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Yeo BSY, Yap DWT, Tan NKW, Tan BKJ, Teo YH, Teo YN, Lee A, See A, Ho HSS, Teoh JYC, Chen K, Toh ST. The Association of Obstructive Sleep Apnea with Urological Cancer Incidence and Mortality-A Systematic Review and Meta-analysis. Eur Urol Focus 2024:S2405-4569(24)00124-X. [PMID: 39089967 DOI: 10.1016/j.euf.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/16/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND AND OBJECTIVE While obstructive sleep apnea (OSA) and urological cancer are both strongly associated with hypoxia, controversy exists regarding their association with each other. This study aims to summarize and synthesize evidence to clarify the association between OSA and urological cancer incidence and mortality. METHODS According to a prespecified protocol, PubMed, Embase, Cochrane Library, and Scopus were searched from inception to November 16, 2023, for observational and randomized studies reporting the association of OSA with urological cancer incidence or mortality. We pooled maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse variance-weighted model. Two reviewers independently assessed the quality of evidence using the Newcastle-Ottawa Scale and the Grading of Recommendations, Assessment, Development and Evaluation framework. KEY FINDINGS AND LIMITATIONS From 1814 records, we included 12 studies comprising 9 290 818 participants in total, of which nine studies were analyzed quantitatively. OSA patients had an increased risk of kidney (HR: 1.75, 95% confidence interval [CI]: 1.21-2.53) and bladder (HR: 1.76, 95% CI: 1.05-2.96) cancer. However, OSA was not associated with prostate cancer incidence (HR: 1.29, 95% CI: 0.82-2.04). We systematically reviewed evidence surrounding OSA and testicular cancer incidence and urological cancer mortality. CONCLUSIONS AND CLINICAL IMPLICATIONS OSA may be associated with a higher risk of kidney and bladder cancer, but not prostate cancer. Future work may help clarify the possibility of a dose-response relationship between OSA and urological cancer, and the effect of OSA treatment on urological cancer incidence or progression. PATIENT SUMMARY This research highlights a potential longitudinal association between OSA and kidney and bladder cancer, but not prostate cancer.
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Affiliation(s)
- Brian Sheng Yep Yeo
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Dominic Wei Ting Yap
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Nicole Kye Wen Tan
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Benjamin Kye Jyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore; Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore; Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Yao Hao Teo
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Yao Neng Teo
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Alvin Lee
- Department of Urology, Singapore General Hospital, Singapore; Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore
| | - Anna See
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore; Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore; Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Henry Sun Sien Ho
- Department of Urology, Singapore General Hospital, Singapore; Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Jeremy Yuen-Chun Teoh
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Kenneth Chen
- Department of Urology, Singapore General Hospital, Singapore; Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore.
| | - Song Tar Toh
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore; Department of Otorhinolaryngology-Head & Neck Surgery, Singapore General Hospital, Singapore; Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore; SingHealth Duke-NUS Sleep Centre, Singapore.
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Shang S, Zhang L, Liu K, Lv M, Zhang J, Ju D, Wei D, Sun Z, Wang P, Yuan J, Zhu Z. Landscape of targeted therapies for advanced urothelial carcinoma. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2024; 5:641-677. [PMID: 38966172 PMCID: PMC11220318 DOI: 10.37349/etat.2024.00240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/06/2024] [Indexed: 07/06/2024] Open
Abstract
Bladder cancer (BC) is the tenth most common malignancy globally. Urothelial carcinoma (UC) is a major type of BC, and advanced UC (aUC) is associated with poor clinical outcomes and limited survival rates. Current options for aUC treatment mainly include chemotherapy and immunotherapy. These options have moderate efficacy and modest impact on overall survival and thus highlight the need for novel therapeutic approaches. aUC patients harbor a high tumor mutation burden and abundant molecular alterations, which are the basis for targeted therapies. Erdafitinib is currently the only Food and Drug Administration (FDA)-approved targeted therapy for aUC. Many potential targeted therapeutics aiming at other molecular alterations are under investigation. This review summarizes the current understanding of molecular alterations associated with aUC targeted therapy. It also comprehensively discusses the related interventions for treatment in clinical research and the potential of using novel targeted drugs in combination therapy.
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Affiliation(s)
- Shihao Shang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Kepu Liu
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Maoxin Lv
- Department of Urology, First Affiliated Hospital of Kunming Medical University, Kunming 65000, Yunnan, China
| | - Jie Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
- College of Life Sciences, Northwest University, Xi’an 710068, Shaanxi, China
| | - Dongen Ju
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Di Wei
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Zelong Sun
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Pinxiao Wang
- School of Clinical Medicine, Xi’an Medical University, Xi’an 710021, Shaanxi, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
| | - Zheng Zhu
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
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Gu JS, Ryu JW, Yu SH, Chung HS, Hwang JE, Bae WK, Ku JY, Lee CH, Ha HK, Jung SI, Hwang EC, Kwon DD. Prognostic value of the endothelial activation and stress index in patients with upper tract urothelial cancer undergoing radical nephroureterectomy. Investig Clin Urol 2022; 63:623-630. [PMID: 36347551 PMCID: PMC9643726 DOI: 10.4111/icu.20220204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/30/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The relationship with endothelial activation and stress index (EASIX), which represents the degree of endothelial dysfunction, is unwell known in upper tract urothelial carcinoma (UTUC). The present study aims to assess the prognostic value of the EASIX for recurrence-free survival (RFS) and overall survival (OS) in patients with UTUC who underwent radical nephroureterectomy (RNU). Materials and Methods We retrospectively reviewed the clinical data of 627 patients with UTUC who underwent RNU without neoadjuvant chemotherapy at three hospitals between 2002 and 2019. EASIX scores were calculated using the formula “serum lactate dehydrogenase (U/L)×creatinine (mg/dL)/platelet count (109/L)” and evaluated based on log2-transformed values. We divided the patients according to the EASIX score (>1.27 vs. ≤1.27). Results Among 627 patients, 380 were finally analyzed. Using maximally selected log-rank statistics, the optimal EASIX cutoff value was 1.27 on the log2 scale. The baseline characteristics were similar between the two groups except for age. The high EASIX score group had worse RFS and OS than the low EASIX score group (log-rank p=0.001 and p=0.006, respectively). At 5 years, the mean RFS and OS difference between the low and high EASIX score groups was 11.1 and 7.35 months, respectively. High EASIX score remained a key prognosticator of RFS and OS after RNU in multivariable analysis. Conclusions EASIX score may represent endothelial dysfunction in patients with UTUC and may serve as a readily available prognostic factor for oncologic outcomes.
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Affiliation(s)
- Jin Seok Gu
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Ji Won Ryu
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Seong Hyeon Yu
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Jun Eul Hwang
- Department of Hemato-Oncology, Chonnam National University Medical School, Hwasun, Korea
| | - Woo Kyun Bae
- Department of Hemato-Oncology, Chonnam National University Medical School, Hwasun, Korea
| | - Ja Yoon Ku
- Department of Urology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Chan Ho Lee
- Department of Urology, Inje University School of Medicine, Busan, Korea
| | - Hong Koo Ha
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, Hwasun, Korea
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Ghafouri S, Burkenroad A, Pantuck M, Almomani B, Stefanoudakis D, Shen J, Drakaki A. VEGF inhibition in urothelial cancer: the past, present and future. World J Urol 2020; 39:741-749. [PMID: 32361873 DOI: 10.1007/s00345-020-03213-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 04/11/2020] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To describe the role of anti-angiogenic agents that have been used as a treatment approach for locally advanced or metastatic urothelial cancers and to propose future directions. METHODS PubMed/MEDLINE was searched for articles related to VEGF inhibition and locally advanced or metastatic urothelial cancer. RESULTS Angiogenesis is a fundamental process for urothelial cancer initiation and progression. First-line therapy for locally advanced or metastatic urothelial cancer includes cisplatin-based chemotherapy combinations; subsequent systemic therapy includes taxanes, nanoparticle albumin-bound (nab) paclitaxel, or pemetrexed. More recently, several anti-PD-L1 and anti-PD-1 antibodies have shown promising activity in the first-line and post-platinum setting; however, immunotherapy remains ineffective in most patients. FGFR inhibitor erdafitinib was recently approved in the third-line setting. Studies on bevacizumab, pazopanib and ramucirumab have shown improved response rates when added to chemotherapy in selected patients, but have not led to overall survival (OS) benefit in randomized controlled studies. CONCLUSION Anti-angiogenic agents have shown promise in recent studies treating locally advanced or metastatic urothelial cancer. However, further work is needed to elucidate ideal treatment combinations in selected patient populations to maximize benefit, with the ultimate goal of being added to the FDA-approved treatment armamentarium for this disease.
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Affiliation(s)
- Sanaz Ghafouri
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Aaron Burkenroad
- Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Morgan Pantuck
- Lewis Katz School of Medicine, Temple University, Philadelphia, USA
| | - Bara Almomani
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | | | - John Shen
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Alexandra Drakaki
- Division of Hematology and Oncology, David Geffen School of Medicine, UCLA, Los Angeles, USA.
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Gao X, Jiang P, Zhang Q, Liu Q, Jiang S, Liu L, Guo M, Cheng Q, Zheng J, Yao H. Peglated-H1/pHGFK1 nanoparticles enhance anti-tumor effects of sorafenib by inhibition of drug-induced autophagy and stemness in renal cell carcinoma. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:362. [PMID: 31426831 PMCID: PMC6699135 DOI: 10.1186/s13046-019-1348-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 07/29/2019] [Indexed: 12/19/2022]
Abstract
Background Tumor targeting small molecular inhibitors are the most popular treatments for many malignant diseases, including cancer. However, the lower clinical response and drug resistance still limit their clinical efficacies. HGFK1, the first kringle domain of hepatocyte growth factor, has been defined as a potent anti-angiogenic factor. Here, we aimed to develop and identify novel nanoparticles—PH1/pHGFK1 as potential therapeutic agents for the treatment of renal cell carcinoma (RCC). Methods We produced a novel cationic polymer—PH1 and investigated the anti-tumor activity of PH1/pHGFK1 nanoparticle alone and its combination therapy with sorafenib in RCC cell line xenografted mice model. Then, we figured out its molecular mechanisms in human RCC cell lines in vitro. Results We firstly demonstrated that intravenous injection of PH1/pHGFK1 nanoparticles significantly inhibited tumor growth and prolonged the survival time of tumor-bearing mice, as well as synergistically enhanced anti-tumor activities of sorafenib. Furthermore, we elucidated that recombinant HGFK1 improved sorafenib-induced cell apoptosis and arrested cell cycle. In addition, HGFK1 could also decrease sorafenib-induced autophagy and stemness via blockading NF-κB signaling pathway in RCC both in vitro and in vivo. Conclusions HGFK1 could inhibit tumor growth, synergistically enhance anti-tumor activities of sorafenib and reverse its drug resistance evolution in RCC. Our results provide rational basis for clinical application of sorafenib and HGFK1 combination therapy in RCC patients. Electronic supplementary material The online version of this article (10.1186/s13046-019-1348-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoge Gao
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Pin Jiang
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Qian Zhang
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Qian Liu
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Shuangshuang Jiang
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Ling Liu
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Maomao Guo
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Qian Cheng
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China
| | - Junnian Zheng
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China. .,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China.
| | - Hong Yao
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, People's Republic of China. .,Department of Cancer Biotherapy Center, Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650118, People's Republic of China.
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Li XD, Zi H, Fang C, Zeng XT. Association between HIF1A rs11549465 polymorphism and risk of prostate cancer: a meta-analysis. Oncotarget 2018; 8:44910-44916. [PMID: 28415653 PMCID: PMC5546530 DOI: 10.18632/oncotarget.16489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/13/2017] [Indexed: 12/13/2022] Open
Abstract
The hypoxia inducible factor 1-alpha (HIF1A) gene has been suggested to play a critical role in cancer progression, and the relationship between HIF1A rs11549465 polymorphism and risk of prostate cancer has been investigated in previous studies. Nevertheless, conflicting results have been obtained. Hence, we reevaluated this issue by means of this meta-analysis, with the purpose of providing more precise conclusion on this issue. The electronic databases of PubMed, EMBASE and Chinese National Knowledge Infrastructure (CNKI) as well as other sources were searched for relevant reports concerning on the role of HIF1A rs11549465 polymorphism in the occurrence of prostate cancer. The strength of the relationship was determined by calculating odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs). Besides, subgroup analyses by ethnicity and source of control were further performed to examine this relationship. All statistical analyses were performed using STATA software 12.0. Although HIF1A rs11549465 polymorphism showed a tendency of increasing the risk of prostate cancer, no statistical significance was detected under any genetic models. Similar results were also revealed in subgroup analyses on the basis of ethnicity and control source. Our findings indicate that HIF1A rs11549465 polymorphism may not independently play a significant role in the occurrence of prostate cancer.
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Affiliation(s)
- Xiao-Dong Li
- Department of Urology, Center for Evidence-Based Medicine, Management Office of Scientific Research and Postgraduate Affairs, Huaihe Hospital of Henan University, Kaifeng, China
| | - Hao Zi
- Department of Urology, Center for Evidence-Based Medicine, Management Office of Scientific Research and Postgraduate Affairs, Huaihe Hospital of Henan University, Kaifeng, China
| | - Cheng Fang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xian-Tao Zeng
- Department of Urology, Center for Evidence-Based Medicine, Management Office of Scientific Research and Postgraduate Affairs, Huaihe Hospital of Henan University, Kaifeng, China.,Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Vainrib M, Golan M, Amir S, Dang DT, Dang LH, Bar-Shira A, Orr-Urtreger A, Matzkin H, Mabjeesh NJ. HIF1AC1772T polymorphism leads to HIF-1α mRNA overexpression in prostate cancer patients. Cancer Biol Ther 2014; 13:720-6. [DOI: 10.4161/cbt.20554] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Wang YH, Yeh SD, Wu MM, Liu CT, Shen CH, Shen KH, Pu YS, Hsu LI, Chiou HY, Chen CJ. Comparing the joint effect of arsenic exposure, cigarette smoking and risk genotypes of vascular endothelial growth factor on upper urinary tract urothelial carcinoma and bladder cancer. JOURNAL OF HAZARDOUS MATERIALS 2013; 262:1139-1146. [PMID: 23009795 DOI: 10.1016/j.jhazmat.2012.08.056] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 08/21/2012] [Accepted: 08/24/2012] [Indexed: 06/01/2023]
Abstract
Arsenic exposure and cigarette smoking are environmental risk factors for urothelial carcinoma (UC). Vascular endothelial growth factor (VEGF) is the key regulator of angiogenesis in various malignancies. This study investigates the joint effect of arsenic exposure, cigarette smoking, and VEGF polymorphisms on UC risk. This was a hospital-based case-control study consisting of 730 histopathologically confirmed UC cases, including 470 bladder cancers, 260 upper urinary tract UCs (UUTUCs), and 850 age-matched controls, recruited from September 1998 to December 2009. UC risk was estimated by odds ratios and 95% confidence intervals using unconditional logistic regression. Ever smokers with high arsenic exposure had significantly increased risks of 5.7 and 6.4 for bladder cancer and UUTUC, respectively. Moreover, ever smokers with high arsenic exposure carrying 1 or 2 risk genotypes of the VEGF gene had a significantly increased risk of 6.6 for bladder cancer and a strikingly higher risk of 9.9 for UUTUC. Additionally, UUTUC cases with high arsenic exposure carrying 1 or 2 risk genotypes of the VEGF gene had a non-significant increased risk of advanced tumor stage. Our findings suggest that arsenic exposure, cigarette smoking, and risk genotypes of VEGF contribute to a higher risk of UUTUC than of bladder cancer.
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Affiliation(s)
- Yuan-Hung Wang
- School of Public Health, Taipei Medical University, Taipei, Taiwan; Division of Urology, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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9
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Msaouel P, Nandikolla G, Pneumaticos SG, Koutsilieris M. Bone microenvironment-targeted manipulations for the treatment of osteoblastic metastasis in castration-resistant prostate cancer. Expert Opin Investig Drugs 2013; 22:1385-400. [PMID: 24024652 DOI: 10.1517/13543784.2013.824422] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Most patients with advanced prostate cancer will develop incurable bone metastasis. Although prostate cancer is the quintessential androgen-dependent neoplastic disease in males, the tumor will ultimately become refractory to androgen ablation treatment. Understanding the complex dialog between prostate cancer and the bone microenvironment has allowed the development of promising treatment strategies. AREAS COVERED The present review summarizes the pathophysiology of prostate cancer bone metastasis and provides a concise update on bone microenvironment-targeted therapies for prostate cancer. The current and future prospects and challenges of these strategies are also discussed. EXPERT OPINION A wide variety of signaling pathways, bone turnover homeostatic mechanisms and immunoregulatory networks are potential targets for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Anti-survival factor therapy can enhance the efficacy of existing treatment regimens for mCRPC by exploiting the interaction between the bone microenvironment and androgen signaling networks. In addition, many novel bone microenvironment-targeted strategies have produced promising objective clinical responses. Further elucidation of the complex interactions between prostate cancer cells and the bone stroma will open up new avenues for treatment interventions that can produce sustained cancer suppression.
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Affiliation(s)
- Pavlos Msaouel
- Jacobi Medical Center, Department of Internal Medicine, Albert Einstein College of Medicine , Bronx, NY , USA
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10
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Li P, Cao Q, Shao PF, Cai HZ, Zhou H, Chen JW, Qin C, Zhang ZD, Ju XB, Yin CJ. Genetic polymorphisms in HIF1A are associated with prostate cancer risk in a Chinese population. Asian J Androl 2012; 14:864-9. [PMID: 23042446 PMCID: PMC3720106 DOI: 10.1038/aja.2012.101] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The hypoxia-inducible factor-1α (HIF-1α) plays an important role in regulating angiogenesis, which is essential for tumor growth and metastasis. Genetic variations of HIF1A (coding HIF-1α) have been shown to influence an individual's susceptibility to many human tumors; however, evidence on associations between HIF1A single-nucleotide polymorphisms (SNPs) and prostate cancer (PCa) risk is conflicting. We genotyped three potentially functional polymorphisms in HIF1A (rs11549465, rs11549467 and rs2057482) using the TaqMan method and assessed their associations with PCa risk in a case-control study of 662 PCa patients and 716 controls in a Chinese Han population. Compared with rs11549467 GG genotype, the variant genotypes GA+AA had a significantly increased PCa risk (adjusted odds ratio (OR)=1.70; 95% confidence interval (CI)=1.06-2.72), particularly among older patients (OR=2.01; 95%CI=1.05-3.86), smokers (OR=2.06; 95%CI=1.07-3.99), never drinkers (OR=2.16; 95%CI=1.20-3.86) and patients without a family history of cancer (OR=1.71; 95%CI=1.02-2.89). Furthermore, patients with rs11549467 variant genotypes were associated with a higher Gleason score (OR=2.14; 95%CI=1.22-3.75). No altered PCa risk was associated with the rs11549465 and rs2057482 polymorphism. However, the combined variant genotypes of rs2057482 and rs11549467 were associated with increased PCa risk (OR=2.10; 95%CI=1.23-3.57 among subjects carrying three or more risk alleles). These results suggest that HIF1A polymorphisms may impact PCa susceptibility and progression in the Chinese Han population.
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Affiliation(s)
- Pu Li
- State Key Laboratory of Reproductive Medicine, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Abstract
Epithelial ovarian cancer (EOC) remains the most lethal gynecological malignancy despite several decades of progress in diagnosis and treatment. Taking advantage of the robust development of discovery and utility of prognostic biomarkers, clinicians and researchers are developing personalized and targeted treatment strategies. This review encompasses recently discovered biomarkers of ovarian cancer, the utility of published prognostic biomarkers for EOC (especially biomarkers related to angiogenesis and key signaling pathways), and their integration into clinical practice.
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Affiliation(s)
- Jie Huang
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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12
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Jiang J, Chen YQ, Zhu YK, Yao XH, Qi J. Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens. Br J Radiol 2012; 85:e979-86. [PMID: 22700257 DOI: 10.1259/bjr/63794331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study was designed to identify factors that influenced the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography (CETRUS). METHODS 139 patients suspected of prostate cancer were evaluated with CETRUS followed by systematic and targeted transrectal ultrasound-guided biopsies. The degree of enhancement of the lesions was objectively measured using peak intensity with time-intensity curve analysis software. Ultrasound findings were correlated with clinical characteristics as well as biopsy and radical prostatectomy findings. RESULTS Prostate cancers were detected in 230 biopsy sites from 91 patients. The mean peak intensity value of prostate cancer was significantly higher than that of the benign lesions (9.82 ± 3.73 vs 7.51 ± 2.97; p<0.001), and the peak intensity value of the cancer foci varied across the prostate. The mixed model analysis revealed that the location and Gleason score of tumour foci were the influencing factors of the peak intensity value, and the former had a stronger influence upon peak intensity than the latter (p=0.000 and 0.040, respectively). However, age, prostate volume or serum prostate-specific antigen of the patient had no significant influence on the peak intensity value (p>0.05). Furthermore, the peak intensity value of tumours larger than 5 mm diameter was significantly higher than tumours of 5 mm or smaller diameter (9.28 ± 2.46 vs 6.69 ± 2.65; p<0.001). CONCLUSIONS The prostate cancer lesions with a higher Gleason score and larger tumour size which were located in the lateral peripheral zone (PZ) were more likely to show a marked enhancement. Lesions with lower peak intensity that are located in the medial PZ should also be treated as suspicious.
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Affiliation(s)
- J Jiang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Huang Y, Yu J, Yan C, Hou J, Pu J, Zhang G, Fu Z, Wang X. Effect of small interfering RNA targeting hypoxia-inducible factor-1α on radiosensitivity of PC3 cell line. Urology 2011; 79:744.e17-24. [PMID: 22196409 DOI: 10.1016/j.urology.2011.10.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 10/14/2011] [Accepted: 10/14/2011] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To evaluate the effect of silencing hypoxia-inducible factor-1α (HIF-1α) expression by small interfering RNA (siRNA) on the radiosensitivity of the PC3 cell line. METHODS The expression of HIF-1α in PC3, a p53-null and androgen-independent prostate cancer cell line, was knocked down by siRNA. Irradiation was performed at 48 hours after transfection. The cells were divided into 3 groups: the PC3 group, control group (transfected with scramble siRNA), and HIF-1α silence group. HIF-1α expression was determined using real-time polymerase chain reaction and Western immunoblotting. A clonogenic assay and the cell counting kit-8 assay were performed to determine the radiosensitivity. Flow cytometry was used to assess apoptosis and cell cycle distribution. RESULTS HIF-1α siRNA downregulated HIF-1α expression in PC3 cells on the mRNA level and protein level, and its silencing effect on mRNA level was evident at 24-72 hours. The HIF-1α silence group had a low final slope of exponential part of a radiation survival curve, survival fraction of 2 Gy, quasi-threshold dose, and extrapolation number, and the sensitizing enhancement ratio was 1.24. The cell counting kit-8 assay showed decreased cellular viability (24 hours, F = 139.74, P < .01; 48 hours, F = 495.49, P < .01; 72 hours, F = 426.89, P < .01; 96 hours, F = 471.11, P < .01) in the HIF-1α silence group. Silencing HIF-1α also induced more apoptosis (PC3, 17.9% ± 1.65%; control group, 18.6% ± 1.37%; HIF-1α silence group, 29.1% ± 2.16%; F = 169.9, P < .01) and cell cycle arrest at the S, G(2)/M phase. CONCLUSION The suppression of HIF-1α in PC3 cells sensitizes the PC3 cells to irradiation. We have shown that HIF-1α inhibition attenuates repair of postradiation injury, with an increase in both interphase death and reproductive death after irradiation, apoptotic potential, and cell cycle arrest at the proliferative phase.
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Affiliation(s)
- Yuhua Huang
- Department of Urology, First Affiliated Hospital of Soozhow University, Suzhou, Jiangsu, China
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14
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Szarvas T, László V, Vom Dorp F, Reis H, Szendröi A, Romics I, Tilki D, Rübben H, Ergün S. Serum endostatin levels correlate with enhanced extracellular matrix degradation and poor patients' prognosis in bladder cancer. Int J Cancer 2011; 130:2922-9. [PMID: 21815140 DOI: 10.1002/ijc.26343] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 07/20/2011] [Indexed: 01/13/2023]
Abstract
Endostatin, the proteolytic fragment of collagen XVIII, is an inhibitor of angiogenesis and tumor growth. Interestingly, elevated circulating endostatin levels have been found to correlate with poor patients' prognosis in several cancers. The aim of this study was to assess the prognostic value of endostatin in bladder cancer (BC) and to gain insight into the mechanisms involved in its production. This retrospective study included a total of 337 patients with BC and 103 controls. Collagen XVIII gene expression was analyzed using real-time PCR (n = 82). Endostatin tissue localization was assessed by immunohistochemistry (n = 27). Endostatin serum (n = 87) and urine (n = 153) levels were determined by ELISA. In 12 cases, both serum and paraffinized tissue samples from the same patients were available. We found decreased collagen XVIII tissue expression and increased endostatin urine and serum concentration in samples of patients with BC compared to controls. High serum endostatin levels correlated with the presence of lymph node metastases and MMP-7 concentrations and were independently associated with poor metastasis-free and disease-specific survival. Immunohistochemical analysis revealed a strong endostatin staining in the wall of tumor associated blood vessels in superficial but not in muscle-invasive BCs. Based on these, we concluded that elevated endostatin levels in patients with BC are the consequence of enhanced extracellular matrix degradation and are independent from collagen XVIII expression. Furthermore, serum endostatin levels may provide prognostic information independent from histopathological parameters and may therefore help to optimize therapy decisions. Loss of endostatin expression in tumor associated blood vessels might represent an important step supporting tumor-induced angiogenesis.
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Affiliation(s)
- Tibor Szarvas
- Department of Urology, University of Duisburg-Essen, Germany.
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15
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Abstract
In the last few years, angiogenesis has confirmed its critical role in the development of malignant neoplasms. Antiangiogenic drugs, mainly bevacizumab, sorafenib, or sunitinib, are currently approved in a wide number of tumor types, such as breast, colorectal, liver, or kidney cancer, and have changed dramatically the evolution of our patients. Unfortunately, in urothelial carcinoma, which is a very common neoplasm, antiangiogenic agents are still in a very preliminary phase of clinical research. In this study, we focus on the biological basis of angiogenesis in urothelial tumors, its influence in the prognosis of these malignancies, and the available evidence about the use of antiangiogenic drugs in urothelial carcinoma.
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Nassif AE, Tâmbara Filho R. Expressão imunohistoquímica do marcador tumoral CD34 e P27 como fator prognóstico em adenocarcinoma de próstata clinicamente localizado após prostatectomia radical. Rev Col Bras Cir 2010; 37:338-44. [DOI: 10.1590/s0100-69912010000500006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 09/30/2009] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Analisar a expressão imunoistoquímica do marcador CD34 e p27, como fator prognóstico em pacientes com neoplasia de próstata localizada. MÉTODOS: Análise de 100 casos de pacientes portadores de neoplasia prostática localizada submetida à cirurgia curativa. Realizou-se o preparo histológico habitual, seguido da reação imunoistoquímica para a detecção do acúmulo da proteína CD34 e p27 seguida de análise estatística. RESULTADOS: Na avaliação do marcador P27 e na correlação com as variáveis, observou-se diferença significativa no escore de Gleason com expressão positiva (P27 positivo) relacionada com PSA médio mais baixo (p=0,091), escore de Gleason mais baixo (p<0,0001) e menor área de tumor no CD34 (p=0,036). Correlacionando-se o marcador CD34 na área tumoral observou-se quanto menor o CD34 positivo menor é o valor do PSA (p<0,0001), e menor é o escore de Gleason (r=0,5726 ; p<0,0001) e quanto maior o CD34 positivo maior é o estadiamento (r=0,3305 ; p<0,0001) e a chance de recidiva (p=0,002). Os pacientes com estadiamento mais alto, também tinham maior área CD34 positivo (p<0,0001). CONCLUSÃO: Os marcadores P27 e CD34 estão associados com os eventos próprios ao câncer de próstata; contudo, apenas o CD34 foi capaz de determinar a possibilidade de recidiva bioquímica.
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Lovisa B, Jichlinski P, Weber BC, Aymon D, van den Bergh H, Wagnières G. High-magnification vascular imaging to reject false-positive sites in situ during Hexvix® fluorescence cystoscopy. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:051606. [PMID: 21054080 DOI: 10.1117/1.3484257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Fluorescence imaging for detection of non-muscle-invasive bladder cancer is based on the selective production and accumulation of fluorescing porphyrins-mainly, protoporphyrin IX-in cancerous tissues after the instillation of Hexvix®. Although the sensitivity of this procedure is very good, its specificity is somewhat limited due to fluorescence false-positive sites. Consequently, magnification cystoscopy has been investigated in order to discriminate false from true fluorescence positive findings. Both white-light and fluorescence modes are possible with the magnification cystoscope, allowing observation of the bladder wall with magnification ranging between 30× for standard observation and 650×. The optical zooming setup allows adjusting the magnification continuously in situ. In the high-magnification (HM) regime, the smallest diameter of the field of view is 600 microns and the resolution is 2.5 microns when in contact with the bladder wall. With this cystoscope, we characterized the superficial vascularization of the fluorescing sites in order to discriminate cancerous from noncancerous tissues. This procedure allowed us to establish a classification based on observed vascular patterns. Seventy-two patients subject to Hexvix® fluorescence cystoscopy were included in the study. Comparison of HM cystoscopy classification with histopathology results confirmed 32∕33 (97%) cancerous biopsies and rejected 17∕20 (85%) noncancerous lesions.
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Affiliation(s)
- Blaise Lovisa
- Ecole Polytechnique Fédérale de Lausanne, Medical Photonics Group, Station 6, and CHUV University Hospital, Department of Urology, CH-1015 Lausanne, Switzerland
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18
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Pannellini T, Iezzi M, Liberatore M, Sabatini F, Iacobelli S, Rossi C, Alberti S, Di Ilio C, Vitaglione P, Fogliano V, Piantelli M. A dietary tomato supplement prevents prostate cancer in TRAMP mice. Cancer Prev Res (Phila) 2010; 3:1284-91. [PMID: 20716635 DOI: 10.1158/1940-6207.capr-09-0237] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transgenic adenocarcinoma of the mouse prostate (TRAMP) is a model for progressive prostate cancer that mirrors the stages of the human form. In this study, the effects of a diet enriched with processed whole tomatoes on survival, tumorigenesis, and progression of prostate cancer, and the antioxidant and inflammatory status of TRAMP mice were investigated. Tomato diet significantly increased overall survival (P < 0.01), delayed progression from prostatic intraepithelial neoplasia to adenocarcinoma, and decreased the incidence of poorly differentiated carcinoma. Biochemical data disclosed an increase in serum antioxidant activity and a reduction of serum inflammation/angiogenesis biomarkers of particular importance in prostate carcinogenesis.
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Affiliation(s)
- Tania Pannellini
- Department of Oncology and Neurosciences, G. d'Annunzio University, Chieti, Italy
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Msaouel P, Galanis E, Koutsilieris M. Somatostatin and somatostatin receptors: implications for neoplastic growth and cancer biology. Expert Opin Investig Drugs 2010; 18:1297-316. [PMID: 19678799 DOI: 10.1517/13543780903176399] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Somatostatin agonists (SM-As) are capable of achieving durable symptomatic relief and significant clinical responses in certain tumours. Herein, we review the diverse direct and indirect mechanisms of antineoplastic activity elicited by SM-As as well as the hurdles that complicate their use as monotherapies in a broader range of malignancies. Emphasis is placed on recent clinical attempts to neutralise the IGF-mediated survival factor effects in the bone metastasis microenvironment in advanced prostate cancer. The first clinical trials of this 'anti-survival factor manipulation' strategy utilised the ability of SM-As to suppress the growth hormone-dependent liver-derived IGF-I bioavailability in combination with other drugs, such as dexamethasone, zolendronate and oestrogens, acting systemically and at the bone metastasis microenvironment. These regimens restored androgen ablation responsiveness in stage D3 prostate cancer patients and successfully produced objective clinical responses while only mild toxicities were observed. Furthermore, we focus on the preclinical experimental data of a targeted SM-A coupled to the super-potent doxorubicin derivative AN-201. The resulting conjugate (AN-238) has shown increased antitumour potency with a favourable toxicity profile. The potential use of novel SM-As as anticancer drugs is discussed in relation to data suggesting other direct and indirect treatment approaches pertaining to the somatostatin system.
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Affiliation(s)
- Pavlos Msaouel
- National & Kapodistrian University of Athens, Medical School, Department of Experimental Physiology, 75 Micras Asias St, Goudi-Athens 11527, Greece
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20
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Burgu B, Aydogdu O. Vascular endothelial growth factor and bladder from a different perspective: not only an angiogenic factor. J Pediatr Surg 2010; 45:447-52. [PMID: 20152373 DOI: 10.1016/j.jpedsurg.2009.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 10/03/2009] [Accepted: 10/06/2009] [Indexed: 01/23/2023]
Abstract
Angiogenesis has a key role for embryonic development and is crucial in several major diseases. Molecular basis of angiogenesis has been widely investigated (J Biochem Mol Biol. 2006;39:469-478, Oncogene. 2000;19:5598-5605). In this review, vascular endothelial growth factor (VEGF) and related receptors and their key roles in embryonic bladder development are discussed. The normal VEGF expression and related angiogenesis pattern of embryonic bladder are highlighted. The VEGF family especially VEGF-A is the major player in angiogenesis as well as many other angiogenic factors and activates 2 tyrosine kinase receptors, VEGFR-1 and VEGFR-2 (J Biochem Mol Biol. 2006;39:469-478). Besides its worthy role in angiogenesis, VEGF-A also seems to participate in normal bladder development (J Urol. 2007;177:1552-1557, Br J Urol Int. 2006;98:217-225). In previous studies, we have shown that exogenous VEGF or hypoxia-induced endogenous upregulation of this protein accelerates the growth of the bladder by detrusor and urothelium hypertrophy and hyperplasia (J Urol. 2007;177:1552-1557, Br J Urol Int. 2006;98:217-225, Dev Biol. 1997;183:139-149, Neurourol Urodyn. 2004;23:342-348). This abrupt role of VEGF on detrusor muscle through a hypoxic pathway may potentially be a part of the solution for many urologic conditions such as remodeling of detrusor muscle in antenatal bladder outlet obstruction.
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Affiliation(s)
- Berk Burgu
- Division of Pediatric Urology, Urology, Ankara University School of Medicine, 06100 Ankara, Turkey
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21
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Carretero-Ortega J, Walsh CT, Hernández-García R, Reyes-Cruz G, Brown JH, Vázquez-Prado J. Phosphatidylinositol 3,4,5-triphosphate-dependent Rac exchanger 1 (P-Rex-1), a guanine nucleotide exchange factor for Rac, mediates angiogenic responses to stromal cell-derived factor-1/chemokine stromal cell derived factor-1 (SDF-1/CXCL-12) linked to Rac activation, endothelial cell migration, and in vitro angiogenesis. Mol Pharmacol 2009; 77:435-42. [PMID: 20018810 DOI: 10.1124/mol.109.060400] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Stromal cell-derived factor-1 (SDF-1/CXCL-12) and vascular endothelial growth factor (VEGF), which can be secreted by hypoxic tumors, promote the generation of new blood vessels. These potent angiogenic factors stimulate endothelial cell migration via the activation of Rho GTPases and the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway. Thus, characterization of guanine nucleotide exchange factors critical in the angiogenic signaling cascades offers the possibility of identifying novel molecular targets. We demonstrated previously that mammalian target of rapamycin, an important effector and regulator of PI3K/AKT, activates phosphatidylinositol 3,4,5-triphosphate-dependent Rac exchanger 1 (P-Rex1), a Rac guanine nucleotide exchange factor identified as a target of G betagamma and PI3K, via direct interactions. In this study, we tested the hypothesis that P-Rex1 is involved in the angiogenic responses elicited by SDF-1 and VEGF. Using a knockdown approach, we demonstrate that P-Rex1 is indeed required for SDF-1 promoted signaling pathway, because there is decreased Rac activation, cell migration, and in vitro angiogenesis in P-Rex1 knockdown cells stimulated with SDF-1. In contrast, P-Rex1 knockdown does not affect responses to VEGF, and signaling to extracellular signal-regulated kinase in response to either angiogenic factor is not sensitive to P-Rex1 knockdown. We also demonstrate that in endothelial cells, VEGF promotes an increase in the expression of endogenous P-Rex1 and the SDF-1 receptor CXCR4, In addition, VEGF-pretreated cells show an increased migratory and angiogenic response to SDF-1, suggesting that VEGF stimulation can complement SDF-1/CXCR4 signaling to induce angiogenesis. We conclude that P-Rex1 is a key element in SDF-1-induced angiogenic responses and a potential target for therapeutic intervention.
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Affiliation(s)
- Jorge Carretero-Ortega
- Department of Pharmacology, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), México, D.F. 14740 México
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22
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Ebbesen P, Pettersen EO, Gorr TA, Jobst G, Williams K, Kieninger J, Wenger RH, Pastorekova S, Dubois L, Lambin P, Wouters BG, Van Den Beucken T, Supuran CT, Poellinger L, Ratcliffe P, Kanopka A, Görlach A, Gasmann M, Harris AL, Maxwell P, Scozzafava A. Taking advantage of tumor cell adaptations to hypoxia for developing new tumor markers and treatment strategies. J Enzyme Inhib Med Chem 2009; 24 Suppl 1:1-39. [PMID: 19005871 DOI: 10.1080/14756360902784425] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cancer cells in hypoxic areas of solid tumors are to a large extent protected against the action of radiation as well as many chemotherapeutic drugs. There are, however, two different aspects of the problem caused by tumor hypoxia when cancer therapy is concerned: One is due to the chemical reactions that molecular oxygen enters into therapeutically targeted cells. This results in a direct chemical protection against therapy by the hypoxic microenvironment, which has little to do with cellular biological regulatory processes. This part of the protective effect of hypoxia has been known for more than half a century and has been studied extensively. However, in recent years there has been more focus on the other aspect of hypoxia, namely the effect of this microenvironmental condition on selecting cells with certain genetic prerequisites that are negative with respect to patient prognosis. There are adaptive mechanisms, where hypoxia induces regulatory cascades in cells resulting in a changed metabolism or changes in extracellular signaling. These processes may lead to changes in cellular intrinsic sensitivity to treatment irrespective of oxygenation and, furthermore, may also have consequences for tissue organization. Thus, the adaptive mechanisms induced by hypoxia itself may have a selective effect on cells, with a fine-tuned protection against damage and stress of many kinds. It therefore could be that the adaptive mechanisms may take advantage of for new tumor labeling/imaging and treatment strategies. One of the Achilles' heels of hypoxia research has always been the exact measurements of tissue oxygenation as well as the control of oxygenation in biological tumor models. Thus, development of technology that can ease this control is vital in order to study mechanisms and perform drug development under relevant conditions. An integrated EU Framework project 2004-2009, termed EUROXY, demonstrates several pathways involved in transcription and translation control of the hypoxic cell phenotype and evidence of cross-talk with responses to pH and redox changes. The carbonic anhydrase isoenzyme CA IX was selected for further studies due to its expression on the surface of many types of hypoxic tumors. The effort has led to marketable culture flasks with sensors and incubation equipment, and the synthesis of new drug candidates against new molecular targets. New labeling/imaging methods for cancer diagnosing and imaging of hypoxic cancer tissue are now being tested in xenograft models and are also in early clinical testing, while new potential anti-cancer drugs are undergoing tests using xenografted tumor cancers. The present article describes the above results in individual consortium partner presentations.
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Affiliation(s)
- Peter Ebbesen
- Laboratory for Stem Cell Research, Aalborg University, Aarhus, Denmark.
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23
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Thomas CY, Theodorescu D. Molecular Pathogenesis of Urothelial Carcinoma and the Development of Novel Therapeutic Strategies. Bladder Cancer 2009. [DOI: 10.1007/978-1-59745-417-9_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Matsumoto S, Shimizu N, Hanai T, Uemura H, Levin R. Bladder outlet obstruction accelerates bladder carcinogenesis. BJU Int 2008; 103:1436-9. [PMID: 19076130 DOI: 10.1111/j.1464-410x.2008.08261.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the correlation between partial bladder outlet obstruction (PBOO) and bladder carcinogenesis. MATERIALS AND METHODS Female Wistar rats (6 weeks old) were divided into three groups of 10 each: group 1 was exposed to n-butyl-n-butanol nitrosamine (BBN, a carcinogen) in drinking water for 8 weeks; group 2 had PBOO induced surgically after exposure to BBN for 8 weeks; group 3 had a sham operation and the rats drank normal water (control group). After 20 weeks, all of the rats were killed humanely and their bladders analysed. RESULTS There were no significant differences in body weight among the groups. The bladder weight of group 2 was significantly greater than either group 1 or group 3. Histopathologically, bladder smooth muscle hypertrophy was the major cause of the increased bladder weight for group 2. In group 2 there were increases in bladder wall thickness and many nipple-shaped urothelial tumours. Basic fibroblast growth factor and hypoxia-inducible factor-1alpha expression were significantly greater in group 2 than in groups 1 and 3. CONCLUSIONS Exposure of the bladder to carcinogens during bladder hyperplasia and hypertrophy induced by PBOO results in a greater incidence of superficial bladder carcinoma.
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Affiliation(s)
- Seiji Matsumoto
- Urological and Urodynamics Center, Koushinkai Hospital, Osaka, Japan.
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25
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26
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Kim J, Choi YL, Vallentin A, Hunrichs BS, Hellerstein MK, Peehl DM, Mochly-Rosen D. Centrosomal PKCbetaII and pericentrin are critical for human prostate cancer growth and angiogenesis. Cancer Res 2008; 68:6831-9. [PMID: 18701509 DOI: 10.1158/0008-5472.can-07-6195] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Angiogenesis is critical in the progression of prostate cancer. However, the interplay between the proliferation kinetics of tumor endothelial cells (angiogenesis) and tumor cells has not been investigated. Also, protein kinase C (PKC) regulates various aspects of tumor cell growth, but its role in prostate cancer has not been investigated in detail. Here, we found that the proliferation rates of endothelial and tumor cells oscillate asynchronously during the growth of human prostate cancer xenografts. Furthermore, our analyses suggest that PKCbetaII was activated during increased angiogenesis and that PKCbetaII plays a key role in the proliferation of endothelial cells and tumor cells in human prostate cancer; treatment with a PKCbetaII-selective inhibitor, betaIIV5-3, reduced angiogenesis and tumor cell proliferation. We also find a unique effect of PKCbetaII inhibition on normalizing pericentrin (a protein regulating cytokinesis), especially in endothelial cells as well as in tumor cells. PKCbetaII inhibition reduced the level and mislocalization of pericentrin and normalized microtubule organization in the tumor endothelial cells. Although pericentrin has been known to be up-regulated in epithelial cells of prostate cancers, its level in tumor endothelium has not been studied in detail. We found that pericentrin is up-regulated in human tumor endothelium compared with endothelium adjacent to normal glands in tissues from prostate cancer patients. Our results suggest that a PKCbetaII inhibitor such as betaIIV5-3 may be used to reduce prostate cancer growth by targeting both angiogenesis and tumor cell growth.
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Affiliation(s)
- Jeewon Kim
- Department of Chemical and Systems Biology, Stanford University, School of Medicine, Stanford, California 94305-5174, USA
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27
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Wink M, Frauscher F, Cosgrove D, Chapelon JY, Palwein L, Mitterberger M, Harvey C, Rouvière O, de la Rosette J, Wijkstra H. Contrast-enhanced ultrasound and prostate cancer; a multicentre European research coordination project. Eur Urol 2008; 54:982-92. [PMID: 18584944 DOI: 10.1016/j.eururo.2008.06.057] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Accepted: 06/12/2008] [Indexed: 11/29/2022]
Abstract
CONTEXT Contrast-enhanced ultrasound is a real-time imaging technique with the capability of visualizing perfusion patterns. Since tumour growth is associated with changes in vascularisation, this modality is under research for imaging of various tumour types. Studies have shown promising results for the diagnosis of prostate cancer for various imaging techniques; however, the exact value of each technique is still unclear. OBJECTIVE To determine the value of contrast-enhanced ultrasound (CEUS) in the detection, localisation, and follow-up of treatment for prostate cancer. EVIDENCE ACQUISITION In the period 2002-2006, research in four European centres regarding CEUS of the prostate was coordinated in a combined program. This paper describes and combines the results of these studies. EVIDENCE SYNTHESIS Various techniques were developed and researched during the period of this program. Studies showed that prostate cancer could be visualized and localized in up to 78%. Visualization of the tumour enabled better detection; targeted biopsies lead to fewer biopsies per session without loss of detection rate. A combined approach offered the highest detection rate. CEUS could be used to visualize the effects of high-intensity focussed ultrasound and hormonal therapy for prostate cancer with success, and identified patients with an early relapse. Unfortunately, pretreatment evaluation could not identify the nonresponders beforehand. CONCLUSIONS This research project was a first step towards routine use of CEUS in the clinical detection and follow-up of prostate cancer; and new combined studies are initiated.
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Affiliation(s)
- Margot Wink
- Department of Urology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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28
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Nadaoka J, Horikawa Y, Saito M, Kumazawa T, Inoue T, Narita S, Yuasa T, Satoh S, Nishiyama H, Ogawa O, Tsuchiya N, Habuchi T. Prognostic significance of HIF-1 alpha polymorphisms in transitional cell carcinoma of the bladder. Int J Cancer 2008; 122:1297-302. [PMID: 18000826 DOI: 10.1002/ijc.23256] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recently, two single nucleotide polymorphisms in the hypoxia-inducible factor-1 alpha (HIF-1 alpha) gene, P582S and A588T, were shown to cause significantly higher transcriptional activity than the wild type. We investigated the association between the HIF-1 alpha polymorphisms and the incidence and progression of transitional cell carcinoma of the bladder, and the relationship between the polymorphisms and the tissue vascular endothelial growth factor (VEGF) level or microvessel density (MVD). A total of 219 patients with bladder cancer and 464 healthy native Japanese control subjects were enrolled. Tissue VEGF and HIF-1 alpha expression levels and the mean MVD were evaluated in 73 radical cystectomy specimens by immunohistochemistry. The HIF-1 alpha genotype did not significantly influence the incidence or disease status of bladder cancer. Among patients who underwent radical cystectomy, those with a variant allele had significantly worse disease-free survival (p = 0.001) and disease-specific survival (p = 0.006) than those without a variant allele. Multivariate analysis using a Cox proportional hazard model revealed that the presence of a variant allele was an independent predictor of disease-free survival (HR = 3.10, 95%CI = 1.38-6.99, p = 0.006). Although not statistically significant, the moderate/high expression levels of VEGF in tumor tissues were more frequently observed in patients with a HIF-1 alpha variant allele (11/13, 84.6%) than in those without (33/60, 55%, p = 0.063). The HIF-1 alpha polymorphisms may have a significant influence on the poor prognosis of the patients undergoing radical cystectomy for bladder cancer, while they seem to have no relation to the bladder cancer occurrence.
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Affiliation(s)
- Junichi Nadaoka
- Department of Urology, Akita University School of Medicine, Akita, Japan
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Msaouel P, Pissimissis N, Halapas A, Koutsilieris M. Mechanisms of bone metastasis in prostate cancer: clinical implications. Best Pract Res Clin Endocrinol Metab 2008; 22:341-55. [PMID: 18471791 DOI: 10.1016/j.beem.2008.01.011] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Prostate cancer shows a strong predilection to spread to the bones. Once prostate tumour cells are engrafted in the skeleton, curative therapy is no longer possible and palliative treatment becomes the only option. Herein, we review the multifactorial mechanisms and complex cellular interactions that take place inside the bone metastatic microenvironment. Emphasis is given to the detection and treatment of the micrometastatic stage of prostate cancer, as well as our recent attempts to target the bone metastasis microenvironment-related survival factors using an anti-survival factor manipulation which can increase the efficacy of anticancer therapies such as androgen ablation therapy and chemotherapy in advanced prostate cancer.
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Affiliation(s)
- Pavlos Msaouel
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Goudi-Athens, Greece
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Huamani J, Willey C, Thotala D, Niermann KJ, Reyzer M, Leavitt L, Jones C, Fleishcher A, Caprioli R, Hallahan DE, Kim DWN. Differential efficacy of combined therapy with radiation and AEE788 in high and low EGFR-expressing androgen-independent prostate tumor models. Int J Radiat Oncol Biol Phys 2008; 71:237-46. [PMID: 18337021 DOI: 10.1016/j.ijrobp.2007.12.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Revised: 12/16/2007] [Accepted: 12/18/2007] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine the efficacy of combining radiation (XRT) with a dual epidermal growth factor receptor (EGFR)/vascular endothelial growth factor receptor inhibitor, AEE788, in prostate cancer models with different levels of EGFR expression. METHODS AND MATERIALS Immunoblotting was performed for EGFR, phosphorylated-EGFR, and phosphorylated-AKT in prostate cancer cells. Clonogenic assays were performed on DU145, PC-3, and human umbilical vein endothelial cells treated with XRT +/- AEE788. Tumor xenografts were established for DU145 and PC-3 on hind limbs of athymic nude mice assigned to four treatment groups: (1) control, (2) AEE788, (3) XRT, and (4) AEE788 + XRT. Tumor blood flow and growth measurements were performed using immunohistochemistry and imaging. RESULTS AEE788 effectively decreased phosphorylated-EGFR and phosphorylated-AKT levels in DU145 and PC-3 cells. Clonogenic assays showed no radiosensitization for DU145 and PC-3 colonies treated with AEE788 + XRT. However, AEE788 caused decreased proliferation in DU145 cells. AEE788 showed a radiosensitization effect in human umbilical vein endothelial cells and increased apoptosis susceptibility. Concurrent AEE788 + XRT compared with either alone led to significant tumor growth delay in DU145 tumors. Conversely, PC-3 tumors derived no added benefit from combined-modality therapy. In DU145 tumors, a significant decrease in tumor blood flow with combination therapy was shown by using power Doppler sonography and tumor blood vessel destruction on immunohistochemistry. Maldi-spectrometry (MS) imaging showed that AEE788 is bioavailable and heterogeneously distributed in DU145 tumors undergoing therapy. CONCLUSIONS AEE788 + XRT showed efficacy in vitro/in vivo with DU145-based cell models, whereas PC-3-based models were adequately treated with XRT alone without added benefit from combination therapy. These findings correlated with differences in EGFR expression and showed effects on both tumor cell proliferation and vascular destruction.
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Affiliation(s)
- Jessica Huamani
- Radiation Oncology, Vanderbilt University, Nashville, TN, USA
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Chan N, Koritzinsky M, Zhao H, Bindra R, Glazer PM, Powell S, Belmaaza A, Wouters B, Bristow RG. Chronic hypoxia decreases synthesis of homologous recombination proteins to offset chemoresistance and radioresistance. Cancer Res 2008; 68:605-14. [PMID: 18199558 DOI: 10.1158/0008-5472.can-07-5472] [Citation(s) in RCA: 238] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Hypoxic and/or anoxic tumor cells can have increased rates of mutagenesis and altered DNA repair protein expression. Yet very little is known regarding the functional consequences of any hypoxia-induced changes in the expression of proteins involved in DNA double-strand break repair. We have developed a unique hypoxic model system using H1299 cells expressing an integrated direct repeat green fluorescent protein (DR-GFP) homologous recombination (HR) reporter system to study HR under prolonged chronic hypoxia (up to 72 h under 0.2% O(2)) without bias from altered proliferation, cell cycle checkpoint activation, or severe cell toxicity. We observed decreased expression of HR proteins due to a novel mechanism involving decreased HR protein synthesis. Error-free HR was suppressed 3-fold under 0.2% O(2) as measured by the DR-GFP reporter system. This decrease in functional HR resulted in increased sensitivity to the DNA cross-linking agents mitomycin C and cisplatin but not to the microtubule-interfering agent, paclitaxel. Chronically hypoxic H1299 cells that had decreased functional HR were relatively radiosensitive [oxygen enhancement ratio (OER), 1.37] when compared with acutely hypoxic or anoxic cells (OER, 1.96-2.61). Using CAPAN1 cells isogenic for BRCA2 and siRNA to RAD51, we confirmed that the hypoxia-induced radiosensitivity was due to decreased HR capacity. Persistent down-regulation of HR function by the tumor microenvironment could result in low-fidelity DNA repair and have significant implications for response to therapy and genetic instability in human cancers.
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Affiliation(s)
- Norman Chan
- Princess Margaret Hospital (University Health Network), University of Toronto, Toronto, Ontario, Canada
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Taylor JA, Kuchel GA, Hegde P, Voznesensky OS, Claffey K, Tsimikas J, Leng L, Bucala R, Pilbeam C. Null mutation for macrophage migration inhibitory factor (MIF) is associated with less aggressive bladder cancer in mice. BMC Cancer 2007; 7:135. [PMID: 17650334 PMCID: PMC1939709 DOI: 10.1186/1471-2407-7-135] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 07/24/2007] [Indexed: 12/25/2022] Open
Abstract
Background Inflammatory cytokines may promote tumorigenesis. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine with regulatory properties over tumor suppressor proteins involved in bladder cancer. We studied the development of bladder cancer in wild type (WT) and MIF knockout (KO) mice given N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN), a known carcinogen, to determine the role of MIF in bladder cancer initiation and progression. Methods 5-month old male C57Bl/6 MIF WT and KO mice were treated with and without BBN. Animals were sacrificed at intervals up to 23 weeks of treatment. Bladder tumor stage and grade were evaluated by H&E. Immunohistochemical (IHC) analysis was performed for MIF and platelet/endothelial cell adhesion molecule 1 (PECAM-1), a measure of vascularization. MIF mRNA was analyzed by quantitative real-time polymerase chain reaction. Results Poorly differentiated carcinoma developed in all BBN treated mice by week 20. MIF WT animals developed T2 disease, while KO animals developed only T1 disease. MIF IHC revealed predominantly urothelial cytoplasmic staining in the WT control animals and a shift toward nuclear staining in WT BBN treated animals. MIF mRNA levels were 3-fold higher in BBN treated animals relative to controls when invasive cancer was present. PECAM-1 staining revealed significantly more stromal vessels in the tumors in WT animals when compared to KOs. Conclusion Muscle invasive bladder cancer with increased stromal vascularity was associated with increased MIF mRNA levels and nuclear redistribution. Consistently lower stage tumors were seen in MIF KO compared to WT mice. These data suggest that MIF may play a role in the progression to invasive bladder cancer.
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Affiliation(s)
- John A Taylor
- Division of Urology, University of Connecticut Health Center, Farmington, CT, USA
| | - George A Kuchel
- Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Poornima Hegde
- Department of Pathology, University of Connecticut Health Center, Farmington, CT, USA
| | - Olga S Voznesensky
- Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Kevin Claffey
- Department of Vascular Biology, University of Connecticut Health Center, Farmington, CT, USA
| | - John Tsimikas
- Division of Epidemiology and Statistics, University of Connecticut Health Center, Farmington, CT, USA
| | - Lin Leng
- Department of Medicine & Pathology, Yale University, New Haven, CT, USA
| | - Richard Bucala
- Department of Medicine & Pathology, Yale University, New Haven, CT, USA
| | - Carol Pilbeam
- Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
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Daghini E, Zhu XY, Versari D, Bentley MD, Napoli C, Lerman A, Lerman LO. Antioxidant vitamins induce angiogenesis in the normal pig kidney. Am J Physiol Renal Physiol 2007; 293:F371-81. [PMID: 17429028 DOI: 10.1152/ajprenal.00475.2006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effects of chronic supplementation with antioxidant vitamins on angiogenesis are controversial. The aim of the present study was to evaluate in kidneys of normal pigs the effect of chronic supplementation with vitamins E and C, at doses that are effective in reducing oxidative stress and attenuating angiogenesis under pathological conditions. Domestic pigs were randomized to receive a 12-wk normal diet without ( n = 6) or with antioxidant vitamins supplementation (1g/day vitamin C, 100 IU·kg−1·day−1 vitamin E; n = 6). Electron beam computed tomography (CT) was used to evaluate renal cortical vascular function in vivo, and micro-CT was to assess the spatial density and average diameter of cortical microvessels (diameter <500 μm) ex vivo. Oxidative stress and expressions of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF)-1α were evaluated in renal tissue. The effects of increasing concentrations of the same vitamins on redox status and angiogenesis were also evaluated in human umbilical vascular endothelial cells (HUVEC). Compared with normal pigs, the density of cortical transmural microvessels was significantly greater in vitamin-supplemented pigs (149.0 ± 11.7 vs. 333.8 ± 48.1 vessel/cm2, P < 0.05), whereas the cortical perfusion response to ACh was impaired. This was accompanied by a significant increase in tissue oxidative stress and levels of VEGF and HIF-1α. A low dose of antioxidant decreased, whereas a high dose increased, HUVEC oxidative stress and angiogenesis, which was partly mediated by hydrogen peroxide. Antioxidant vitamin supplementation can increase tissue oxidative redox and microvascular proliferation in the normal kidney, probably due to a biphasic effect that depends on basal redox balance.
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Affiliation(s)
- Elena Daghini
- Division of Nephrology and Hypertension, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
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Chan N, Milosevic M, Bristow RG. Tumor hypoxia, DNA repair and prostate cancer progression: new targets and new therapies. Future Oncol 2007; 3:329-41. [PMID: 17547528 DOI: 10.2217/14796694.3.3.329] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Increasingly, the tumor microenvironment and hypoxia are being studied as potential prognostic factors in prostate cancer given their effects on the hypoxia inducible factor-1α and vascular endothelial growth factor signaling pathways. Based on immunohistochemical studies using hypoxic cell markers and direct oxygen-electrode measurements, clinically relevant levels of hypoxia are detected in 30–90% of prostate cancers. Exciting new data suggest that hypoxia can alter cell-cycle checkpoints and DNA repair within the prostate epithelium, thereby driving genetic instability and tumor aggression. Novel therapies designed to target the hypoxic response and resulting defective DNA repair may therefore be effective as chemoprevention agents or as adjuncts to surgery, radiotherapy and chemotherapy to improve clinical outcome.
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Affiliation(s)
- Norman Chan
- Departments of Medical Biophysics & Radiation Oncology, University of Toronto, Princess Margaret Hospital (University Health Network), Toronto, Ontario, Canada.
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Bristow RG, Ozcelik H, Jalali F, Chan N, Vesprini D. Homologous recombination and prostate cancer: a model for novel DNA repair targets and therapies. Radiother Oncol 2007; 83:220-30. [PMID: 17531338 DOI: 10.1016/j.radonc.2007.04.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Accepted: 04/17/2007] [Indexed: 01/30/2023]
Abstract
Using elegant targeting techniques such as IMRT, radiation oncology has improved the therapeutic ratio of prostate cancer radiotherapy through increased physical precision (e.g. increased local control through dose-escalation without increased normal tissue toxicity). The therapeutic ratio might be further improved by the addition of "biologic precision and escalation" pertaining to the use of molecular inhibitors of DNA damage sensing and repair. Indeed, proteins involved in the ATM-p53 damage signaling axis and the homologous (HR) and non-homologous end-joining (NHEJ) pathways of DNA double-strand break (DNA-dsb) rejoining pathways may be attractive candidates to elucidate cancer risk, prognosis, prediction of response and to develop sensitizers towards oxic and hypoxic prostate tumor cells. This review highlights DNA-dsb in prostate cancer research in terms of novel molecular inhibitors, the role of the microenvironment in DNA-dsb repair and potential DNA-dsb biomarkers for clinical trials.
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Affiliation(s)
- Robert G Bristow
- Department of Medical Biophysics, University of Toronto and Princess Margaret Hospital (University Health Network), Toronto, Canada.
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Burgu B, Medina Ortiz WE, Pitera JE, Woolf AS, Wilcox DT. Vascular Endothelial Growth Factor Mediates Hypoxic Stimulated Embryonic Bladder Growth in Organ Culture. J Urol 2007; 177:1552-7. [PMID: 17382777 DOI: 10.1016/j.juro.2006.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2006] [Indexed: 11/21/2022]
Abstract
PURPOSE Tissue hypoxia enhances embryonic angiogenesis at least in part by up-regulating vascular endothelial growth factor. Additionally, exogenous vascular endothelial growth factor-A enhances embryonic bladder explant growth. We hypothesized that developing bladders are hypoxic in vivo and oxygen tensions modulate explanted bladder growth by altering vascular endothelial growth factor-A expression. MATERIALS AND METHODS Embryonic day 14 mouse bladders were cultured in 20% O(2) or 3% O(2) atmospheres. Some cultures were supplemented with a vascular endothelial growth factor receptor 1/Fc chimera to block vascular endothelial growth factor bioactivity. After 6 days explant areas, DNA, protein, total cell numbers, and proportions expressing endothelial and smooth muscle markers were measured. Pimonidazole was administered to pregnant mice and hypoxia was sought in embryonic tissues by immunohistochemistry. RESULTS In vivo pimonidazole adducts and vascular endothelial growth factor-A immunolocalized to embryonic urothelium and bladders up-regulated total vascular endothelial growth factor-A between embryonic days 14 and 18. All growth parameters and vascular endothelial growth factor-A protein levels were enhanced in hypoxic vs normoxic culture. Addition of vascular endothelial growth factor receptor 1/Fc prevented this accelerated growth. CONCLUSIONS In vivo embryonic bladders are hypoxic and express vascular endothelial growth factor-A. In vitro, when oxygen tensions are manipulated, vascular endothelial growth factor-A protein positively correlates with the growth of whole explants as well as endothelium. Normal embryonic bladder development may be driven at least in part by hypoxic up-regulation of vascular endothelial growth factor-A.
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Affiliation(s)
- Berk Burgu
- Department of Pediatric Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA.
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Thomas CY, Theodorescu D. Molecular markers of prognosis and novel therapeutic strategies for urothelial cell carcinomas. World J Urol 2006; 24:565-78. [PMID: 17063322 DOI: 10.1007/s00345-006-0119-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Christopher Y Thomas
- Department of Hematology and Oncology, UVA HSC, P.O. Box 800716, Charlottesville, VA 22908, USA
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Lidgren A, Hedberg Y, Grankvist K, Rasmuson T, Bergh A, Ljungberg B. Hypoxia-inducible factor 1alpha expression in renal cell carcinoma analyzed by tissue microarray. Eur Urol 2006; 50:1272-7. [PMID: 16814458 DOI: 10.1016/j.eururo.2006.05.043] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Accepted: 05/30/2006] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Angiogenesis is important for tumour progression and metastatic spread. Hypoxia-inducible factor 1alpha (HIF-1alpha) is a major factor regulating a number of other angiogenic factors. Renal cell carcinoma (RCC) is a malignancy with a variable clinical course, partly attributable to specific genetic alterations of the different RCC types. We therefore analysed HIF-1alpha expression using immunohistochemistry and related the results to RCC type and clinicopathologic variables. MATERIAL AND METHODS We semiquantitatively analysed HIF-1alpha expression using immunohistological staining of a prepared tissue microarray. There were 216 patients including 176 conventional, 26 papillary, and 14 chromophobe RCCs. RESULTS The HIF-1alpha staining was found mainly in the cytoplasm. The tumours were subdivided into HIF-1alpha(LOW) and HIF-1alpha(HIGH) on the basis of staining intensity. HIF-1alpha expression between the RCC types did not differ. Patients with conventional RCC showed a trend (p=0.055) towards a prolonged survival for those with HIF-1alpha(HIGH)-staining versus HIF-1alpha(LOW)-staining tumors. In conventional RCC there were significant differences in HIF-1alpha expression in relation to TNM stage, nuclear grade, and vein invasion. In patients with papillary RCC, difference in HIF-1alpha expression was observed only for nuclear grade. CONCLUSIONS We studied HIF-1alpha expression in RCC using tissue microarray. In patients with conventional RCC, HIF-1alpha levels were significantly lower in locally aggressive tumors versus localized tumors, and patients with high HIF-1alpha levels tended to have a better prognosis. There seems to be a diverging regulation of angiogenesis between the different RCC types. Further studies of HIF and angiogenesis in RCC are encouraged.
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Affiliation(s)
- Anders Lidgren
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
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