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Park DG, Jin B, Lee WW, Kim HJ, Kim JH, Choi SJ, Hong SD, Shin JA, Cho SD. Apoptotic activity of genipin in human oral squamous cell carcinoma in vitro by regulating STAT3 signaling. Cell Biochem Funct 2023; 41:1319-1329. [PMID: 37792550 DOI: 10.1002/cbf.3866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/01/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
Genipin, a natural compound derived from the fruit of Gardenia jasminoides Ellis, was reported to have activity against various cancer types. In this study, we determined the underlying mechanism for genipin-induced cell death in human oral squamous cell carcinoma (OSCC). The growth-inhibitory effects of genipin in human OSCC cells was examined by the Cell Counting Kit-8 and soft agar assays. The effects of genipin on apoptosis were assessed by nuclear morphological changes by 4',6-diamidino-2-phenylindole staining, measurement of the sub-G1 population, and Annexin V-fluorescein isothiocyanate/propidium iodide double staining. The underlying mechanism of genipin activity was analyzed by western blot analysis, subcellular fractionation of the nucleus and cytoplasm, immunocytochemistry, and quantitative real-time polymerase chain reaction. Genipin inhibited the growth of OSCC cells and induced apoptosis, which was mediated by a caspase-dependent pathway. Genipin reduced the phosphorylation of signal transducer and activator of transcription 3 (STAT3) at Tyr705 and its nuclear localization. Furthermore, inhibition of p-STAT3Tyr705 levels following genipin treatment was required for the reduction of survivin and myeloid cell leukemia-1 (Mcl-1) expression, leading to apoptotic cell death. The genipin-mediated reduction in survivin and Mcl-1 expression was caused by transcriptional and/or posttranslational regulatory mechanisms. The results provide insight into the regulatory mechanism by which genipin induces apoptotic cell death through the abrogation of nuclear STAT3 phosphorylation and suggest that genipin may represent a potential therapeutic option for the treatment of human OSCC.
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Affiliation(s)
- Dong-Guk Park
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Bohwan Jin
- Laboratory Animal Center, CHA Biocomplex, CHA University, Seongnam, Republic of Korea
| | - Won W Lee
- Laboratory Animal Center, CHA Biocomplex, CHA University, Seongnam, Republic of Korea
| | - Hyun-Ji Kim
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ji-Hoon Kim
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Su-Jung Choi
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seong-Doo Hong
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ji-Ae Shin
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sung-Dae Cho
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Latha HA, Prakash AR, Kanth MR, Reddy AVS, Sreenath G, Vidya KS. Expression of anti - Apoptotic survivin in odontogenic keratocyst, adenomatoid odontogenic tumor and ameloblastoma. J Oral Maxillofac Pathol 2023; 27:601. [PMID: 38033952 PMCID: PMC10683921 DOI: 10.4103/jomfp.jomfp_446_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/15/2023] [Indexed: 12/02/2023] Open
Abstract
Background The process of odontogenesis is complex involving epithelial-mesenchymal interactions, along with the molecular signalling pathways triggering the initiating process. The triggering factors and cells precisely involved in the pathogenesis of odontogenic cysts and tumors are unknown. There is a vast array of biomarkers used to stain different sites, thereby helpful in diagnosing and evaluating the prognosis of these cysts and tumors. In the following study, Anti Apoptotic survivin expression patterns were assessed quantitatively in 48 samples (12 each) of Reduced Enamel Epithelium, Adenomatoid Odontogenic Tumor, Odontogenic Keratocyst and Ameloblastoma. Aim The Aim of this study is to assess the anti-apoptotic survivin expression in Reduced Enamel Epithelium, Adenomatoid odontogenic tumour, Odontogenic Keratocyst and Ameloblastoma. Materials and Methods The present study is carried out with 12 samples in each group. Routine hematoxylin and eosin staining was performed for confirmatory diagnosis. Later Immunohistochemistry was performed using survivin antibody. Survivin protein expression was analyzed using the parameters like location, intensity, percentage of cells positivity with survivin protein and extent of staining. With the help of Olympus BX 43 microscope, with ProgRes microscope camera, the 48 slides obtained were examined. The region of interest was selected in each slide and number of cells positively stained was counted. Data was analyzed using SPSS software version 23. Descriptive for scale data, results were analysed by using ANOVA with Chi-square test for intergroup comparison. Results The results showed significant P value <0.05. Expression of survivin was highest in Ameloblastoma, followed by Odontogenic keratocyst, Adenomatoid odontogenic tumor, and Reduced Enamel Epithelium. Conclusion Survivin was involved in the inhibition of apoptosis as well as the detailed understanding of the biological behaviour of odontogenic cysts and tumours, thereby increasing therapeutic approaches.
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Affiliation(s)
- H. Aparna Latha
- Department of Oral and Maxillofacial Pathology and Microbiology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - A. Ravi Prakash
- Department of Oral and Maxillofacial Pathology and Microbiology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - M. Rajini Kanth
- Department of Oral and Maxillofacial Pathology and Microbiology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - A. Vikram Simha Reddy
- Department of Oral and Maxillofacial Pathology and Microbiology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - G. Sreenath
- Department of Oral and Maxillofacial Pathology and Microbiology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - Karanam S. Vidya
- Department of Oral and Maxillofacial Pathology and Microbiology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
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Ghritlahare H, Einstein A, Singaraju S, Patel S, Gulati N, Mishra SD. Immunohistochemical expression of survivin in oral epithelial dysplasia and different grades of oral squamous cell carcinoma. J Oral Maxillofac Pathol 2022; 26:451-457. [PMID: 37082058 PMCID: PMC10112080 DOI: 10.4103/jomfp.jomfp_301_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/16/2022] [Accepted: 02/26/2022] [Indexed: 04/22/2023] Open
Abstract
Background Survivin, a member of the inhibitor of apoptosis proteins family, is not detectable in most differentiated normal adult tissues but is expressed in a wide range of cancer tissues. Survivin expression in cancer has been associated with poor prognosis, cancer progression, and drug resistance, and the expression levels correlate with more aggressive disease and a poor clinical outcome. Objective To evaluate and compare the immunoexpression of survivin in the normal oral epithelium (NOE), oral epithelial dysplasia (OED), and different grades of oral squamous cell carcinoma (OSCC). Methodology The patterns of survivin immunoexpression and immunoreactivity were assessed in previously diagnosed, paraffin-embedded sections of 10 tissues of NOE and 15 tissues each of OED and the three grades of OSCC (well-, moderately-, and poorly-differentiated). The pattern of survivin expression was recorded as cytoplasmic, nuclear, or both. Survivin immunoreactivity was assessed semi-quantitatively as the immunoreactive score (IRS). Analysis of variance and Tukey-HSD tests were employed for statistical analysis. Results No immunoreactivity for survivin was evident in the NOE tissues. In the OED tissues, the immunoexpression pattern of survivin was predominantly nuclear in the basal cells, and in the OSCC tissues, cytoplasmic and nuclear. IRS was highest among the moderately- differentiated OSCC, followed by poorly- and well-differentiated OSCC and OED, with a statistically significant difference in the IRS scores between the normal and the study groups. Conclusion Survivin protein expression may be an important early event in oral carcinogenesis and may predict unfavorable prognosis in OSCC.
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Affiliation(s)
- Himanta Ghritlahare
- Oral Pathology and Microbiology, Government Dental College, Raipur, Chhattisgarh, India
| | - Aroquiassamy Einstein
- Oral Pathology and Microbiology, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute, Chennai, Tamil Nadu, India
| | - Sasidhar Singaraju
- Oral Pathology and Microbiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Swatantra Patel
- Oral Pathology and Microbiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Namrata Gulati
- Oral Pathology and Microbiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Shubhangi D. Mishra
- Oral Pathology and Microbiology, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
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Zhang W, Ning N, Huang J. Artesunate Suppresses the Growth of Lung Cancer Cells by Downregulating the AKT/Survivin Signaling Pathway. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9170053. [PMID: 35372571 PMCID: PMC8975660 DOI: 10.1155/2022/9170053] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 01/01/2023]
Abstract
NSCLC (non-small-cell lung cancer) is the deadliest cancer in the world. Artesunate is one of the most potent and rapidly acting antimalarial agents. Recently, emerging evidence has suggested the anticancer function of artesunate. In our work, we aimed to investigate the molecular mechanism of artesunate-induced growth inhibition in human lung adenocarcinoma cells and reported that the anticancer effects of artesunate is related to its ability in downregulating AKT/Survivin signaling in A549 cells. The effect of artesunate on the proliferation of A549 cells was determined by CCK-8 assay and colony formation assay; its effect on A549 cell apoptosis was evaluated by lactate dehydrogenase (LDH) release assay. The role of artesunate on the activation of AKT/Survivin signaling was analyzed by western blot and quantitative QPCR. Finally, we used two mouse tumor models to investigate the function of artesunate on the in vivo growth of lung cancer cells. Artesunate treatment caused significant growth inhibition and apoptosis in A549 cells. Mechanistically, artesunate downregulated the activation of AKT/Survivin signaling. In agreement, hyperactivation of AKT signaling restored artesunate-induced growth inhibition in A549 cells. In mouse lung cancer models, artesunate administration significantly reduced the growth of A549 cells and LLC cells in nude mice and immunocompetent mice, respectively. Our findings suggest that artesunate serves as a potential tumor suppressor in lung cancer and hopefully can provide new insight into the development of therapeutic strategies in the clinical lung cancer treatment.
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Affiliation(s)
- Weiwei Zhang
- Department of traditional Chinese Medicine, Hunan Provincial People's Hospital, Changsha 410005, Hunan, China
| | - Ning Ning
- Scientific Research Office of Hunan Provincial People's Hospital, Changsha, Hunan 410005, China
| | - Jie Huang
- Department of Emergency, Hunan Provincial People's Hospital, Changsha, Hunan 410005, China
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Shibata K, Nishijima N, Hirai K, Watanabe S, Yamanaka T, Chikazu D, Inazu M. A Novel Plant-Derived Choline Transporter-like Protein 1 Inhibitor, Amb544925, Induces Apoptotic Cell Death via the Ceramide/Survivin Pathway in Tongue Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:329. [PMID: 35053491 PMCID: PMC8773621 DOI: 10.3390/cancers14020329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Despite recent advances in the early detection and treatment of TSCC patients, recurrence rates and survival rates have not improved. The high frequency of lymph node metastasis is one of the causes, and the drug development of new therapeutic mechanisms such as metastasis control is desired. Choline transporter-like protein 1 (CTL1) has attracted attention as a target molecule in cancer therapy. In this study, we examined the antitumor effects of Amb544925, a plant-derived CTL1 inhibitor. METHODS The TSCC cell line HSC-3 was used to measure [3H]choline uptake, cell survival, caspase activity, and cell migration. Xenograft model mice were prepared to verify the antitumor effect of Amb544925. RESULTS Amb544925 inhibited cell viability and increased caspase-3/7 activity at concentrations that inhibited choline uptake. Amb544925 and ceramide increased SMPD4 expression and suppressed surivivin expression. Furthermore, Amb544925 and ceramide inhibited the migration of HSC-3 cells. In the xenograft model mice, Amb544925 suppressed tumor growth and CTL1 mRNA expression. CONCLUSIONS The plant-derived CTL1 inhibitor Amb544925 is a lead compound of a new anticancer agent exhibiting antitumor effects and inhibition of cell migration through the ceramide/survivin pathway.
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Affiliation(s)
- Kaoru Shibata
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Nozomi Nishijima
- Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Kaho Hirai
- Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Saiichiro Watanabe
- Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Tsuyoshi Yamanaka
- Department of Molecular Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Masato Inazu
- Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
- Department of Molecular Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
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Sun Z, Sun X, Chen Z, Du J, Wu Y. Head and Neck Squamous Cell Carcinoma: Risk Factors, Molecular Alterations, Immunology and Peptide Vaccines. Int J Pept Res Ther 2021; 28:19. [PMID: 34903958 PMCID: PMC8653808 DOI: 10.1007/s10989-021-10334-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 12/29/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) arises from the epithelial lining of the oral cavity, hypopharynx, oropharynx, and larynx. There are several potential risk factors that cause the generation of HNSCC, including cigarette smoking, alcohol consumption, betel quid chewing, inadequate nutrition, poor oral hygiene, HPV and Epstein–Barr virus, and Candida albicans infections. HNSCC has causative links to both environmental factors and genetic mutations, with the latter playing a more critical role in cancer progression. These molecular changes to epithelial cells include the inactivation of cancer suppressor genes and proto-oncogenes overexpression, resulting in tumour cell proliferation and distant metastasis. HNSCC patients have impaired dendritic cell (DC) and natural killer (NK) cell functions, increased production of higher immune-suppressive molecules, loss of regulatory T cells and co-stimulatory molecules and major histocompatibility complex (MHC) class Ι molecules, lower number of lymphocyte subsets, and a poor response to antigen-presenting cells. At present, the standard treatment modalities for HNSCC patients include surgery, chemotherapy and radiotherapy, and combinatorial therapy. Despite advances in the development of novel treatment modalities over the last few decades, survival rates of HNSCC patients have not increased. To establish effective immunotherapies, a greater understanding of interactions between the immune system and HNSCC is required, and there is a particular need to develop novel therapeutic options. A therapeutic cancer vaccine has been proposed as a promising method to improve outcome by inducing a powerful adaptive immune response that leads to cancer cell elimination. Compared with other vaccines, peptide cancer vaccines are more robust and specific. In the past few years, there have been remarkable achievements in peptide-based vaccines for HNSCC patients. Here, we summarize the latest molecular alterations in HNSCC, explore the immune response to HNSCC, and discuss the latest developments in peptide-based cancer vaccine strategies. This review highlights areas for valuable future research focusing on peptide-based cancer vaccines.
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Affiliation(s)
- Zhe Sun
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021 China
| | - Xiaodong Sun
- Department of Endodontics, Gaoxin Branch of Jinan Stomatological Hospital, Jinan, Shandong 250000 China
| | - Zhanwei Chen
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021 China
| | - Juan Du
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021 China
| | - Yihua Wu
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021 China
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Pansini PF, do Valle IB, Damasceno TCD, de Abreu PM, Có ACG, López RVM, Lenzi J, Rocha RM, Souza ED, Curado MP, Mehanna H, Nankivell P, de Podestá JRV, von Zeidler SV. Differential Expression of Potential Biomarkers of Oral Squamous Cell Carcinoma Development. Head Neck Pathol 2021; 15:1127-1136. [PMID: 33840043 PMCID: PMC8633043 DOI: 10.1007/s12105-021-01322-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
To evaluate molecular epithelial changes, we investigated whether a profile of survivin, cyclin dependent kinase inhibitor 2A (CDKN2A), epidermal growth factor receptor (EGFR), polo like kinase 1 (PLK1), p63, p40 (Δnp63 isoform), cyclin D1 (CCND1) and BCL2 apoptosis regulator (BCL2) proteins could predict malignant transformation. Different tissue segments (tumor adjacent epithelium; dysplasia and tumor) from a total of 109 patients were analyzed by immunohistochemistry. An increased expression of survivin (p < 0.001), PLK1 (p = 0.001), and p63 (p < 0.001) in parallel to reduced immunostaining of p40 (p < 0.001) and BCL2 (p = 0.029) was observed among the tissue segments analyzed. Our study revealed that survivin, PLK1, p63, p40 and BCL2 play a role in oral tumorigenesis and represent promising biomarkers able to recognize mesenchymal phenotype induction in the transition from nonmalignant cells to tumor cells. These results reveals critical interaction between survivin, PLK1, p63, p40 promising proteins during invasive carcinoma development.
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Affiliation(s)
- Paola Fernandes Pansini
- Departamento de Patologia, Programa de Pós-Graduação Em Biotecnologia, Centro de Ciências da Saúde - Universidade Federal do Espírito santo, Av. Marechal Campos, 1468 Maruípe, Vitoria, Espírito Santo 29.043-900 Brazil
| | - Isabella Bittencourt do Valle
- Departamento de Patologia, Programa de Pós-Graduação Em Biotecnologia, Centro de Ciências da Saúde - Universidade Federal do Espírito santo, Av. Marechal Campos, 1468 Maruípe, Vitoria, Espírito Santo 29.043-900 Brazil
- Programa de Pós-Graduação em Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais Brazil
| | - Thabata Coeli Dias Damasceno
- Departamento de Patologia, Programa de Pós-Graduação Em Biotecnologia, Centro de Ciências da Saúde - Universidade Federal do Espírito santo, Av. Marechal Campos, 1468 Maruípe, Vitoria, Espírito Santo 29.043-900 Brazil
| | - Priscila Marinho de Abreu
- Departamento de Patologia, Programa de Pós-Graduação Em Biotecnologia, Centro de Ciências da Saúde - Universidade Federal do Espírito santo, Av. Marechal Campos, 1468 Maruípe, Vitoria, Espírito Santo 29.043-900 Brazil
| | - Anna Clara Gregório Có
- Departamento de Patologia, Programa de Pós-Graduação Em Biotecnologia, Centro de Ciências da Saúde - Universidade Federal do Espírito santo, Av. Marechal Campos, 1468 Maruípe, Vitoria, Espírito Santo 29.043-900 Brazil
| | - Rossana Verónica Mendoza López
- Instituto do Câncer do Estado de São Paulo (ICESP) - Center for Translational Research in Oncology, Universidade de São Paulo, São Paulo, Brazil
| | - Jeferson Lenzi
- Programa de Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitoria, Espírito Santo Brazil
| | - Ricardo Mai Rocha
- Programa de Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitoria, Espírito Santo Brazil
| | - Evandro Duccini Souza
- Programa de Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitoria, Espírito Santo Brazil
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, AC Camargo Cancer Center, São Paulo, São Paulo Brazil
| | - Hisham Mehanna
- Institute for Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - Paul Nankivell
- Institute for Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - José Roberto Vasconcelos de Podestá
- Programa de Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitoria, Espírito Santo Brazil
| | - Sandra Ventorin von Zeidler
- Departamento de Patologia, Programa de Pós-Graduação Em Biotecnologia, Centro de Ciências da Saúde - Universidade Federal do Espírito santo, Av. Marechal Campos, 1468 Maruípe, Vitoria, Espírito Santo 29.043-900 Brazil
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Chintala L, Hussain KA, Kodangal S, Lingam AS, Dantu R, Nagabhyrava P. Expression of survivin in oral leukoplakia and oral lichen planus. Minerva Dent Oral Sci 2021; 71:125-130. [PMID: 34672483 DOI: 10.23736/s2724-6329.21.04578-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Up to one third (3-33%) oral squamous cell carcinomas develop from potentially malignant lesions. Most common potentially malignant lesions (PML) are Leukoplakia and Lichen planus. It is very important to diagnose PML at early stage to prevent malignant transformation of lesion. Survivin is a smallest member of the Inhibitor of Apoptosis (IAP) family of proteins. Survivin plays an important role in apoptosis regulation. High expression of survivin is an early event during oral carcinogenesis and it acts as a tool for the identification of precancerous lesions at higher risk of progression into invasive carcinoma. The aim of the study was to evaluate the expression of Survivin in oral leukoplakia, oral lichen planus. METHODS AND MATERIAL 15 patients with oral lichen planus, 15 patients of oral leukoplakia were selected as subjects for the present study and 15 patients with normal oral mucosa were selected as controls and all were evaluated for expression of survivin. All sections were H & E stained and were studied immunohistochemically for the expression of surviving. RESULTS Expression of survivin was evaluated based on percent of cells expressing survivin and grading was given according to that. Significant survivin expression was detected in oral leukoplakia, oral lichen planus, (P < 0.001). CONCLUSIONS Expression of survivin in potentially malignant lesions indicate potential risk of malignant transformation.
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Affiliation(s)
- Lalitha Chintala
- Department of Oral Medicine and Radiology, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
| | | | | | - Amara S Lingam
- Department of Surgical and Diagnostic Sciences, Dar Al Uloom University, Riyadh, Saudi Arabia -
| | - Raghunath Dantu
- Department of Oral Medicine and Radiology, Malla Reddy Institute of Dental Sciences, Hyderabad, Telangana, India
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Hoes L, Dok R, Verstrepen KJ, Nuyts S. Ethanol-Induced Cell Damage Can Result in the Development of Oral Tumors. Cancers (Basel) 2021; 13:cancers13153846. [PMID: 34359747 PMCID: PMC8345464 DOI: 10.3390/cancers13153846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Alcohol consumption is linked to 26.4% of all lip and oral cavity cancer cases worldwide. Despite this clear causal relationship, the exact molecular mechanisms by which ethanol damages cells are still under investigation. It is well-established that the metabolism of ethanol plays an important role. Ethanol metabolism yields reactive metabolites that can directly damage the DNA. If the damage is repaired incorrectly, mutations can be fixed in the DNA sequence. Whenever mutations affect key regulatory genes, for instance cell cycle regulating genes, uncontrolled cell growth can be the consequence. Recently, global patterns of mutations have been identified. These so-called mutational signatures represent a fingerprint of the different mutational processes over time. Interestingly, there were ethanol-related signatures discovered that did not associate with ethanol metabolism. This finding highlights there might be other molecular effects of ethanol that are yet to be discovered. Abstract Alcohol consumption is an underestimated risk factor for the development of precancerous lesions in the oral cavity. Although alcohol is a well-accepted recreational drug, 26.4% of all lip and oral cavity cancers worldwide are related to heavy drinking. Molecular mechanisms underlying this carcinogenic effect of ethanol are still under investigation. An important damaging effect comes from the first metabolite of ethanol, being acetaldehyde. Concentrations of acetaldehyde detected in the oral cavity are relatively high due to the metabolization of ethanol by oral microbes. Acetaldehyde can directly damage the DNA by the formation of mutagenic DNA adducts and interstrand crosslinks. Additionally, ethanol is known to affect epigenetic methylation and acetylation patterns, which are important regulators of gene expression. Ethanol-induced hypomethylation can activate the expression of oncogenes which subsequently can result in malignant transformation. The recent identification of ethanol-related mutational signatures emphasizes the role of acetaldehyde in alcohol-associated carcinogenesis. However, not all signatures associated with alcohol intake also relate to acetaldehyde. This finding highlights that there might be other effects of ethanol yet to be discovered.
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Affiliation(s)
- Lore Hoes
- Laboratory for Systems Biology, VIB-KU Leuven Center for Microbiology, 3000 Leuven, Belgium; (L.H.); (K.J.V.)
- Laboratory of Genetics and Genomics, Centre for Microbial and Plant Genetics, KU Leuven, 3000 Leuven, Belgium
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000 Leuven, Belgium;
| | - Rüveyda Dok
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000 Leuven, Belgium;
| | - Kevin J. Verstrepen
- Laboratory for Systems Biology, VIB-KU Leuven Center for Microbiology, 3000 Leuven, Belgium; (L.H.); (K.J.V.)
- Laboratory of Genetics and Genomics, Centre for Microbial and Plant Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, KU Leuven, 3000 Leuven, Belgium;
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospital Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-1634-7600; Fax: +32-1634-7623
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Recurrence in Oral Premalignancy: Clinicopathologic and Immunohistochemical Analysis. Diagnostics (Basel) 2021; 11:diagnostics11050872. [PMID: 34066207 PMCID: PMC8151734 DOI: 10.3390/diagnostics11050872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 01/13/2023] Open
Abstract
Oral leukoplakia (OL) has a propensity for recurrence and malignant transformation (MT). Herein, we evaluate sociodemographic, clinical, microscopic and immunohistochemical parameters as predictive factors for OL recurrence, also comparing primary lesions (PLs) with recurrences. Thirty-three patients with OL, completely removed either by excisional biopsy or by laser ablation following incisional biopsy, were studied. Selected molecules associated with the STAT3 oncogenic pathway, including pSTAT3, Bcl-xL, survivin, cyclin D1 and Ki-67, were further analyzed. A total of 135 OL lesions, including 97 PLs and 38 recurrences, were included. Out of 97 PLs, 31 recurred at least once and none of them underwent MT, during a mean follow-up time of 48.3 months. There was no statistically significant difference among the various parameters in recurrent vs. non-recurrent PLs, although recurrence was most frequent in non-homogeneous lesions (p = 0.087) and dysplastic lesions recurred at a higher percentage compared to hyperplastic lesions (34.5% vs. 15.4%). Lower levels of Bcl-xL and survivin were identified as significant risk factors for OL recurrence. Recurrences, although smaller and more frequently homogeneous and non-dysplastic compared to their corresponding PLs, exhibited increased immunohistochemical expression of oncogenic molecules, especially pSTAT3 and Bcl-xL. Our results suggest that parameters associated with recurrence may differ from those that affect the risk of progression to malignancy and support OL management protocols favoring excision and close monitoring of all lesions.
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Sekar B, Indrapriyadharshini K, Ambika M, Saranyan R, Nirmal M, Manzoor S. Survivin Expression in Metastatic and Nonmetastatic Oral Squamous Cell Carcinoma: A Comparative Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820968448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: Survivin is a multifunctional protein chiefly involved in apoptosis and cell cycle regulation. Increased expression of survivin in tumors and fetal tissue determines its antiapoptotic activity. The aim of the study is to identify the immunoexpression of survivin in metastatic and nonmetastatic oral squamous cell carcinoma (OSCC) and also to evaluate and compare the expression of survivin in metastatic and nonmetastatic OSCC of buccal mucosa. Materials and Methods: In total, 40 histopathologically proven cases of OSCC, including 20 metastatic and 20 nonmetastatic cases, are selected. Among the 20 metastatic and nonmetastatic cases, 10 well-differentiated and 10 moderately differentiated squamous cell carcinoma cases were included and were subjected to immunohistochemical staining for survivin expression. The results were analyzed by SPSS version 11.5 using chi-square test. Results: The expression of survivin in metastatic and nonmetastatic tumors is 15%–70% and 15%–60%, respectively. When comparing the cases of moderately differentiated squamous cell carcinoma in metastatic and nonmetastatic tumors, 70% cases show moderate staining intensity. Conclusion: The survivin expression was comparatively high in metastatic OSCC. Also based on the aforementioned results, survivin expression was high in increasing grades of OSCC.
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Affiliation(s)
- B. Sekar
- Department of Oral Pathology and Microbiology, Vinayaka Mission’s Sankarachariyar Dental College, VMRF (Deemed to be University), Ariyanoor, Tamil Nadu, India
| | - K. Indrapriyadharshini
- Department of Oral Pathology and Microbiology, Vinayaka Mission’s Sankarachariyar Dental College, VMRF (Deemed to be University), Ariyanoor, Tamil Nadu, India
| | - M. Ambika
- Department of Oral Pathology and Microbiology, Vinayaka Mission’s Sankarachariyar Dental College, VMRF (Deemed to be University), Ariyanoor, Tamil Nadu, India
| | - R. Saranyan
- Department of Periodontics, Vinayaka Mission’s Sankarachariyar Dental College, VMRF (Deemed to be University), Ariyanoor, Tamil Nadu, India
| | - Madhavan Nirmal
- Department of Oral Pathology and Microbiology, Raja Muthiah Dental College, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Sathick Manzoor
- Department of Dental Radiology, MAHSA University, Kuala Lumpur, Malaysia
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Angelin D, Nair BJ. Comparative evaluation of survivin expression in leukoplakia, lichen planus, and oral squamous cell carcinoma: An immunohistochemical study. J Cancer Res Ther 2020; 16:569-574. [PMID: 32719269 DOI: 10.4103/jcrt.jcrt_421_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Screening for oral squamous cell carcinomas (OSCCs) and oral premalignant lesions may decrease the devastating morbidity and mortality associated with the disease. This has led to widespread research for the identification of molecular-based biomarkers. Among them, survivin is a recently characterized protein which is a member of the inhibitor of apoptosis family. The aim of this study is evaluating the expression of survivin in oral leukoplakia, oral lichen planus, and OSCC compared with normal mucosa. Materials and Methods The retrospective study consisted of twenty cases of oral leukoplakia, oral lichen planus, and OSCC in the age group of 20-70 years. Twenty cases of normal mucosa made up the control group. Immunohistochemical staining was performed with the use of survivin polyclonal antibody. Grades of expression of survivin were evaluated. Kruskal-Wallis test was used for statistical analysis. Results The expression of survivin was higher in OSCC (80%) when compared to oral leukoplakia (70%), oral lichen planus (45%), and normal mucosa (35%). The variation in the expression of survivin between the samples was statistically significant with P = 0.015 (Kruskal-Wallis test significant at 0.01 level). Conclusion It is concluded that survivin can be identified as a useful tool for the identification of potentially malignant disorders at higher risk for progression into invasive carcinoma.
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Affiliation(s)
- D Angelin
- Department of Oral Pathology, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Tamil Nadu, India
| | - Bindu J Nair
- Dr. Vivek's Dental Clinic, Thiruvananthapuram, Kerala, India
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13
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Rajanna VR, Raveendranath MC, Kathiresan S, Srinivasan S, Ilango J. Expression of Survivin in Oral Potentially Malignant Disorders: An Immunohistochemical Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:S382-S388. [PMID: 33149491 PMCID: PMC7595508 DOI: 10.4103/jpbs.jpbs_114_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/06/2020] [Accepted: 03/02/2020] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study was to compare the immunohistochemical expression of survivin in oral potentially malignant disorders (OPMDs) and evaluate its prognostic significance among oral leukoplakia (OL), oral submucous fibrosis (OSMF), and oral lichen planus (OLP). MATERIALS AND METHODS The study material consisted of 60 formalin-fixed paraffin-embedded tissue samples: 15 cases each of OL, OSMF, OLP, and normal oral mucosal epithelium as control. Survivin expression was analyzed immunohistochemically, and data analysis was accomplished using Statistical Package for Social Sciences, version 22.0 (SPSS Inc., Chicago, IL). Fisher's chi-square test was opted to compare the study groups. RESULTS Survivin was expressed in all the OPMDs including OL, OSMF, and OLP, but was absent in normal oral tissue samples. Higher immunoreactivity and survivin staining was observed in OLP compared to OL and OSMF whereas OL showed a significant difference in the distribution of survivin immunoexpression against OLP. An increased nuclear expression of survivin along with distribution in the basal and parabasal layers was evident in all OPMDs. CONCLUSION Survivin was expressed more in OLP in comparison to OSMF and OLP, indicating unfavorable prognosis. OL showed increased expression in comparison to OSMF, showing unfavorable prognosis. On the basis of this study, it was concluded that survivin may be used as an important diagnostic and prognostic marker for OPMDs.
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Affiliation(s)
- Venkatraman R Rajanna
- Department of Oral Pathology and Microbiology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Murali C Raveendranath
- Department of Oral Pathology and Microbiology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Shanmugam Kathiresan
- Department of Oral Pathology and Microbiology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Soundarya Srinivasan
- Department of Oral Pathology and Microbiology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Janani Ilango
- Department of Oral Pathology and Microbiology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
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14
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Ben Elhadj M, Fourati A, El Amine O, Goucha A, El May A, El May MV, Mokni Baizig N. Prevalence and Prognostic Value of HPV among Tunisian Patients with Laryngeal Cancer and Relationship between DNA HPV and p16, IGF-1R, Survivin, p53 Expressions. Ann Otol Rhinol Laryngol 2020; 129:863-871. [PMID: 32364419 DOI: 10.1177/0003489420918280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Tobacco and alcohol are the main etiological factors common to laryngeal cancers. However, the Human Papilloma Virus (HPV) constitutes an alternative risk factor according to several studies. In Tunisia, despite the annual increasing incidence of laryngeal squamous cell carcinoma (LSCC), the prevalence and prognostic significance of HPV have never been explored.In this study, we sought to highlight HPV DNA in 70 biopsies of laryngeal cancer, and to analyze the status of HPV infection in association with p53, p16, survivin, and IGF-1R expressions. METHODS HPV high risk (HPV HR) DNA was detected in tumors by in situ hybridization. However, the expression of p53, p16, survivin and IGF-1R were stained by immunohistochemistry test. The correlations of HPV status with clinicopathological parameters, overall survival, disease-free survival and proteins expressions were statistically evaluated. RESULTS HPV HR DNA was detected in 39 out of 70 (55.71%) laryngeal tumors. HPV+ patients have a better overall survival (P = .081) and long disease-free-survival (P = .016) with a low rate of recurrence (P = .006) than HPV- patients. No significant correlations were found between HPV HR status and clinicopathological parameters (all P > .005). Moreover, HPV+ tumors were not associated with expression of p53, p16 and survivin. However, HPV HR status correlates with weak to moderate IGF-1R expression (P = .043). CONCLUSION The substantial detection of HPV HR in LSCC tumors suggest that this virus plays an important part in laryngeal cancer in Tunisia. It is a good prognostic factor. In addition, HPV infection could act to block the pathway of IGF-1R expression.
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Affiliation(s)
- Mariem Ben Elhadj
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Asma Fourati
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Olfa El Amine
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Aida Goucha
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Ahmed El May
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Michèle-Veronique El May
- Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Nehla Mokni Baizig
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
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Sakthivel R, Ramamoorthy A, Jeddy N, Singaram M. Evaluation and Expression of Survivin in Potentially Malignant Lesions and Squamous Cell Carcinoma: A Comparative Study. Cureus 2020; 12:e7551. [PMID: 32382455 PMCID: PMC7202583 DOI: 10.7759/cureus.7551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Overexpression of survivin, an anti-apoptotic protein, has been associated with the progression of cancer, resistance to drugs, and a poor prognosis. The expression level of survivin indicates the progression of the disease, early recurrence, and a failure to respond to therapy. Our study was a retrospective analysis performed on archival specimens. Materials and methods The study included a total of 50 histopathologically proven cases of potentially malignant lesions and squamous cell carcinoma. Immunohistochemical staining was carried out using primary rabbit monoclonal antibodies to survivin (PathnSitu, Telangana, India) along with a horseradish peroxidase detection kit (Leica Biosystems, Maharashtra, India). The intensity of staining of survivin in the epithelium was determined, and the data obtained from potentially malignant lesions, oral squamous cell carcinoma, fetal tissue, and normal oral mucosa were compared. Results The expression of survivin was positive in 70% of the samples of oral squamous cell carcinoma followed by 50% from cases of leukoplakia, 20% of oral submucous fibrosis samples, and 10% of lichen planus samples (P < 0.05). Conclusion Malignant transformation of these potentially malignant lesions increases with increased expression of survivin. This expression of the anti-apoptotic protein might be an early phenomenon in the initiation and advancement of oral squamous cell carcinoma. The prognosis of oral squamous cell carcinomas becomes poorer with increased expression of survivin. Therefore, survivin might be helpful as an important therapeutic target because it is expressed more in tumor cells and absent in most adult tissues.
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Affiliation(s)
- Rekhaa Sakthivel
- Oral Pathology, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | | | - Nadeem Jeddy
- Oral and Maxillofacial Pathology, Thai Moogambigai Dental College and Hospital, Chennai, IND
| | - Mamta Singaram
- Oral and Maxillofacial Surgery, Thai Moogambigai Dental College and Hospital, Chennai, IND
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Xu M, Hu X, Zhang M, Ge Y. What is the impact of BIRC5 gene polymorphisms on urinary cancer susceptibility? Evidence from 9348 subjects. Gene 2019; 733:144268. [PMID: 31809840 DOI: 10.1016/j.gene.2019.144268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/29/2022]
Abstract
As a member of apoptosis inhibition gene family, baculoviral IAP repeat containing 5 (BIRC5) protein acts as a survival factor in oncology through multiple ways. There are huge inconsistent results between urinary cancer risk and BIRC5 polymorphisms, so we searched and documented all eligible articles to clear up the mystery with the help of meta-analysis. According to the inclusion and exclusion criteria, we performed an overall search in Web of Science, PubMed, Google Scholar, Medline, CNKI and Wanfang database with pre-set search strategy up to November 2019. Z-test was performed to determine the statistical difference by Odds ratios (ORs) and 95% confidence intervals (CIs). The stability of the pooled ORs was conducted by one-way sensitivity analyses, Begg's funnel plots and Egger's test were employed to access the potential publication bias. The relationship of polymorphisms and BIRC5 expression was exposed by in-silico analysis, as well as the effects to tumorigenesis and prognosis. Finally, we enrolled 19 case-control studies to conducted this meta-analysis. An upgrade risk in rs9904341 of BIRC5 were revealed to be associated with urinary cancer in allele contrast model (OR = 1.222, P = 0.012), homozygote contrast model (OR = 1.579, P = 0.0001) and recessive contrast model (OR = 1.433, P < 0.001), as well as rs2071214 polymorphism in the subgroup analysis of BCa in allele contrast model (OR = 1.362, P = 0.011) and recessive contrast model (OR = 1.417, P = 0.015). On the other hand, rs17878467 variant plays an important role in prevent the tumorigenicity of urinary cancer in allele contrast model (OR = 0.672, P = 0.009), heterozygote contrast model (OR = 0.585, P = 0.006) and dominant contrast model (OR = 0.595, P = 0.004). In conclusion, we found that BIRC5 rs9904341, rs2071214 polymorphisms might cause the increased risk of urinary cancer, while rs17878467 reduces risk.
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Affiliation(s)
- Ming Xu
- Department of Urology, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Shenzhen 518000, China
| | - Xianyu Hu
- The First Clinical College of Anhui Medical University, Hefei 230032, China.
| | - Meng Zhang
- Department of Urology, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Shenzhen 518000, China; Department of Urology, The First Affiliated Hospital of Anhui Medical University, & Institute of Urology, & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022, China
| | - Yating Ge
- Department of Nephrology, The Second People's Hospital of Hefei, Affiliated Hefei Hospital of Anhui Medical University, Hefei 230011, China.
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17
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Başpınar Y, Erel-Akbaba G, Kotmakçı M, Akbaba H. Development and characterization of nanobubbles containing paclitaxel and survivin inhibitor YM155 against lung cancer. Int J Pharm 2019; 566:149-156. [DOI: 10.1016/j.ijpharm.2019.05.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/04/2019] [Accepted: 05/13/2019] [Indexed: 12/21/2022]
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18
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Ben Elhadj M, Amine OEL, Mokni Baizig N, Ben Ayoub W, Goucha A, El May MV, Fourati A. Expression Profile of Survivin and p16 in Laryngeal Squamous Cell Carcinoma: Contribution of Tunisian Patients. EAR, NOSE & THROAT JOURNAL 2019; 100:NP7-NP15. [PMID: 31159573 DOI: 10.1177/0145561319855644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The objective of this study was to evaluate the expression of survivin and p16 in laryngeal squamous cell carcinoma (LSCC) in order to analyze their pathogenesis and prognostic significance in Tunisian patients. A total of 70 patients with LSCC collected at the Salah Azaiez Cancer Institute of Tunis were retrospectively evaluated. Expression of survivin and p16 was examined using immunohistochemistry, and the correlations with clinicopathological parameters, overall survival (OS), and disease-free survival (DFS) were statistically evaluated. The positive expression of survivin and p16 were found in 58.6% and 51.43% of LSCC cases, respectively. The p16 expression was not associated with either clinical parameters or patient survival, whereas there was a strong correlation of survivin expression and lymph node metastases (P = .002), alcohol consumption (P = .024), and therapeutic protocol (with or without chemotherapy; P = .001). Kaplan-Meier survival curves showed that patients with LSCC having positive survivin expression have shorter OS (P = .026) and shorter DFS (P = .01) than those with negative expression. Positive survivin expression was also correlated with high recurrence rate (P = .014). Therefore, survivin is a poor prognostic marker for LSCC but the therapeutic protocol remains, in multivariate study, the most decisive for the OS and DFS of our patients with P < .01. Our data indicated that, in Tunisian laryngeal squamous cell carcinoma, survivin expression is associated with unfavorable outcomes and represents a predictor marker of recurrence and chemoresistance. However, p16 expression has no prognosis value.
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Affiliation(s)
- Mariem Ben Elhadj
- Department of Immuno-Histo-Cytology, 59075Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Olfa E L Amine
- Department of Immuno-Histo-Cytology, 59075Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Nehla Mokni Baizig
- Department of Immuno-Histo-Cytology, 59075Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Wided Ben Ayoub
- Departement of Epidemiology, 59075Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Aida Goucha
- Department of Immuno-Histo-Cytology, 59075Salah Azaiez Cancer Institute, Tunis, Tunisia
| | | | - Asma Fourati
- Department of Immuno-Histo-Cytology, 59075Salah Azaiez Cancer Institute, Tunis, Tunisia
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Troiano G, Guida A, Aquino G, Botti G, Losito NS, Papagerakis S, Pedicillo MC, Ionna F, Longo F, Cantile M, Pennella A, Lo Russo L, Di Gioia G, Mariggiò MA, Lo Muzio L, Pannone G. Integrative Histologic and Bioinformatics Analysis of BIRC5/Survivin Expression in Oral Squamous Cell Carcinoma. Int J Mol Sci 2018; 19:ijms19092664. [PMID: 30205554 PMCID: PMC6174346 DOI: 10.3390/ijms19092664] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/02/2018] [Indexed: 12/27/2022] Open
Abstract
Survivin is a well-known protein involved in the inhibition of apoptosis in many different cancer types. The aim of this study was to perform an integrated bioinformatic and histologic analysis in order to study the expression and prognostic role of Survivin and its related gene BIRC5 in oral cancer. Publicly available databases were accessed via Gene Expression Omnibus and Oncomine, in addition raw data from The Cancer Genome Atlas (TCGA) were also obtained in order to analyze the rate of gene mutation, expression and methylation in patients with oral squamous cells carcinoma (OSCC). Immunohistochemistry (IHC) was also performed in order to evaluate the nuclear and cytoplasmic expression of Survivin and their correlation with cell proliferation in samples from OSCC patients. Results of this study revealed that Survivin is rarely mutated in OSCC samples and upregulated when compared to non-cancerous tissue. A negative correlation between the methylation of the island cg25986496 and BIRC5 mRNA expression was detected from TCGA data. IHC staining revealed that cytoplasmic (and not nuclear) expression of Survivin is associated with poor overall survival in OSCC patients, while the nuclear expression correlates with higher proliferation rate. In addition, data from TCGA database revealed that BIRC5 gene expression is an independent prognostic factor for OSCC patients.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Agostino Guida
- Maxillofacial and ENT Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Gabriella Aquino
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Nunzia Simona Losito
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Silvana Papagerakis
- Department of Surgery, Cancer Research Cluster, Room 4D10.2, Health Sciences Building, Saskatchewan University, Saskatoon, SKS7N5E5, Canada.
| | - Maria Carmela Pedicillo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Franco Ionna
- Maxillofacial and ENT Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Francesco Longo
- Maxillofacial and ENT Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Monica Cantile
- Pathology Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione G. Pascale, IRCCS, Naples 80131, Italy.
| | - Antonio Pennella
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Giovanni Di Gioia
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Maria Addolorata Mariggiò
- Department of Biomedical Sciences and Human Oncology, University of Bari. Piazza Giulio Cesare 11, Bari 70124, Italy.
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
| | - Giuseppe Pannone
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, Foggia 71122, Italy.
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Survivin-Based Treatment Strategies for Squamous Cell Carcinoma. Int J Mol Sci 2018; 19:ijms19040971. [PMID: 29587347 PMCID: PMC5979467 DOI: 10.3390/ijms19040971] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 02/07/2023] Open
Abstract
Survivin, an anti-apoptotic molecule abundantly expressed in most human neoplasms, has been reported to contribute to cancer initiation and drug resistance in a wide variety of human tumors. Efficient downregulation of survivin can sensitize tumor cells to various therapeutic interventions, generating considerable efforts in its validation as a new target in cancer therapy. This review thoroughly analyzes up-to-date information on the potential of survivin as a therapeutic target for new anticancer treatments. The literature dealing with the therapeutic targeting of survivin will be reviewed, discussing specifically squamous cell carcinomas (SCCs), and with emphasis on the last clinical trials. This review gives insight into the recent developments undertaken in validating various treatment strategies that target survivin in SCCs and analyze the translational possibility, identifying those strategies that seem to be the closest to being incorporated into clinical practice. The most recent developments, such as dominant-negative survivin mutants, RNA interference, anti-sense oligonucleotides, small-molecule inhibitors, and peptide-based immunotherapy, seem to be helpful for effectively downregulating survivin expression and reducing tumor growth potential, increasing the apoptotic rate, and sensitizing tumor cells to chemo- and radiotherapy. However, selective and efficient targeting of survivin in clinical trials still poses a major challenge.
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21
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Current Insights into Oral Cancer Epigenetics. Int J Mol Sci 2018; 19:ijms19030670. [PMID: 29495520 PMCID: PMC5877531 DOI: 10.3390/ijms19030670] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 12/30/2022] Open
Abstract
Epigenetic modifications have emerged into one of the cancer hallmarks, replacing the concept of malignant pathologies as being solely genetic-based conditions. The epigenetic landscape is responsible for normal development but also for the heterogeneity among tissues in terms of gene expression patterns. Dysregulation in these mechanisms has been associated with disease stage, and increased attention is now granted to cancer in order to take advantage of these modifications in terms of novel therapeutic strategies or diagnosis/prognosis tools. Oral cancer has also been subjected to epigenetic analysis with numerous studies revealing that the development and progression of this malignancy are partially induced by an altered epigenetic substrate together with genetic alterations and prolonged exposure to environmental risk factors. The present review summarizes the most important epigenetic modifications associated with oral cancer and also their potential to be used as new therapeutic targets.
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Wang X, Beitler JJ, Huang W, Chen G, Qian G, Magliocca K, Patel MR, Chen AY, Zhang J, Nannapaneni S, Kim S, Chen Z, Deng X, Saba NF, Chen ZG, Arbiser JL, Shin DM. Honokiol Radiosensitizes Squamous Cell Carcinoma of the Head and Neck by Downregulation of Survivin. Clin Cancer Res 2017; 24:858-869. [PMID: 29180609 DOI: 10.1158/1078-0432.ccr-17-0345] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/16/2017] [Accepted: 11/20/2017] [Indexed: 12/26/2022]
Abstract
Purpose: Previous studies revealed diverging results regarding the role of survivin in squamous cell carcinoma of the head and neck (SCCHN). This study aimed to evaluate the clinical significance of survivin expression in SCCHN; the function of survivin in DNA-damage repair following ionizing radiation therapy (RT) in SCCHN cells; and the potential of honokiol to enhance RT through downregulation of survivin.Experimental Design: Expression of survivin in SCCHN patient primary tumor tissues (n = 100) was analyzed and correlated with clinical parameters. SCCHN cell lines were used to evaluate the function of survivin and the effects of honokiol on survivin expression in vitro and in vivoResults: Overexpression of survivin was significantly associated with lymph nodes' metastatic status (P = 0.025), worse overall survival (OS), and disease-free survival (DFS) in patients receiving RT (n = 65, OS: P = 0.024, DFS: P = 0.006) and in all patients with SCCHN (n = 100, OS: P = 0.002, DFS: P = 0.003). In SCCHN cells, depletion of survivin led to increased DNA damage and cell death following RT, whereas overexpression of survivin increased clonogenic survival. RT induced nuclear accumulation of survivin and its molecular interaction with γ-H2AX and DNA-PKCs. Survivin specifically bound to DNA DSB sites induced by I-SceI endonuclease. Honokiol (which downregulates survivin expression) in combination with RT significantly augmented cytotoxicity in SCCHN cells with acquired radioresistance and inhibited growth in SCCHN xenograft tumors.Conclusions: Survivin is a negative prognostic factor and is involved in DNA-damage repair induced by RT. Targeting survivin using honokiol in combination with RT may provide novel therapeutic opportunities. Clin Cancer Res; 24(4); 858-69. ©2017 AACR.
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Affiliation(s)
- Xu Wang
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Jonathan J Beitler
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Wen Huang
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Guo Chen
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Guoqing Qian
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Kelly Magliocca
- Department of Pathology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Mihir R Patel
- Department of Otolaryngology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Amy Y Chen
- Department of Otolaryngology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Jun Zhang
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Department of Internal Medicine, Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Sreenivas Nannapaneni
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Sungjin Kim
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Zhengjia Chen
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Xingming Deng
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Zhuo Georgia Chen
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Jack L Arbiser
- Department of Dermatology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia.,Veterans Affairs Medical Center, Decatur, Georgia
| | - Dong M Shin
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia.
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Lima CF, Crastechini E, Dos Santos NC, Prado Ribeiro AC, Brandão TB, Castro FCF, Issa JS, Almeida JD. Smoking cessation leads to changes in survivin expression in oral mucosa. J Oral Pathol Med 2017; 47:293-298. [PMID: 29160903 DOI: 10.1111/jop.12664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Survivin is an inhibitor protein of apoptosis and plays a role in oral carcinogenesis mechanism. METHODS The aim of this study was to evaluate the effect of smoking in survivin expression of oral mucosa of chronic smokers with and without oral squamous cell carcinoma (OSCC). The study was composed of three groups: Group 1-26 patients smoking more than 20 cigarettes/day/10 years without either history of oral malignant neoplasia or visible clinical signs in the examined site; Group 2-26 patients with OSCC; Group 3-22 patients surgically treated for OSCC for at least 1 month. The immunohistochemistry was performed with 1 smear for each group and analyzed by microscopy regarding extension, intensity of positive cells for survivin, and intracellular location. RESULTS The survivin expression was observed in 100% of the cases in Group 1, 88.5% in Group 2, and 100% in Group 3. Concerning to Groups 1 and 3, the survivin expression with cytoplasmic location occurred in 100%, while in Group 2 occurred in 87.5%. The cytoplasmic and nuclear expression was observed only in Group 2, with 7.69%. The results were correlated with clinical-pathological data by Fischer's exact test with significant relation between smoking cessation and intensity (P = .015) for Group 2. CONCLUSIONS The extension and intensity of survivin expression in the cytological smears were related to the smoking cessation in the group with OSCC. However, the smoking history (packs/years) did not influence the survivin expression.
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Affiliation(s)
- Celina F Lima
- University Braz Cubas, Mogi das Cruzes, São Paulo, Brazil.,Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Erica Crastechini
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Nathalia C Dos Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
| | - Ana Carolina Prado Ribeiro
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, São Paulo, Brazil
| | - Thais B Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, São Paulo, Brazil
| | | | - Jaqueline S Issa
- Outpatient Program for the Treatment of Smoking, Heart Institute São Paulo, University Hospital, Medical School, University of São Paulo, Araçatuba, São Paulo, Brazil
| | - Janete D Almeida
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo, Brazil
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Pang S, Yee M, Saba Y, Chino T. Artepillin C as a targeting survivin molecule in oral squamous cell carcinoma cells in vitro: A preliminary study. J Oral Pathol Med 2017; 47:48-52. [PMID: 28833597 DOI: 10.1111/jop.12624] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Seokjoon Pang
- International Dental Studies Program; Arthur A. Dugoni School of Dentistry; University of the Pacific; San Francisco CA USA
| | - Michael Yee
- Department of Biomedical Sciences; Arthur A. Dugoni School of Dentistry; University of the Pacific; San Francisco CA USA
| | - Yasmin Saba
- Department of Biomedical Sciences; Arthur A. Dugoni School of Dentistry; University of the Pacific; San Francisco CA USA
| | - Takahiro Chino
- Department of Biomedical Sciences; Arthur A. Dugoni School of Dentistry; University of the Pacific; San Francisco CA USA
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25
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Nuclear Survivin as a Prognostic Factor in Squamous-Cell Carcinoma of the Oral Cavity. Appl Immunohistochem Mol Morphol 2017; 25:566-570. [DOI: 10.1097/pai.0000000000000336] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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26
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Deo PN, Deshmukh R. Expression of survivin in dysplasia and different grades of oral squamous cell carcinoma. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2017. [DOI: 10.1177/2057178x17710147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Priya Nimish Deo
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Pune, Maharashtra, India
| | - Revati Deshmukh
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth Deemed University, Dental College and Hospital, Pune, Maharashtra, India
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Yan X, Su H. YM155 Down-Regulates Survivin and Induces P53 Up-Regulated Modulator of Apoptosis (PUMA)-Dependent in Oral Squamous Cell Carcinoma Cells. Med Sci Monit 2017; 23:1963-1972. [PMID: 28435150 PMCID: PMC5412973 DOI: 10.12659/msm.901643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND YM155, which inhibits the anti-apoptotic protein survivin, is known to exert anti-tumor effects in various cancers. However, there were few reports describing the inhibitory effect of YM155 on human oral squamous cell carcinoma (OSCC) cells that highly express survivin. In this study, we investigated the anti-tumor effects of YM155 on OSCC cells and then examined its molecular mechanisms. MATERIAL AND METHODS SCC9 cells of OSCC were treated with series of concentrations of YM155 (0.01, 0.1, 1, and 10 ng/ml) for 6, 12, and 24 h. The effect of YM155 on survival of SCC9 cells was detected by MTT and colony formation assay. Cell apoptosis was detected by flow cytometric analysis and the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) assays. Western blot was used to detect the protein expression of survivin, p53, and PUMA. Caspase-3 activity was measured by cleavage of the caspase-3 substrate. To test the role of PUMA and caspase-3 on YM155-induced apoptosis and growth inhibition, the SCC9 cells was transfected with PUMA siRNA or caspase-3 siRNA or control siRNA for 16 h before YM155 (1 and 10 ng/ml) treatment for 24 h. In addition, we also investigated the effect of YM155 in an in vivo xenograft model. RESULTS Treatment of YM155 efficiently reduced survivin expression and increased PUMA expression and caspase-3 activation in the SCC9 cells. YM155 treatment resulted in 18-86% decrease in cell viability, 10-60% decrease in colony numbers, and 8-40% increase in cell apoptosis (p<0.05 and p<0.01). However, the induction of cell apoptosis growth inhibition was reversed by PUMA siRNA or caspase-3 transfection. In addition, animals treated with YM155 showed more than 60% tumor growth inhibition compared to the controls (p<0.05). CONCLUSIONS YM155 is a potent inhibitor of progression of SCC9 cells, which could be due to attenuation of survivin, and activation of the PUMA/caspase-3 cellular signaling processes. This study suggests that YM155 may be a potential molecular target with therapeutic relevance for the treatment of OSCC.
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Affiliation(s)
- Xiang Yan
- Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China (mainland)
| | - Han Su
- Department of Stomatology, Jinling Hospital, Clinical School, Medical College, Nanjing University, Nanjing, Jiangsu, China (mainland)
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Khan Z, Khan AA, Yadav H, Prasad GBKS, Bisen PS. Survivin, a molecular target for therapeutic interventions in squamous cell carcinoma. Cell Mol Biol Lett 2017; 22:8. [PMID: 28536639 PMCID: PMC5415770 DOI: 10.1186/s11658-017-0038-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/27/2017] [Indexed: 12/14/2022] Open
Abstract
Squamous cell carcinoma (SCC) is the most common cancer worldwide. The treatment of locally advanced disease generally requires various combinations of radiotherapy, surgery, and systemic therapy. Despite aggressive multimodal treatment, most of the patients relapse. Identification of molecules that sustain cancer cell growth and survival has made molecular targeting a feasible therapeutic strategy. Survivin is a member of the Inhibitor of Apoptosis Protein (IAP) family, which is overexpressed in most of the malignancies including SCC and totally absent in most of the normal tissues. This feature makes survivin an ideal target for cancer therapy. It orchestrates several important mechanisms to support cancer cell survival including inhibition of apoptosis and regulation of cell division. Overexpression of survivin in tumors is also associated with poor prognosis, aggressive tumor behavior, resistance to therapy, and high tumor recurrence. Various strategies have been developed to target survivin expression in cancer cells, and their effects on apoptosis induction and tumor growth attenuation have been demonstrated. In this review, we discuss recent advances in therapeutic potential of survivin in cancer treatment.
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Affiliation(s)
- Zakir Khan
- School of Studies in Biotechnology, Jiwaji University, Gwalior, 474001 MP India.,Department of Biomedical Sciences, Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA 90048 USA
| | - Abdul Arif Khan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Hariom Yadav
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | | | - Prakash Singh Bisen
- School of Studies in Biotechnology, Jiwaji University, Gwalior, 474001 MP India
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Fiedler M, Weber F, Hautmann MG, Haubner F, Reichert TE, Klingelhöffer C, Schreml S, Meier JK, Hartmann A, Ettl T. Biological predictors of radiosensitivity in head and neck squamous cell carcinoma. Clin Oral Investig 2017; 22:189-200. [PMID: 28315964 DOI: 10.1007/s00784-017-2099-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/06/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aim of this study is to investigate the influence of prognostic biomarkers on radiosensitivity and survival of advanced head and neck squamous cell carcinomas treated by primary (chemo)radiation. MATERIAL AND METHODS The clinicopathological data and immunohistochemical staining of p16, c-Met, survivin, PD-1, and PD-L1 of 82 primarily (chemo)irradiated patients with head and neck squamous cell carcinoma were analyzed. Associations with local and locoregional radiation response, overall survival (OS), disease-free (DFS), and disease-specific survival (DSS) were assessed. RESULTS Complete tumor response was associated with increased patient age (p = 0.007), N0-status (p = 0.022), M0-status (p = 0.007), and p16-positivity (p = 0.022). High PD-L1 was associated with M0-status (p = 0.026) and indicated tumor response to irradiation (p = 0.057); survivin expression showed higher rates of response failure (p = 0.073). Low PD-1 was associated with increased T-stage (p = 0.029) and local recurrence (p = 0.014). High PD-1 was strongly correlated with PD-L1-positive tumor infiltrating lymphocytes (p < 0.001). Low PD-L1 showed a significant correlation with high c-Met expression (p = 0.01). Significant predictors for unfavorable univariate survival were incomplete tumor response (DSS, p < 0.001), single radiotherapy (DSS, p = 0.002), M1-status (DSS, p < 0.001), decreased radiation dose (DSS, p = 0.014), high survivin (DSS, p = 0.045), and high c-Met (OS, p < 0.05). Survivin and c-Met also showed prognostic significance in multivariate survival analysis. CONCLUSIONS P16 and PD-L1 indicate radiosensitivity, whereas survivin and c-Met implicate radioresistance in primarily (chemo)irradiated head and neck squamous cell carcinomas. The role of the PD-1/PD-L1 immune checkpoints in radiation response and survival merits further investigation. CLINICAL RELEVANCE The findings may improve patient-specific therapy according to individual tumor characteristics.
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Affiliation(s)
- Mathias Fiedler
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Florian Weber
- Institute of Pathology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Matthias G Hautmann
- Department of Radiotherapy, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Frank Haubner
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Torsten E Reichert
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Christoph Klingelhöffer
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Stephan Schreml
- Department of Dermatology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Johannes K Meier
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital of Erlangen, Krankenhausstraße 8/10, 91054, Erlangen, Germany
| | - Tobias Ettl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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30
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cIAP-2 Expression Increases in Elderly Patients with Squamous Cell Carcinoma of the Head and Neck. INT J GERONTOL 2017. [DOI: 10.1016/j.ijge.2016.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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31
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Enzenhofer E, Kadletz L, Stanisz I, Kotowski U, Seemann R, Schmid R, Thurnher D, Heiduschka G. Effect of the histone deacetylase inhibitor resminostat on head and neck squamous cell carcinoma cell lines. Head Neck 2017; 39:900-907. [PMID: 28170128 DOI: 10.1002/hed.24699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 11/11/2016] [Accepted: 12/06/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Carcinogenesis is determined by various epigenetic events, such as histone deacetylation. The purpose of this study was to investigate the effect of the new histone deacetylase inhibitor resminostat on head and neck squamous cell carcinoma (HNSCC) cell lines. METHODS The cytotoxicity of resminostat and cisplatin on HNSCC cell lines SCC25, CAL27, and FaDu was determined using CCK-8 cell proliferation assay and combination index analysis. Cells were irradiated with 2 to 8 Gray. Apoptosis was measured using flow cytometry and expression of Mcl-1, p-AKT, and survivin was investigated. RESULTS Treatment with resminostat showed a decrease of cell proliferation of HNSCC cell lines. In addition, a synergistic effect with cisplatin as well as with radiation treatment could be observed. Induction of cell death and dose-dependent downregulation of survivin was evident in all cell lines. CONCLUSION Resminostat is a promising treatment of HNSCC because of its antiproliferative, chemosensitizing, and radiosensitizing effects. © 2017 Wiley Periodicals, Inc. Head Neck 39: 900-907, 2017.
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Affiliation(s)
- Elisabeth Enzenhofer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Lorenz Kadletz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Isabella Stanisz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Ulana Kotowski
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Rudolf Seemann
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria
| | - Rainer Schmid
- Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
| | - Dietmar Thurnher
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - Gregor Heiduschka
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Liu MD, Xiong SJ, Tan F, Liu Y. Physcion 8-O-β-glucopyranoside induces mitochondria-dependent apoptosis of human oral squamous cell carcinoma cells via suppressing survivin expression. Acta Pharmacol Sin 2016; 37:687-97. [PMID: 27063218 DOI: 10.1038/aps.2015.152] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/24/2015] [Indexed: 12/26/2022] Open
Abstract
AIM A previous study has shown that physcion 8-O-β-glucopyranoside (PG) derived from Rumex japonicusHoutt causes apoptosis and blocks cell cycle progression in human lung cancer cells. In the present study we investigated the molecular mechanisms underlying PG-induced cancer cell apoptosis. METHODS Human OSCC-derived cell line KB was treated PG (10, 20, 50 μg/mL). Cell apoptosis was detected with flow cytometry. Mitochondrial membrane potential (MMP) and release of cytochome C from mitochondria were measured; the expression of relevant signaling proteins was analyzed using Western blotting or qRT-PCR. For evaluation of in vivo anticancer action, nude mice grafted with KB cells were treated with PG (10, 20, 40 mg·kg(-1)·d(-1), ip) for 24 days. RESULTS PG dose-dependently suppressed cell proliferation and induced apoptosis in KB cells. PG-induced apoptosis was mediated via the intrinsic mitochondrial pathway, as evidenced by the decreased Bcl-2, increased Bax and Bax/Bcl-2 ratio, as well as the loss of MMP, caspase-9 activation, and increased cytosolic cytochrome c. Furthermore, PG suppressed the expression of survivin, whereas overexpression of survivin markedly attenuated PG-induced apoptosis. Meanwhile PG increased the expression of tumor suppressor PTEN, and decreased p-Akt, p-GSK3β and miR-21 levels. Pharmacological activation of Akt/GSK3β signaling or transfection with miR-21 mimic abolished PG-induced survivin reduction and cell apoptosis. Similar results were observed in PG-treated nude mice grafted with KB cells. CONCLUSION Physcion 8-O-β-glucopyranoside induces mitochondria-dependent apoptosis of human OSCC cells by suppressing survivin expression via miR-21/PTEN/Akt/GSK3β signaling pathway.
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Comparison of Immunohistochemical Expression of Antiapoptotic Protein Survivin in Normal Oral Mucosa, Oral Leukoplakia, and Oral Squamous Cell Carcinoma. PATHOLOGY RESEARCH INTERNATIONAL 2015; 2015:840739. [PMID: 26457223 PMCID: PMC4592734 DOI: 10.1155/2015/840739] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/06/2015] [Accepted: 09/06/2015] [Indexed: 12/26/2022]
Abstract
Background. Oral squamous cell carcinoma is the sixth most frequent malignant tumor worldwide and the third most common cancers in developing countries. Oral leukoplakia is the best-known precursor lesion of oral squamous cell carcinoma. The aim of the present study was to compare immunohistochemical expression of antiapoptotic protein survivin in normal oral mucosa, oral leukoplakia, and oral squamous cell carcinoma. Method. Total 45 specimens of formalin fixed paraffin embedded tissue blocks, 15 in each of the following: normal oral mucosa, leukoplakia, and oral squamous cell carcinoma were used for the study. Immunohistochemical reaction for survivin protein was performed for the 4 µm thick histological sections taken on positively charged slides. Results. 20% normal mucosa cases, 53.33% cases of leukoplakia, and 80% of oral squamous cell carcinoma were found out to be survivin positive. One way ANOVA test indicated statistically significant difference of survivin expression between the three different groups (p < 0.001). Conclusion. A high incidence of survivin protein expression in oral epithelial dysplasia and squamous cell carcinoma samples indicate that survivin protein expression may be an early event in initiation and progression of oral squamous cell carcinoma.
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Zhang M, Zhang X, Zhao S, Wang Y, Di W, Zhao G, Yang M, Zhang Q. Prognostic value of survivin and EGFR protein expression in triple-negative breast cancer (TNBC) patients. Target Oncol 2015; 9:349-57. [PMID: 24233638 DOI: 10.1007/s11523-013-0300-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/30/2013] [Indexed: 12/12/2022]
Abstract
Triple-negative breast cancer (TNBC) is a particular type of breast cancer which is characterized by its biological aggressiveness, worse prognosis, and lack of prognostic markers or therapeutic targets in contrast with hormonal receptor-positive and human epidermal growth factor receptor 2-positive (HER2+) breast cancers. We aimed to evaluate survivin and epidermal growth factor receptor (EGFR) expression and their prognostic value and determine their relationships with the clinicopathological parameters of TNBC. A total of 136 patients who had undergone a resection of primary TNBC were enrolled at the Third Affiliated Hospital of Harbin Medical University from March 2003 to September 2005. Expression of ER, PR, HER2, EGFR, and survivin was assessed by immunohistochemistry. The association of TNBC and other clinicopathological variables and the prognostic value of survivin and EGFR expression were evaluated. Survivin was expressed in 62 (45.6 %) cases and EGFR was expressed in 82 (60.3 %) cases. Survivin expression was associated with menopausal status (P = 0.011), tumor size (P = 0.037), and lymph node status (P = 0.001). EGFR expression was associated with menopausal status (P = 0.029), lymph node status (P = 0.004), P53 expression (P = 0.001), Ki-67 expression (P = 0.028), and lymphatic vascular invasion (P = 0.037). A multivariate analysis demonstrated that tumor size (hazard ratio (HR) 1.587, 95 % confidence interval (CI) 1.081–2.330, P = 0.018 for disease-free survival (DFS); HR 1.606, 95%CI 1.096–2.354, P = 0.015 for overall survival (OS)), lymph node status (HR 2.873, 95%CI 1.544–5.344, P = 0.001 for DFS; HR 2.915, 95%CI 1.553–5.471, P = 0.001 for OS), tumor grade (HR 1.914, 95%CI 1.218–3.007, P = 0.005 for DFS; HR 1.983, 95%CI 1.228–3.203, P = 0.005 for OS), EGFR (HR 3.008, 95%CI 1.331–6.792, P = 0.008 for DFS; HR 3.151, 95%CI 1.374–7.226, P = 0.007 for OS), and survivin (HR 1.573, 95%CI 1.087–2.277, P = 0.016 for DFS; HR 1.607, 95%CI 1.088–2.374, P = 0.017 for OS) were of prognostic significance for disease-free and overall survival. We draw a conclusion from the present study that survivin and EGFR expression are useful prognostic markers of TNBC and might be useful for molecular targeting therapy of TNBC treatment.
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Santarelli A, Mascitti M, Rubini C, Bambini F, Zizzi A, Offidani A, Ganzetti G, Laino L, Cicciù M, Lo Muzio L. Active inflammatory biomarkers in oral lichen planus. Int J Immunopathol Pharmacol 2015; 28:562-8. [PMID: 26303119 DOI: 10.1177/0394632015592101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 05/21/2015] [Indexed: 11/17/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic disease, with a central role to cell-mediated autoimmunity. Osteopontin promotes migration and recruitment of immune cells, CD44 is its receptor, and Survivin seems to be important in skin/mucosa homeostasis. The aim of this study was to investigate their expression in biopsy specimens of patients with different OLP clinical types and healthy controls.Biopsy specimens from 30 patients with OLP (15 atrophic and 15 hyperplastic) and 15 healthy controls were subjected to immune-histochemical analysis, to detect the expression of osteopontin, CD44, and Survivin in oral epithelia. The distributions of positively stained cells were evaluated with a quantitative method, while the inflammation degree was evaluated with a semi-quantitative one.Expression of osteopontin and CD44 was higher in OLP than controls, while Survivin expression was lower in OLP patients. There was a greater reduction of Survivin expression in atrophic OLP than hyperplastic OLP. A correlation between osteopontin expression and a high degree of inflammation was found. Furthermore, Survivin expression was higher in cases with low intensity of inflammation.Osteopontin, CD44, and Survivin seem to be involved in OLP pathogenesis, and further investigations are needed for clarifying their role in this oral disease.
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Affiliation(s)
- Andrea Santarelli
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Marco Mascitti
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Corrado Rubini
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Fabrizio Bambini
- Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Antonio Zizzi
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Annamaria Offidani
- Department of Clinical and Molecular Medicine, Marche Polytechnic University, Ancona, Italy
| | - Giulia Ganzetti
- Department of Clinical and Molecular Medicine, Marche Polytechnic University, Ancona, Italy
| | - Luigi Laino
- Departement of Human Pathology, University of Messina, Italy
| | - Marco Cicciù
- Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy
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Xie S, Xu H, Shan X, Liu B, Wang K, Cai Z. Clinicopathological and prognostic significance of survivin expression in patients with oral squamous cell carcinoma: evidence from a meta-analysis. PLoS One 2015; 10:e0116517. [PMID: 25710884 PMCID: PMC4339736 DOI: 10.1371/journal.pone.0116517] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 12/10/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Survivin has been proposed as a promising prognostic marker in oral squamous cell carcinoma (OSCC), but the published data on survivin expression in patients with this condition are controversial. To address this we performed a meta-analysis systematically to assess the clinicopathological and prognostic significance of survivin expression in OSCC. METHODS We searched PubMed, Embase, Web of Science and Ovid databases for papers investigating the clinicopathological and prognostic significance of survivin expression in OSCC. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to determine the relevance of survivin. RESULTS A total of 15 papers, including 1040 cases in which survivin expression was detected by immunohistochemistry (IHC) or reverse transcription polymerase chain reaction (RT-PCR), were included. A meta-analysis of clinicopathological variables revealed a correlation between survivin expression and lymph node metastasis (OR = 0.62, 95% CI = 0.44-0.88, p < 0.05) and clinical stage (OR = 0.63, 95% CI = 0.41-0.96, p < 0.05). However, no significant associations were found between survivin expression and tumor differentiation grade (OR = 0.72, 95%CI = 0.26-1.11, p > 0.05), depth of invasion (OR = 0.76, 95% CI = 0.50-1.14, p > 0.05), age (OR = 0.78, 95% CI = 0.48-1.29, p > 0.05) or gender (OR = 1.31, 95% CI = 0.86-2.01, p > 0.05). Subgroup analysis using stratified detection methods showed no significant associations between the expression of survivin protein and clinicopathological variables in OSCC. A correlation between survivin expression and poor prognosis of patients with OSCC (HR = 1.62, 95% CI = 1.23-2.01, p < 0.05) was demonstrated. CONCLUSION Survivin is a potential prognostic marker of OSCC. Future studies with larger sample sizes and well-designed inclusion criteria will be needed to dissect the role of survivin expression in determining the clinicopathological features and/or prognosis of OSCC.
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Affiliation(s)
- Shang Xie
- Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China
| | - Hui Xu
- Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China
| | - Xiaofeng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China
| | - Baozhong Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China
| | - Kan Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China
| | - Zhigang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China
- * E-mail:
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Identification of novel helper epitope peptides of Survivin cancer-associated antigen applicable to developing helper/killer-hybrid epitope long peptide cancer vaccine. Immunol Lett 2014; 161:20-30. [PMID: 24794408 DOI: 10.1016/j.imlet.2014.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 03/31/2014] [Accepted: 04/16/2014] [Indexed: 12/22/2022]
Abstract
We identified novel helper epitope peptides of Survivin cancer antigen, which are presented to both HLA-DRB1*01:01 and DQB1*06:01. The helper epitope also contained three distinct Survivin-killer epitopes presented to HLA-A*02:01 and A*24:02. This 19 amino-acids epitope peptide (SU18) induced weak responses of Survivin-specific CD4(+) and CD8(+) T cells though it contained both helper and killer epitopes. To enhance the vaccine efficacy, we synthesized a long peptide by conjugating SU18 peptide and another DR53-restricted helper epitope peptide (SU22; 12 amino-acids) using glycine-linker. We designated this artificial 40 amino-acids long peptide containing two helper and three killer epitopes as Survivin-helper/killer-hybrid epitope long peptide (Survivin-H/K-HELP). Survivin-H/K-HELP allowed superior activation of IFN-γ-producing CD4(+) Th1 cells and CD8(+) Tc1 cells compared with the mixture of its component peptides (SU18 and SU22) in the presence of OK-432-treated monocyte-derived DC (Mo-DC). Survivin-H/K-HELP-pulsed Mo-DC pretreated with OK-432 also exhibited sustained antigen-presentation capability of stimulating Survivin-specific Th1 cells compared with Mo-DC pulsed with a mixture of SU18 and SU22 short peptides. Moreover, we demonstrated that Survivin-H/K-HELP induced a complete response in a breast cancer patient with the induction of cellular and humoral immune responses. Thus, we believe that an artificially synthesized Survivin-H/K-HELP will become an innovative cancer vaccine.
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Expression of hypoxic signaling markers in head and neck squamous cell carcinoma and its clinical significance. Eur Arch Otorhinolaryngol 2014; 272:219-28. [PMID: 24627073 DOI: 10.1007/s00405-014-2954-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
Abstract
Hypoxia is a consistent finding in fast-growing tumors; it contributes to tumor progression and therapeutic responses. We explored the expression of hypoxia-associated biomarkers in head and neck squamous cell carcinoma (HNSCC) to assess their relationship with clinical factors in HNSCC. In total, 90 patients with HNSCC were enrolled. Expression of HIF-1α, HSP70, HSP90, VEGF, IGF-1R, and P16 was investigated by immunohistochemistry. Their correlations with clinical factors, including location of primary sites, T stage, N stage, M stage, HPV status, primary treatment success/failure, recurrences, disease-free survival (DFS), and overall survival, were analyzed. HIF-1α, HPS70, HPS90, VEGF, and IGF-1R were positive in 33 of 89 (37.1 %), 62 of 87 (71.3 %), 83 of 89 (93.3 %), 41 of 87 (47.1 %), and 50 of 56 (89.3 %) cases, respectively. Expression levels of some of these markers were correlated. High HIF-1α or HSP 70 correlated with poor DFS, and expression of HSP70 correlated with LN metastasis. HPV-related carcinomas showed high HSP 70 and IGF-1R expression. Hypoxia-associated proteins were highly expressed and associated with aggressive clinical features in HNSCC. Expression of HIF-1α or HSP70 can be considered poor prognostic indicator in HNSCC. Our results suggest that hypoxic signaling is activated in HNSCC, especially in HPV-related tumors.
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Pannone G, Santoro A, Pasquali D, Zamparese R, Mattoni M, Russo G, Landriscina M, Piscazzi A, Toti P, Cignarelli M, Lo Muzio L, Bufo P. The role of survivin in thyroid tumors: differences of expression in well-differentiated, non-well-differentiated, and anaplastic thyroid cancers. Thyroid 2014; 24:511-9. [PMID: 24117205 DOI: 10.1089/thy.2013.0196] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Survivin is involved in human cancer and is responsible for aggressive biological behavior and poor clinical outcomes in several human malignancies. Thus, we hypothesized that the upregulation of survivin protein expression may be enhanced in parallel with transition toward a poorly differentiated phenotype in human thyroid carcinomas. METHODS The expression of survivin was evaluated, using a standard linked streptavidin-biotin horseradish peroxidase technique technique, in a series of 56 human thyroid carcinomas (42 papillary, 4 poorly differentiated, and 10 anaplastic carcinomas) and thyroid carcinoma cell lines at different degrees of differentiation. RESULTS The cytoplasmic expression of survivin protein was significantly upregulated in all thyroid tumors. A statistically significant association was found between nuclear survivin expression and anaplastic thyroid cancer (mean ± SD: well-differentiated thyroid cancer, 1.22 ± 20.21; non-well-differentiated thyroid cancer, 34.00 ± 25.17; anaplastic thyroid cancer, 56.50 ± 22.10; p<0.001). Nuclear staining of survivin has been shown in poorly differentiated and anaplastic thyroid carcinomas, and this is likely due to the upregulation of the ΔEx3 survivin splicing variant, as shown in poorly differentiated/anaplastic thyroid carcinoma cell lines. Of note, selected thyroid tumors characterized by a mixed population of differentiated and undifferentiated neoplastic cells, likely progressing from well to poorly differentiated and anaplastic phenotypes, exhibited cytoplasmic expression of survivin in differentiated fields and nuclear protein staining in poorly differentiated and anaplastic areas. This expression profile provides substantial added value to conventional clinical markers in predicting anaplastic cancer. The cut-off for distinguishing thyroids that developed ATC from those that remained differentiated was >30% of nuclear survivin expression. The receiver operating characteristic (ROC) area was 0.92, with a p-value of <0.0001. CONCLUSIONS Upregulation of survivin expression may be a molecular marker of dedifferentiation in thyroid epithelial carcinomas, likely being responsible for survival responses of tumor cells and, thus, favoring progression toward a poorly differentiated phenotype.
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Affiliation(s)
- Giuseppe Pannone
- 1 Department of Clinical and Experimental Medicine, Institute of Anatomic Pathology, University of Foggia , Foggia, Italy
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Farnebo L, Tiefenböck K, Ansell A, Thunell LK, Garvin S, Roberg K. Strong expression of survivin is associated with positive response to radiotherapy and improved overall survival in head and neck squamous cell carcinoma patients. Int J Cancer 2013; 133:1994-2003. [PMID: 23564498 DOI: 10.1002/ijc.28200] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/22/2013] [Indexed: 02/06/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a malignancy that is associated with severe mortality despite advances in therapy. Today's standard treatment most commonly includes radiotherapy, often combined with chemotherapy or surgery. There are so far no established biomarkers to predict response to radiation, and thus the aim of this study was to investigate a series of markers that could potentially identify HNSCC patients who would benefit from radiotherapy. The selected markers, both proteins (epidermal growth factor receptor, survivin and p53), and single nucleotide polymorphisms (SNPs) in the genes of XRCC3, XRCC1, XPC, XPD, MDM2, p53 and FGFR4 were correlated to the response to radiotherapy and overall survival. Investigations were performed on pretreatment tumor biopsies from patients classified as responders or nonresponders to radiotherapy. Protein expression was examined using immunohistochemistry and the genotyping of specific SNPs was analyzed using PCR-RFLP or pyrosequencing. We found that survivin expression was significantly stronger in the responder group (p = 0.003) and that patients with a strong survivin expression had a significantly better overall survival (p < 0.001). Moreover, downregulation of survivin by siRNA in two HNSCC cell lines significantly decreased their sensitivity to radiation. Among the SNPs analyzed, patients with the XPD Lys751Gln SNP had a significantly shorter overall survival (p = 0.048), and patients with the FGFR4 Gly388Arg SNP had a significantly longer overall survival (p = 0.010). In conclusion, our results suggest that survivin plays an important role in the response to radiotherapy and may be a useful marker for predicting radiotherapy response in patients with HNSCC.
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Affiliation(s)
- Lovisa Farnebo
- Department of ENT-Head and Neck Surgery, UHL, County Council of Östergötland, Linköping, Sweden
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Chang HL, Chen CY, Hsu YF, Kuo WS, Ou G, Chiu PT, Huang YH, Hsu MJ. Simvastatin induced HCT116 colorectal cancer cell apoptosis through p38MAPK-p53-survivin signaling cascade. Biochim Biophys Acta Gen Subj 2013; 1830:4053-64. [PMID: 23583370 DOI: 10.1016/j.bbagen.2013.04.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 04/02/2013] [Accepted: 04/04/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Statins, the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors with cholesterol-lowering properties, were recently shown to exhibit anti-cancer effects. However, the molecular mechanism underlying statin-induced cancer cell death remains to be elucidated. Elevated level of survivin is often found over-expressed in human cancers and has been implicated in the progression of tumorigenesis. Given its central role in cell division and action as an apoptosis suppressor, survivin represents a potential molecular target in cancer management. METHODS In this study, we explored the underlying mechanisms in simvastatin-induced HCT116 colorectal cancer cell apoptosis. RESULTS Simvastatin decreased cell viability and induced cell apoptosis in HCT116 cells. These results are associated with the modulation of p21(cip/Waf1) and survivin. Survivin knockdown using survivin siRNAs also decreased cell viability and induced cell apoptosis. Simvastatin's actions on p21(cip/Waf1), survivin and apoptosis were reduced in p53 null HCT116 cells. Simvastatin caused an increase in p53 phosphorylation and acetylation. In addition, simvastatin activated p38 mitogen-activated protein kinase (p38MAPK), whereas an inhibitor of p38MAPK signaling abrogated simvastatin's effects of increasing p53 and p21(cip/Waf1) promoter luciferase activity. Cell viability and survivin promoter luciferase activity in the presence of simvastatin were also restored by p38MAPK inhibitor. Furthermore, Sp1 binding to the survivin promoter region decreased while p53 and p63 binding to the promoter region increased after simvastatin exposure. CONCLUSIONS Simvastatin activates the p38MAPK-p53-survivin cascade to cause HCT116 colorectal cancer cell apoptosis. GENERAL SIGNIFICANCE This study delineates, in part, the underlying mechanisms of simvastatin in decreasing survivin and subsequent colorectal cancer cell apoptosis.
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Wellenhofer A, Brustmann H. Expression of human telomerase reverse transcriptase in vulvar intraepithelial neoplasia and squamous cell carcinoma: an immunohistochemical study with survivin and p53. Arch Pathol Lab Med 2013; 136:1359-65. [PMID: 23106581 DOI: 10.5858/arpa.2011-0440-oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Human telomerase reverse transcriptase (hTERT), an enzyme that enables cells to overcome replicative senescence and to divide indefinitely, is overexpressed in many cancers and their precursor lesions. OBJECTIVE To test whether hTERT expression is related to neoplastic progression and resistance to apoptosis in vulvar epithelia. DESIGN Immunoexpression of hTERT was evaluated in 101 formalin-fixed, paraffin-embedded archival vulvar epithelia consisting of normal squamous vulvar epithelia (n = 25), lichen sclerosus (n = 10), high-grade classic vulvar intraepithelial neoplasia (n = 16), differentiated vulvar intraepithelial neoplasia (n = 18), and vulvar invasive keratinizing squamous cell carcinoma (n = 32) and related to survivin and p53 expression. Immunostaining for all factors was scored for moderate and strong intensities with regard to quantity to determine upregulation and overexpression (score 0, 0% immunoreactive cells; score 1+, <5% immunoreactive cells; score 2+, 5% to 50% immunoreactive cells; score 3+, >50% immunoreactive cells). Score 3+ was considered as overexpression. RESULTS Nuclear hTERT immunoexpression was closely related to survivin reactivity, increased from normal vulvar squamous epithelia to lichen sclerosus and to high-grade classic vulvar intraepithelial neoplasia, differentiated vulvar intraepithelial neoplasia, and invasive keratinizing squamous cell carcinoma (P < .001), and followed the morphologic distribution of atypical squamous epithelial cells. Overexpression of hTERT was comparable to that seen for p53 in invasive keratinizing squamous cell carcinoma (P = .62); significant differences were calculated for differentiated vulvar intraepithelial neoplasia (P = .003) and high-grade classic vulvar intraepithelial neoplasia (P = .001). CONCLUSION Human telomerase reverse transcriptase is upregulated in vulvar intraepithelial neoplasia and invasive keratinizing squamous cell carcinoma compared with nonneoplastic squamous epithelia of the vulva as an apparently early and preinvasive event in the neoplastic transformation, with development of cellular longevity and resistance to apoptosis by survivin activation as associated features, independent of the etiology of vulvar intraepithelial neoplasia.
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Affiliation(s)
- Alfred Wellenhofer
- Department of Obstetrics and Gynecology, Landesklinikum Thermenregion Baden, Moedling, Austria
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Mostaan LV, Tabari A, Amiri P, Ashtiani MK, Mahdkhah A, Yazdani N, Khaniki M, Tabari A, Tavakkoly-Bazzaz J, Amoli MM. Survivin Gene Polymorphism Association with Tongue Squamous Cell Carcinoma. Genet Test Mol Biomarkers 2013; 17:74-7. [DOI: 10.1089/gtmb.2012.0210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Azin Tabari
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Amiri
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Aydin Mahdkhah
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Yazdani
- Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Khaniki
- Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Tabari
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Tavakkoly-Bazzaz
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa M. Amoli
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Li X, Li W, Ma G, Liang X, Xiao J, Jacobs R. Oral Cavity Carcinogenesis Modeled in Carcinogen-Treated Mice. J HARD TISSUE BIOL 2013. [DOI: 10.2485/jhtb.22.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rationale Behind Survivin Inhibition as a Potential Therapeutic Strategy in Head and Neck Carcinoma too. Curr Oncol Rep 2012; 15:1-2. [DOI: 10.1007/s11912-012-0267-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sun ZJ, Zhang L, Hall B, Bian Y, Gutkind JS, Kulkarni AB. Chemopreventive and chemotherapeutic actions of mTOR inhibitor in genetically defined head and neck squamous cell carcinoma mouse model. Clin Cancer Res 2012; 18:5304-13. [PMID: 22859719 DOI: 10.1158/1078-0432.ccr-12-1371] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE To assess the efficacy of rapamycin treatment in chemoprevention and chemotherapy of tumorigenesis in a genetically defined mouse model of head and neck squamous cell carcinoma (HNSCC). EXPERIMENTAL DESIGN Knockdown of Tgfbr1 and/or Pten using siRNA-mediated RNA interference was carried out in human HNSCC cell lines to analyze molecular changes in the mTOR pathway. Tgfbr1(flox/flox); Pten(flox/flox); K14-CreER(tam) mice were treated with oral gavage of tamoxifen for the conditional deletion of Tgfbr1 and Pten in oral mucosa, resulting in HNSCC. Tgfbr1 and Pten conditonal deletion (2cKO) mice were treated with rapamycin before or after the onset of HNSCC, and the efficacy of this treatment was assessed by determining tumor burden, longevity, and molecular analysis of the mTOR pathway. Molecular changes observed in human HNSCC cell lines and 2cKO mice were compared to identify key alterations in the mTOR pathway. RESULTS Knockdown of Tgfbr1 and/or Pten in human HNSCC cell lines resulted in activation of mTOR activity complex 1 and increased levels of survivin. Furthermore, we observed similar changes in HNSCC of the 2cKO mouse. In the human HNSCC tissue array, a loss of Tgfbr1 expression correlated with increased survivin levels. Chemopreventive rapamycin treatment significantly delayed the onset of the HNSCC tumors and prolonged survival in 2cKO mice. In addition, we also found that rapamycin had a therapeutic effect on squamous cell carcinomas in these mice. In 2cKO HNSCC tongue tumors, rapamycin treatment induced apoptosis, inhibited cell proliferation and phosphorylation of Akt and S6, and decreased survivin expression. CONCLUSIONS These findings indicate that tumorigenesis in 2cKO HNSCC is associated with activation of the Akt/mTOR/survivin pathway, and inhibition of this pathway by rapamycin treatment successfully ameliorates the onset and progression of tumorigenesis.
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Affiliation(s)
- Zhi-Jun Sun
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
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Andric M, Nikolic N, Boskovic M, Milicic B, Skodric S, Basta Jovanovic G, Milasin J. Survivin gene promoter polymorphism -31G/C as a risk factor for keratocystic odontogenic tumor development. Eur J Oral Sci 2012; 120:9-13. [PMID: 22288915 DOI: 10.1111/j.1600-0722.2011.00919.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Several single nucleotide polymorphisms in survivin gene promoters, notably -31G/C, have been shown to modulate the expression and activity of the survivin protein. Consequently, the -31G/C polymorphism has been identified as a risk factor for the development of several types of tumors. The aim of this study was to investigate a possible association between the -31G/C polymorphism and the risk for keratocystic odontogenic tumor (KCOT) development. DNA from 52 biopsy specimens of KCOTs and from 82 buccal swabs of healthy individuals was subjected to PCR restriction fragment length polymorphism analysis to identify individual genotypes. The distribution of genotypes in KCOT and control groups, respectively, was: GG: 30 (57.7%) vs. 26 (31.7%); CG: 17 (32.7%) vs. 45 (54.9%); and CC: 5 (9.6%) vs. 11 (13.4%), respectively. These differences were statistically significant. The G allele was more common in the KCOT group than in the control group: 76 (74%) vs. 96 (59%), respectively. Logistic regression analysis showed that GC heterozygotes had a considerably decreased susceptibility for KCOTs compared with GG homozygotes. The same was true for GC+CC vs. GG. The GG genotype of the -31G/C polymorphism might be a risk factor for KCOT development.
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Affiliation(s)
- Miroslav Andric
- University of Belgrade, School of Dentistry, Clinic of Oral Surgery, Belgrade, Serbia.
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High expression of nuclear survivin and Aurora B predicts poor overall survival in patients with head and neck squamous cell cancer. Strahlenther Onkol 2012; 188:248-54. [PMID: 22311150 DOI: 10.1007/s00066-011-0042-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 11/23/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Survivin is one of the apoptosis inhibitor proteins. Together with Aurora B, it also plays a role in regulating several aspects of mitosis. High expression of these markers is correlated with malignant behavior of various cancers and resistance to therapy. Our aim was to evaluate the prognostic role of these markers in head and neck cancers. PATIENTS AND METHODS We evaluated the expression of Aurora B and survivin in tissue specimens of 58 patients with head and neck squamous cell carcinoma using immunohistochemistry. RESULTS Patients who showed high expression of cytoplasmic and nuclear survivin and Aurora B had significantly shorter overall survival (p = 0.036, p < 0.000, p = 0.032, respectively). In multivariate analysis, high expression of nuclear survivin was the only independent negative prognostic factor (p = 0.024). Moreover, it was found that high co-expression of nuclear survivin and Aurora B had a negative effect on survival in univariate (p < 0.000) and multivariate (p < 0.000) analyses. CONCLUSION The negative prognostic values of high expression of Aurora B and high co-expression of nuclear survivin and Aurora B on survival were shown. These findings suggest that co-expression of nuclear survivin and Aurora B can be useful diagnostic markers and therapeutic targets for head and neck squamous cell carcinoma. However, further studies with a larger number of patients in a more homogeneous disease group are needed to confirm the conclusion.
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immunohistochemical expression of survivin and γ-H2AX in vulvar intraepithelial neoplasia and low-stage squamous cell carcinoma. Int J Gynecol Pathol 2012; 30:583-90. [PMID: 21979596 DOI: 10.1097/pgp.0b013e31821e18fd] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Survivin inhibits apoptosis and is involved in the regulation of cell cycle progression and in the mitotic spindle formation. It is overexpressed in many cancers. The histone γ-H2AX is a marker of activated DNA damage and is overexpressed in different cancers and their precursor lesions. It also forms early during apoptosis. Eighty-seven formalin-fixed, paraffin-embedded archival vulvar tissues originating from 55 preoperatively untreated patients were immunostained with antibodies to survivin and γ-H2AX to determine their expression in normal squamous vulvar epithelia (NE, n=25), lichen sclerosus (n=10), high-grade classic vulvar intraepithelial neoplasia (n=16), differentiated vulvar intraepithelial neoplasia (n=16), and vulvar invasive keratinizing squamous cell carcinoma (ISCC, n=20; FIGO Ib). Immunostaining for both factors was scored for moderate and strong intensities with regard to quantity. Statistical analysis was performed by the χ test and Fisher exact test. Nuclear surviving expression increased from NE and lichen scleros to high-grade classic vulvar intraepithelial neoplasia, differentiated vulvar intraepithelial neoplasia, and ISCC significantly (P=0.0001) and followed the distribution of immature squamous epithelial cells. Positive scores for γ-H2AX were found in nuclei of cells in all diagnostic cohorts, in any epithelial level with some accentuation in the upper layers, was seen in pycnotic nuclei in horn pearls of ISCC and apoptotic bodies, without relevant statistical distributions. Immunoscores did not differ between grade 1 and grades 2/3. Expression patterns were different for both factors, suggesting their involvement in different biologic mechanisms as an early event leading to resistance to apoptosis in vulvar carcinogenesis.
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