT1-high groups were associated with worse survival of GC.

CONCLUSIONS

MALAT1 and H19 have the potential to predict the chemotherapy response and clinical outcomes of GC.

Hyaluronic Acid Interacting Molecules Mediated Crosstalk between Cancer Cells and Microenvironment from Primary Tumour to Distant Metastasis

Hyaluronic acid (HA) is a prominent component of the extracellular matrix, and its interactions with HA-interacting molecules (HAIMs) play a critical role in cancer development and disease progression. This review explores the multifaceted role of HAIMs in the context of cancer, focusing on their influence on disease progression by dissecting relevant cellular and molecular mechanisms in tumour cells and the tumour microenvironment. Cancer progression can be profoundly affected by the interactions between HA and HAIMs. They modulate critical processes such as cell adhesion, migration, invasion, and proliferation. The TME serves as a dynamic platform in which HAIMs contribute to the formation of a unique niche. The resulting changes in HA composition profoundly influence the biophysical properties of the TME. These modifications in the TME, in conjunction with HAIMs, impact angiogenesis, immune cell recruitment, and immune evasion. Therefore, understanding the intricate interplay between HAIMs and HA within the cancer context is essential for developing novel therapeutic strategies. Targeting these interactions offers promising avenues for cancer treatment, as they hold the potential to disrupt critical aspects of disease progression and the TME. Further research in this field is imperative for advancing our knowledge and the treatment of cancer.

An Innovative Electrochemical Immuno-Platform for Monitoring Chronic Conditions Using the Biosensing of Hyaluronic Acid in Human Plasma Samples

Hyaluronic acid (HA) is the main non-sulfated glycosaminoglycan of the extracellular matrix that is synthesized by fibroblasts and other specialized connective tissue cells. The accumulation of HA on different tissues is a characteristic of disorders that are associated with progressive tissue fibrosis. HA is also known to play a critical role in tumorigenesis and tumor metastasis. It is overproduced by many types of tumors and promotes tumor progression and multidrug resistance. There is a great necessity for the development of an easy and cost-effective detection method for the monitoring of HA for both the diagnosis and efficient treatment of related disorders. In the present study, an innovative immune device was designed for the rapid and sensitive recognition of HA in human plasma samples. For this purpose, an efficient alloy (Pt@Au) was fabricated on the surface of the gold electrode. Thus, a novel substrate was used for the preparation of an efficient transducer, which is necessary for the immobilization of biotinylated antibodies. CHA was applied for the electrochemical deposition of Pt@Au nano-alloy on Au electrodes. Additionally, the morphological study of the used nanocomposite was assessed using FESEM at a working voltage of 3 kV, and the chemical structures of the electrode were analyzed using the EDS apparatus. For the first time, a biocompatible alloy-based substrate was prepared for the study of antigen–antibody identification. The developed immunosensor has a linear response within the range of 0.156–160 ng.mL−1 with a limit of detection of 0.039 ng.mL−1 in human plasma samples. This research study offers a novel promising technique for HA analyses and is anticipated to be used in the early diagnosis of some disorders related to abnormal levels of HA in human bio-fluids. Thus, a constructed (pt@Au) nano-alloy provides a useful interface for the dense loading of AB. This excellent design loads high sensations of the biosensor for the selective detection of HA in real samples (human bio-fluids).

A novel immuno-device based on the specific binding of AuNP-supported CTAB with biotinylated antibody of hyaluronic acid toward an early-stage recognition of a biomarker: a bioanalytical assay in real samples using disposal biosensor technology

Hyaluronic Acid (HA) is a non-sulfated glycosaminoglycan, which is a potential biomarker that could be evaluated in the diagnosis of some cancers. For the first time, a novel label-free electrochemical immunosensor was developed based on modified ITO-PET (indium tin oxide-polyethylene terephthalate) electrodes for the sensitive recognition of hyaluronic acid (HA) in real samples. A disposable ITO-coated PET electrode was modified with gold nanoparticles (AuNPs) to construct a suitable substrate for the efficient immobilization of biotinylated antibodies of HA. Importantly, the encapsulation of biotinylated antibody of HA in KCC1-NH-CS₂ was performed successfully, which was another innovative part of this bio-device construction. For determining the immobilization steps and optimization of the biosensor, electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) techniques were used. Furthermore, the morphological characterization of each ITO electrode surface was performed by field emission scanning electron microscopy (FESEM). Specific binding of gold nanoparticles supported CTAB to ITO-PET and its bioconjugation with the biotinylated antibody of HA was studied using the electroanalysis of the sensor performance. For the better performance of the antibody to generate an immunocomplex with HA (antigen), its encapsulation was performed, which led to the excellent behavior of the immunosensor. The proposed HA immunosensor indicated excellent reproducibility, high selectivity, and long-term stability. The HA electrochemical immunosensor performed perfectly with a wide determination range (0.078 to 160 ng mL^-1) and a low limit of quantification (0.078 ng mL^-1) in human plasma samples. It is recommended that the designed biosensor can be used as a diagnostic tool in clinical bioassays in the near future.

Roles of Proteoglycans and Glycosaminoglycans in Cancer Development and Progression

The extracellular matrix (ECM) spatiotemporally controls cell fate; however, dysregulation of ECM remodeling can lead to tumorigenesis and cancer development by providing favorable conditions for tumor cells. Proteoglycans (PGs) and glycosaminoglycans (GAGs) are the major macromolecules composing ECM. They influence both cell behavior and matrix properties through direct and indirect interactions with various cytokines, growth factors, cell surface receptors, adhesion molecules, enzymes, and glycoproteins within the ECM. The classical features of PGs/GAGs play well-known roles in cancer angiogenesis, proliferation, invasion, and metastasis. Several lines of evidence suggest that PGs/GAGs critically affect broader aspects in cancer initiation and the progression process, including regulation of cell metabolism, serving as a sensor of ECM's mechanical properties, affecting immune supervision, and participating in therapeutic resistance to various forms of treatment. These functions may be implemented through the characteristics of PGs/GAGs as molecular bridges linking ECM and cells in cell-specific and context-specific manners within the tumor microenvironment (TME). In this review, we intend to present a comprehensive illustration of the ways in which PGs/GAGs participate in and regulate several aspects of tumorigenesis; we put forward a perspective regarding their effects as biomarkers or targets for diagnoses and therapeutic interventions.

Esophageal Cancer Development: Crucial Clues Arising from the Extracellular Matrix

In the last years, the extracellular matrix (ECM) has been reported as playing a relevant role in esophageal cancer (EC) development, with this compartment being related to several aspects of EC genesis and progression. This sounds very interesting due to the complexity of this highly incident and lethal tumor, which takes the sixth position in mortality among all tumor types worldwide. The well-established increase in ECM stiffness, which is able to trigger mechanotransduction signaling, is capable of regulating several malignant behaviors by converting alteration in ECM mechanics into cytoplasmatic biochemical signals. In this sense, it has been shown that some molecules play a key role in these events, particularly the different collagen isoforms, as well as enzymes related to its turnover, such as lysyl oxidase (LOX) and matrix metalloproteinases (MMPs). In fact, MMPs are not only involved in ECM stiffness, but also in other events related to ECM homeostasis, which includes ECM remodeling. Therefore, the crucial role of distinct MMPs isoform has already been reported, especially MMP-2, -3, -7, and -9, along EC development, thus strongly associating these proteins with the control of important cellular events during tumor progression, particularly in the process of invasion during metastasis establishment. In addition, by distinct mechanisms, a vast diversity of glycoproteins and proteoglycans, such as laminin, fibronectin, tenascin C, galectin, dermatan sulfate, and hyaluronic acid exert remarkable effects in esophageal malignant cells due to the activation of oncogenic signaling pathways mainly involved in cytoskeleton alterations during adhesion and migration processes. Finally, the wide spectrum of interactions potentially mediated by ECM may represent a singular intervention scenario in esophageal carcinogenesis natural history and, due to the scarce knowledge on the cellular and molecular mechanisms involved in EC development, the growing body of evidence on ECM’s role along esophageal carcinogenesis might provide a solid base to improve its management in the future.

Diagnostic accuracy of glycoproteins in the assessment of liver fibrosis: A comparison between laminin, fibronectin, and hyaluronic acid

BACKGROUND/AIMS

Liver fibrosis is a chronic liver injury affecting numerous individuals in the world, and efforts have been exercised for introducing a non-invasive method to evaluate the stages of liver fibrosis, which can be used instead of invasive methods, such as a liver biopsy. Various glycoproteins have been suggested by many investigators as indicators of liver fibrosis. This study aimed to compare the diagnostic accuracy of serum laminin, fibronectin, and hyaluronic acid levels in the assessment of liver fibrosis for discriminating patients from healthy subjects.

MATERIALS AND METHODS

We searched the English language literature to identify relevant studies regarding the role of glycoproteins in the assessment of liver fibrosis, using the following electronic databases: Medline, PubMed central, web of knowledge (ISI), Scopus, Google scholar, Springer, and Science Direct from 1981 to 2016. The key words used for searching were "glycoproteins", "laminin", "hyaluronic acid", "fibronectin", "diagnostic accuracy", "assessment", "liver fibrosis", "cirrhosis", "liver biopsy", "grading", and "staging". The statistical data relevant for the diagnostic accuracy were extracted and analyzed using the summary receiver operating characteristic curves.

RESULTS

The diagnostic accuracy among the glycoproteins involved in this study were compared, and the area under curves for serum levels of laminin, hyaluronic acid, and fibronectin, as indicators of diagnostic accuracy, were 0.89, 0.82, and 0.73, respectively.

CONCLUSION

It can be concluded that when liver biopsy is contraindicated, the serum levels of laminin, hyaluronic acid, and fibronectin can be considered screening tests as well as additional clinically useful tools for the evaluation of liver fibrosis.

Genetic and molecular bases of esophageal Cancer among Iranians: an update

Abstract

Background

Esophageal cancer is one of the leading causes of cancer related deaths among the Iranians. There is still a high ratio of mortality and low 5 years survival which are related to the late onset and diagnosis. Majority of patients refer for the treatment in advanced stages of tumor progression.

Main body

It is required to define an efficient local panel of diagnostic and prognostic markers for the Iranians. Indeed such efficient specific panel of markers will pave the way to decrease the mortality rate and increase the 5 years survival among the Iranian patients via the early diagnosis and targeted therapy.

Conclusion

in present review we have reported all of the molecular markers in different signaling pathways and cellular processes which have been assessed among the Iranian esophageal cancer patients until now.

Colorectal cancer-associated ~ 6 kDa hyaluronan serves as a novel biomarker for cancer progression and metastasis

Low molecular weight hyaluronan (LMW-HA) is believed to accumulate in tumors and to exert protumor effects. This study aimed to identify colorectal cancer (CRC)-associated LMW-HA, precisely determine its MW, and elucidate its role in predicting tumor progression. The MW distribution of HA extracted from CRC and paired noncancerous tissues was evaluated. We found that the level of HA with a MW below 30 kDa was markedly elevated in CRC tissues, and we defined HA with a MW of ~ 6 kDa as CRC-associated LMW-HA. In line with this finding, ~ 6 kDa HA was significantly accumulated in cancer tissues relative to total HA, and this LMW-HA played a critical role in tumor metastasis. Moreover, serum ~ 6 kDa HA levels in CRC patients were significantly increased and positively correlated with the levels in matched cancer tissues. Elevated serum ~ 6 kDa HA levels could be used to discriminate patients with or without CRC and was associated with early relapse, advanced tumor-node-metastasis stage, lymphovascular invasion, and lymph node (LN) metastasis. Notably, serum ~ 6 kDa HA levels were significantly reduced after tumor resection. Our study suggests that ~ 6 kDa HA may serve as a new biomarker for estimating tumor progression, predicting LN metastasis, and monitoring tumor recurrence.

Gel with silver and ultrasmall iron oxide nanoparticles produced with Amanita muscaria extract: physicochemical characterization, microstructure analysis and anticancer properties

Combination therapy remains one of the most promising and intensively developed direction in cancer treatment. This study is aimed to combine and investigate the anticancer properties of silver nanoparticles (NPs) and Amanita muscaria mushroom in gel formulation. For this, hyaluronic acid was used as gel-forming agent, whereas Amanita muscaria extract was used as capping agent during silver and ultrasmall iron oxide (MAg) NPs synthesis. Amanita muscaria compounds formed NP's surface layer and contributed anticancer properties, whereas silver NPs contributed anticancer, fluorescence and photoactive properties to the gel. Physicochemical characterization included X-ray diffraction (XRD), microscopies (SEM, cryo-SEM, TEM, confocal fluorescence), spectrofluorometric method, thermogravimetric analysis (TGA), dynamic light scattering (DLS) techniques, energy dispersive (EDS), Fourier transform infrared (FTIR) and ultraviolet-visible (UV-Vis) spectroscopies, zeta-potential and rheological measurements. Microstructure analysis of hyaluronic acid/MAg NPs gel was performed by cryo-SEM technique. We showed that hyaluronic acid is a perfect gel-forming agent from both biomedical and technological points of view. It is well-mixed with MAg NPs forming stable gel formulation; high homogeneity of hyaluronic acid/MAg NPs gel was shown by SEM EDS elemental mapping. Microstructure of the gel was found to be highly ordered and consisted of domains from perforated parallel tubular structures. This finding expanded our understanding of gels and broke the stereotype of gel structure as chaotic network of fibers. Cytotoxicity studies performed on 2D and 3D HeLa cell cultures pointed to a high potential of hyaluronic acid/MAg NPs gel for local treatment of cancer. Cell response was found to be significantly different for 2D and 3D cell cultures that was related to their different cytoarhitecture and gene expression. Thus, the results of the cellular spheroids viability showed that they were significantly more resistant to the cytotoxic action of MAg NPs and their gel formulation than 2D cell culture. Hyaluronic acid used as gelling agent in gel formulation was found to increase an effectiveness of active components (MAg NPs, Amanita muscaria extract) probably improving their transport inside HeLa spheroids.

Laminin α1 orchestrates VEGFA functions in the ecosystem of colorectal carcinoma

BACKGROUND INFORMATION

Tumor stroma remodeling is a key feature of malignant tumors and can promote cancer progression. Laminins are major constituents of basement membranes that physically separate the epithelium from the underlying stroma.

RESULTS

By employing mouse models expressing high and low levels of the laminin α1 chain (LMα1), we highlighted its implication in a tumor-stroma crosstalk, thus leading to increased colon tumor incidence, angiogenesis and tumor growth. The underlying mechanism involves attraction of carcinoma-associated fibroblasts by LMα1, VEGFA expression triggered by the complex integrin α2β1-CXCR4 and binding of VEGFA to LM-111, which in turn promotes angiogenesis, tumor cell survival and proliferation. A gene signature comprising LAMA1, ITGB1, ITGA2, CXCR4 and VEGFA has negative predictive value in colon cancer.

CONCLUSIONS

Together, we have identified VEGFA, CXCR4 and α2β1 integrin downstream of LMα1 in colon cancer as of bad prognostic value for patient survival.

SIGNIFICANCE

This information opens novel opportunities for diagnosis and treatment of colon cancer.

“Turn on” room-temperature phosphorescent biosensors for detection of hyaluronic acid based on manganese-doped ZnS quantum dots

Biosensors based on excellent optical properties of quantum dots (QDs) nanohybrids are efficient for biological detection. In this work, a room-temperature phosphorescent (RTP) PDAD–Mn–ZnS QDs biosensor was constructed with poly(diallyldimethylammonium chloride) (PDAD) as the modifier of MPA-capped Mn–ZnS QDs, and used to detect hyaluronic acid (HA). The newly-added HA induced severe electrostatic interaction with PDAD–Mn–ZnS QDs, leading to the aggregation between PDAD–Mn–ZnS QDs and HA and thereby enhancing RTP. The enhancement of RTP was proportional to the HA concentrations within certain ranges. On this basis, a high-performance HA sensor was built and this sensor had a detection limit of 0.03 μg mL⁻¹ and a detection range of 0.08–2.8 μg mL⁻¹. This proposed RTP sensor can avoid interferences from the background fluorescence or scattering light of the matrix that are encountered in spectrofluorometry. Thus, this biosensor is potentially suitable for detection of HA in real samples without complicated pretreatment.

Fabricating PDAD–Mn–ZnS QDs nanohybrids as a facile room-temperature phosphorescent biosensor for detection of hyaluronic acid.

Serum Hyaluronic Acid Levels Are Altered in Acute Leukemia Patients: Potential Prognostic Implications

BACKGROUND

Studies on the serum concentration of hyaluronic acid (HA) in newly diagnosed patients with acute myeloid leukemia (AML), B-acute lymphoblastic leukemia (B-ALL), and mantle-cell lymphoma (MCL) are scarce. In this study, we focused on investigating whether HA could serve as a possible prognostic marker in patients with AML, B-ALL, and MCL.

METHODS

The serum concentration of HA was measured in a total of 51 patients with newly diagnosed AML, B-ALL, and MCL. Venous blood was collected 1 day before the initiation of chemotherapy (D0), on day 16 of the first cycle of chemotherapy (D16), and on D30.

RESULTS

The serum HA concentration on D0 in patients with AML, B-ALL, and MCL was higher than in the control group. For all types of hematological malignancy, on D0, serum HA values of nonsurvivors were higher than in survivors. Moreover, patients in relapse had higher levels of serum HA than patients in remission. A strong positive correlation between serum HA and ferritin, β2-microglobulin, and lactate dehydrogenase was found.

CONCLUSION

Serum HA may serve as a possible prognostic marker for AML, B-ALL, and MCL patients, especially on D0. Prospective case-control studies on larger populations may provide further information.

Esophageal Cancer in Golestan Province, Iran: A Review of Genetic Susceptibility and Environmental Risk Factors

Esophageal squamous cell carcinoma (ESCC) is an aggressive tumor that is typically diagnosed only when the tumor has gained remarkable size, extended to peripheral tissues, and led to dysphagia. Five-year survival of advanced cancer is still very poor (19%), even with improved surgical techniques and adjuvant chemoradiation therapy. Therefore, early detection and prevention are the most important strategies to reduce the burden of ESCC. Our review will focus on the studies conducted in Golestan province, an area with a high prevalence of ESCC in northern Iran. We review three aspects of the research literature on ESCC: epidemiological features, environmental factors (including substance abuse, environmental contaminants, dietary factors, and human papillomavirus [HPV]), and molecular factors (including oncogenes, tumor suppressor genes, cell cycle regulatory proteins, and other relevant biomarkers). Epidemiological and experimental data suggest that some chemicals and lifestyle factors, including polycyclic aromatic hydrocarbons (PAHs), cigarette smoking, opium use, and hot tea drinking are associated with the development of ESCC in Golestan. HPV infects the esophageal epithelium, but so far, no firm evidence of its involvement in esophageal carcinogenesis has been provided. Some of these factors, notably hot tea drinking, may render the esophageal mucosa more susceptible to injury by other carcinogens. There are few studies at molecular level on ESCC in Golestan. Increasing awareness about the known risk factors of ESCC could potentially reduce the burden of ESCC in the region. Further studies on risk factors, identifying high risk populations, and early detection are needed.

Laminins and cancer stem cells: Partners in crime?

As one of the predominant protein families within the extracellular matrix both structurally and functionally, laminins have been shown to be heavily involved in tumor progression and drug resistance. Laminins participate in key cellular events for tumor angiogenesis, cell invasion and metastasis development, including the regulation of epithelial-mesenchymal transition and basement membrane remodeling, which are tightly associated with the phenotypic characteristics of stem-like cells, particularly in the context of cancer. In addition, a great deal of studies and reports has highlighted the critical roles of laminins in modulating stem cell phenotype and differentiation, as part of the stem cell niche. Stemming from these discoveries a growing body of literature suggests that laminins may act as regulators of cancer stem cells, a tumor cell subpopulation that plays an instrumental role in long-term cancer maintenance, metastasis development and therapeutic resistance. The accumulating evidence in this emerging research area suggests that laminins represent potential therapeutic targets for anti-cancer treatments against cancer stem cells, and that they may be used as predictive and prognostic markers to inform clinical management and improve patient survival.

Hyaluronic acid algorithm-based models for assessment of liver fibrosis: translation from basic science to clinical application

BACKGROUND

The estimation of liver fibrosis is usually dependent on liver biopsy evaluation. Because of its disadvantages and side effects, researchers try to find non-invasive methods for the assessment of liver injuries. Hyaluronic acid has been proposed as an index for scoring the severity of fibrosis, alone or in algorithm models. The algorithm model in which hyaluronic acid was used as a major constituent was more reliable and accurate in diagnosis than hyaluronic acid alone. This review described various hyaluronic acid algorithm-based models for assessing liver fibrosis.

DATA SOURCE

A PubMed database search was performed to identify the articles relevant to hyaluronic acid algorithm-based models for estimating liver fibrosis.

RESULT

The use of hyaluronic acid in an algorithm model is an extra and valuable tool for assessing liver fibrosis.

CONCLUSIONS

Although hyaluronic acid algorithm-based models have good diagnostic power in liver fibrosis assessment, they cannot render the need for liver biopsy obsolete and it is better to use them in parallel with liver biopsy. They can be used when frequent liver biopsy is not possible in situations such as highlighting the efficacy of treatment protocol for liver fibrosis.

Plasma hyaluronic acid level as a prognostic and monitoring marker of metastatic breast cancer

Conventional tumor markers have limited value for prognostication and treatment monitoring in metastatic breast cancer (MBC) patients and novel circulating tumor markers therefore need to be explored. Hyaluronic acid (HA) is a major macropolysaccharide in the extracellular matrix and is reported to be associated with tumor progression. In our study, we investigated plasma HA level with respect to progression free survival (PFS) and overall survival (OS), as well as the treatment monitoring value in MBC patients. The prognostic value of plasma HA level was investigated in a discovery cohort of 212 MBC patients with 2.5-year follow-up and validated in an independent validation cohort of 334 patients with 5-year follow-up. The treatment monitoring value of plasma HA level was investigated in 61 MBC patients from discovery cohort who had been radiographically examined after first complete cycle of chemo therapy. We found a robust association between high plasma HA level and poor prognosis of MBC patients in both discovery (pPFS = 7.92 × 10(-6) and pOS = 5.27 × 10(-5)) and validation studies (pPFS = 3.66 × 10(-4) and pOS = 1.43 × 10(-4)). In the discovery cohort, the plasma HA level displayed independent prognostic value after adjusted for age and clinicopathological factors, with respect to PFS and OS. Further, the decrease of plasma HA level displayed good concordance with treatment response evaluated by radiographic examination (AUC = 0.79). Plasma HA level displays prognostic value, as well as treatment monitoring value for MBC patients.

Engineering of lipid prodrug-based, hyaluronic acid-decorated nanostructured lipid carriers platform for 5-fluorouracil and cisplatin combination gastric cancer therapy

PURPOSE

The first-line chemotherapy treatment protocol for gastric cancer is combination chemotherapy of 5-fluorouracil (5-FU) and cisplatin (CDDP). The aim of this study was to engineer prodrug-based nanostructured lipid carriers (NLC) platform for codelivery of 5-FU and CDDP to enhance therapy and decrease toxicity.

METHODS

First, 5-FU-stearic acid lipid conjugate was synthesized by two steps. Second, 5-FU-stearic acid prodrug and CDDP were loaded in NLC. Finally, hyaluronic acid (HA) was coated onto NLC surface. Average size, zeta potential, and drug loading capacity of NLC were evaluated. Human gastric cancer cell line BGC823 (BGC823 cells) was used for the testing of in vitro cytotoxicity assays. In vivo antitumor activity of NLC was evaluated in mice bearing BGC823 cells model.

RESULTS

HA-coated 5-FU-stearic acid prodrug and CDDP-loaded NLC (HA-FU/C-NLC) showed a synergistic effect in combination therapy and displayed the greatest antitumor activity than all of the free drugs or uncoated NLC in vitro and in vivo.

CONCLUSION

This work reveals that HA-coated NLC could be used as a novel carrier to code-liver 5-FU and CDDP for gastric cancer therapy. HA-FU/C-NLC could be a promising targeted and combinational therapy in nanomedicine.

Hyaluronic Acid: from biochemical characteristics to its clinical translation in assessment of liver fibrosis

CONTEXT

Hyaluronic acid (HA) is a high molecular weight polysaccharide that is distributed in all bodily tissues and fluids. The liver is the most important organ involved in the synthesis and degradation of HA. Research has shown that liver cell injury can affect serum HA levels. In this review, authors aimed to describe the biochemical and physiological roles of this glycosaminoglycan and its changes in various liver diseases.

EVIDENCE ACQUISITION

Liver fibrosis and in more severe form, cirrhosis are results of an imbalance between fibrogenesis and fibrinolysis. Liver biopsy is the gold standard to assess liver necro inflammatory injuries. This method is invasive and has some major side effects; therefore it is an unfavorable method for both physicians and patients. Now, a wide variety of noninvasive methods have been introduced based on evaluating serum level of different markers. They are safe, readily available, and more favorable. Serum HA levels are used by some researchers to assess stages of liver fibrosis.

RESULTS

There are several scientific studies indicating HA as a biomarker for high score fibrosis and cirrhosis in various liver diseases alone or in algorithm models. It seems from various algorithm models that the use of HA as a major constituent has more diagnostic reliability and accuracy than the use of HA alone.

CONCLUSIONS

Use of HA in an algorithm model, is an extra and valuable tool for assessing liver necro inflammatory injuries- in parallel with liver biopsy- but more comprehensive studies are needed to approve the use of HA as an appropriate clinical tool.

Laminin and procollagen Ⅲ N-terminal peptide in serum and gastric juice as potential tumor markers for gastric cancer

AIM: To investigate the clinical significance of laminin (LN) and procollagen Ⅲ N-terminal peptide (PⅢNP) levels in serum and gastric juice in the diagnosis of gastric cancer.

METHODS: Fifty patients with gastric cancer, 25 patients with gastric precancerous lesions, and 46 patients with mild superficial gastritis were included in this study. The levels of PⅢNP and LN in gastric juice and serum were determined by radioimmunoassay and compared among different groups of patients.

RESULTS: The levels of PⅢNP in gastric juice and serum were significantly higher in patients with gastric cancer than in those with precancerous lesion or mild superficial gastritis (gastric juice: 40.49 μg/L ± 39.07 μg/L vs 8.49 μg/L ± 5.45 μg/L, 7.38 μg/L ± 6.13 μg/L, both P < 0.01; serum: 55.38 μg/L ± 25.13 μg/L vs 41.56 μg/L ± 18.27 μg/L, 39.89 μg/L ± 13.07 μg/L, both P < 0.05). The levels of LN in gastric juice were significantly higher in patients with gastric cancer than in patients with precancerous lesion or mild superficial gastritis (131.61 ng/mL ± 55.71 ng/mL vs 90.92 ng/mL ± 58.36 ng/mL, 80.65 ng/mL ± 59.43 ng/mL, P < 0.05, P < 0.01), and the levels of LN in serum were significantly higher in patients with gastric cancer than in patients with mild superficial gastritis (158.62 ng/mL ± 42.70 ng/mL vs 126.25 ng/mL ± 36.18 ng/mL, both P < 0.01). The sensitivity of PⅢNP and LN in gastric juice for the diagnosis of gastric cancer was 68.00% and 66.00%, respectively, and the sensitivity of combined detection of PⅢNP and LN was 86.00%. The levels of LN and PⅢNP in serum and gastric juice were higher in gastric cancer patients with lymph node metastasis than in those without metastasis. The levels of PⅢNP and LN were related to histologic grade of carcinoma, and patients with poorly differentiated adenocarcinoma had higher levels of PⅢNP and LN in serum and gastric juice than those with well differentiated adenocarcinoma.

CONCLUSION: The levels of LN and PⅢNP in serum and gastric juice can be considered as an adjunct in the diagnosis of gastric cancer.