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Downer MA, Griffin MF, Morgan AG, Parker JB, Li DJ, Berry CE, Liang NE, Kameni L, Cotterell AC, Akras D, Valencia C, Longaker MT, Wan DC. Understanding the Role of Adipocytes and Fibroblasts in Cancer. Ann Plast Surg 2023; 91:779-783. [PMID: 37553786 PMCID: PMC10840614 DOI: 10.1097/sap.0000000000003658] [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] [Indexed: 08/10/2023]
Abstract
ABSTRACT Cancer is currently the second leading cause of death in the United States. There is increasing evidence that the tumor microenvironment (TME) is pivotal for tumorigenesis and metastasis. Recently, adipocytes and cancer-associated fibroblasts (CAFs) in the TME have been shown to play a major role in tumorigenesis of different cancers, specifically melanoma. Animal studies have shown that CAFs and adipocytes within the TME help tumors evade the immune system, for example, by releasing chemokines to blunt the effectiveness of the host defense. Although studies have identified that adipocytes and CAFs play a role in tumorigenesis, adipocyte transition to fibroblast within the TME is fairly unknown. This review intends to elucidate the potential that adipocytes may have to transition to fibroblasts and, as part of the TME, a critical role that CAFs may play in affecting the growth and invasion of tumor cells. Future studies that illuminate the function of adipocytes and CAFs in the TME may pave way for new antitumor therapies.
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Affiliation(s)
- Mauricio A. Downer
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michelle F. Griffin
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Annah G. Morgan
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jennifer B. Parker
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Dayan J. Li
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Charlotte E Berry
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Norah E. Liang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lionel Kameni
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Asha C. Cotterell
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Deena Akras
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Caleb Valencia
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael T. Longaker
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Derrick C. Wan
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
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Wang F, He T, Wang G, Han T, Yao Z. Association of triglyceride glucose-body mass index with non-small cell lung cancer risk: A case-control study on Chinese adults. Front Nutr 2022; 9:1004179. [PMID: 36313086 PMCID: PMC9614218 DOI: 10.3389/fnut.2022.1004179] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objectives Insulin resistance (IR) is closely related to non-small-cell lung cancer (NSCLC) risk. Recently, triglyceride glucose-body mass index (TyG-BMI) has been recognized as one of the simple indexes of insulin resistance (IR). However, there are limited data on the relationship between TyG-BMI and NSCLC. Here, we investigated the association of TyG-BMI with NSCLC risk in Chinese adults. Methods This study consisted of 477 NSCLC cases and 954 healthy subjects. All participants were enrolled from 3201 Hospital affiliated to the Medical Department of Xi'an Jiaotong University. TyG-BMI was calculated based on the values of fasting blood glucose, triglyceride, and BMI. The association of TyG-BMI with NSCLC risk was estimated by logistic regression analysis. Results The mean value of TyG-BMI was statistically increased in patients with NSCLC compared to the control group (201.11 ± 28.18 vs. 174 ± 23.78, P < 0.01). There was a significant positive association between TyG-BMI and NSCLC (OR = 1.014; 95% CI 1.007-1.021; P < 0.001) after controlling for confounding factors. Moreover, the prevalence of NSCLC was significantly elevated in participants in the high TyG-BMI tertiles than those in the intermediate and low TyG-BMI tertiles (60.46% vs. 12.61% vs. 26.83%, P < 0.01). Importantly, TyG-BMI achieved a significant diagnostic accuracy for NSCLC, with an AUC (area under the curve) of 0.769 and a cutoff value of 184.87. Conclusion The findings suggest that TyG-BMI is a useful tool for assessing NSCLC risk. Thus, it is essential to follow up on high TyG-BMI, and lifestyle modification is needed to prevent NSCLC in people with high TyG-BMI.
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Affiliation(s)
- Feifei Wang
- Department of Oncology, The 3201 Hospital Affiliated to Medical Department of Xi’an Jiaotong University, Hanzhong, Shaanxi, China
| | - Ting He
- Department of Oncology, The 3201 Hospital Affiliated to Medical Department of Xi’an Jiaotong University, Hanzhong, Shaanxi, China
| | - Guoliang Wang
- Department of Orthopedics, Second Affiliated Hospital, Air Force Medical University, Xi’an, Shaanxi, China
| | - Tuo Han
- Department of Oncology Surgery, The 3201 Hospital Affiliated to Medical Department of Xi’an Jiaotong University, Hanzhong, Shaanxi, China
| | - Zhongqiang Yao
- Department of Oncology, The 3201 Hospital Affiliated to Medical Department of Xi’an Jiaotong University, Hanzhong, Shaanxi, China,*Correspondence: Zhongqiang Yao,
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Exercise suppresses tumor growth independent of high fat food intake and associated immune dysfunction. Sci Rep 2022; 12:5476. [PMID: 35361802 PMCID: PMC8971502 DOI: 10.1038/s41598-022-08850-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/11/2022] [Indexed: 11/24/2022] Open
Abstract
Epidemiological data suggest that exercise training protects from cancer independent of BMI. Here, we aimed to elucidate mechanisms involved in voluntary wheel running-dependent control of tumor growth across chow and high-fat diets. Access to running wheels decreased tumor growth in B16F10 tumor-bearing on chow (− 50%) or high-fat diets (− 75%, p < 0.001), however, tumor growth was augmented in high-fat fed mice (+ 53%, p < 0.001). Tumor growth correlated with serum glucose (p < 0.01), leptin (p < 0.01), and ghrelin levels (p < 0.01), but not with serum insulin levels. Voluntary wheel running increased immune recognition of tumors as determined by microarray analysis and gene expression analysis of markers of macrophages, NK and T cells, but the induction of markers of macrophages and NK cells was attenuated with high-fat feeding. Moreover, we found that the regulator of innate immunity, ZBP1, was induced by wheel running, attenuated by high-fat feeding and associated with innate immune recognition in the B16F10 tumors. We observed no effects of ZBP1 on cell cycle arrest, or exercise-regulated necrosis in the tumors of running mice. Taken together, our data support epidemiological findings showing that exercise suppresses tumor growth independent of BMI, however, our data suggest that high-fat feeding attenuates exercise-mediated immune recognition of tumors.
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Zhu J, Hao S, Zhang X, Qiu J, Xuan Q, Ye L. Integrated Bioinformatics Analysis Exhibits Pivotal Exercise-Induced Genes and Corresponding Pathways in Malignant Melanoma. Front Genet 2021; 11:637320. [PMID: 33679872 PMCID: PMC7930906 DOI: 10.3389/fgene.2020.637320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/21/2020] [Indexed: 02/03/2023] Open
Abstract
Malignant melanoma represents a sort of neoplasm deriving from melanocytes or cells developing from melanocytes. The balance of energy and energy-associated body composition and body mass index could be altered by exercise, thereby directly affecting the microenvironment of neoplasm. However, few studies have examined the mechanism of genes induced by exercise and the pathways involved in melanoma. This study used three separate datasets to perform comprehensive bioinformatics analysis and then screened the probable genes and pathways in the process of exercise-promoted melanoma. In total, 1,627 differentially expressed genes (DEGs) induced by exercise were recognized. All selected genes were largely enriched in NF-kappa B, Chemokine signaling pathways, and the immune response after gene set enrichment analysis. The protein-protein interaction network was applied to excavate DEGs and identified the most relevant and pivotal genes. The top 6 hub genes (Itgb2, Wdfy4, Itgam, Cybb, Mmp2, and Parp14) were identified, and importantly, 5 hub genes (Itgb2, Wdfy4, Itgam, Cybb, and Parp14) were related to weak disease-free survival and overall survival (OS). In conclusion, our findings demonstrate the prognostic value of exercise-induced genes and uncovered the pathways of these genes in melanoma, implying that these genes might act as prognostic biomarkers for melanoma.
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Affiliation(s)
- Jun Zhu
- Administrative Office, Shanghai Basilica Clinic, Shanghai, China
| | - Suyu Hao
- Shuangwu Information Technical Company Ltd., Shanghai, China
| | - Xinyue Zhang
- School of Education, Hangzhou Normal University, Hangzhou, China
| | - Jingyue Qiu
- School of Physical Science and Engineering, East China University of Science and Technology, Shanghai, China
| | - Qin Xuan
- School of Sports Science and Engineering, East China University of Science and Technology, Shanghai, China
| | - Liping Ye
- Department of Clinical Nursing, Minhang Hospital, Fudan University, Shanghai, China
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Miglio A, Falcinelli E, Mezzasoma AM, Cappelli K, Mecocci S, Gresele P, Antognoni MT. Effect of First Long-Term Training on Whole Blood Count and Blood Clotting Parameters in Thoroughbreds. Animals (Basel) 2021; 11:447. [PMID: 33572086 PMCID: PMC7915801 DOI: 10.3390/ani11020447] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
Training has a strong effect on the physiology of hematological parameters and blood coagulation, both in humans and in horses. Several blood changes have been reported after exercise in horses but available data differ. We aimed to investigate modifications in complete blood count and some hemostatic parameters induced by the first training period in young untrained Thoroughbred racehorses to detect a possible labile blood coagulability in racehorses. Twenty-nine untrained 2-year-old Thoroughbreds were followed during their incremental 4-month sprint exercise schedule. Blood collection was performed once a month, five times (T-30, T0, T30, T60 and T90), before and during the training period for measurement of complete blood count (CBC) and blood clotting parameters (prothrombin time-PT, activated partial prothrombin time-APTT, thrombin clotting time-TCT, fibrinogen-Fb, thrombin-antithrombin complex-TAT). Differences among the time points for each parameter were analyzed (ANOVA, Kruskal-Wallis one-way analysis of variance, p < 0.05). In Thoroughbreds, the first long-term exercise workout period was found to induce a statistical increase in red blood cell indexes and lymphocytes, eosinophils and platelet counts, as well as a hypercoagulability state evident at 30 days of training, which returned to basal levels after 90 days. Regular physical exercise seems to blunt the negative effects of acute efforts on hematological and clotting parameters, an effect that may be attributed to the training condition.
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Affiliation(s)
- Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
| | - Emanuela Falcinelli
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (A.M.M.); (P.G.)
| | - Anna Maria Mezzasoma
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (A.M.M.); (P.G.)
| | - Katia Cappelli
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
| | - Samanta Mecocci
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
| | - Paolo Gresele
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (A.M.M.); (P.G.)
| | - Maria Teresa Antognoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
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Abstract
PURPOSE OF REVIEW Hyperadiposity, as present in obesity, is a substantial threat to cancer risk and prognosis. Studies that have investigated the link between obesity and tumor progression have proposed several mechanistic frameworks, yet, these mechanisms are not fully defined. Further, a comprehensive understanding of how these various mechanisms may interact to create a dynamic disease state is lacking in the current literature. RECENT FINDINGS Recent work has begun to explore not only discrete mechanisms by which obesity may promote tumor growth (for instance, metabolic and growth factor functions of insulin; inflammatory cytokines; adipokines; and others), but also how these putative tumor-promoting factors may interact. SUMMARY This review will highlight the present understanding of obesity, as it relates to tumor development and progression. First, we will introduce the impact of obesity in cancer within the dynamic tumor microenvironment, which will serve as a theme to frame this review. The core of this review will discuss recently proposed mechanisms that implicate obesity in tumor progression, including chronic inflammation and the role of pro-inflammatory cytokines, adipokines, hormones, and genetic approaches. Furthermore, we intend to offer current insight in targeting adipose tissue during the development of cancer prevention and treatment strategies.
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Affiliation(s)
- Andin Fosam
- Department of Internal Medicine
- Department of Cellular & Molecular Physiology, School of Medicine Yale University, TAC, New Haven, Connecticut, USA
| | - Rachel J Perry
- Department of Internal Medicine
- Department of Cellular & Molecular Physiology, School of Medicine Yale University, TAC, New Haven, Connecticut, USA
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Xu Y, Rogers CJ. Impact of physical activity and energy restriction on immune regulation of cancer. Transl Cancer Res 2020; 9:5700-5731. [PMID: 35117934 PMCID: PMC8798226 DOI: 10.21037/tcr.2020.03.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/04/2020] [Indexed: 11/06/2022]
Abstract
Cancer is a major public health issue worldwide. Lifestyle factors, such as body weight and physical activity (PA), significantly impact cancer risk and progression. There is strong evidence that PA reduces and obesity increases risk and mortality from numerous cancer types. Energy restriction (ER) in non-obese hosts significantly reduces tumor incidence in a variety of preclinical models, and reduces body weight and cardiometabolic risk factors in humans. Emerging data suggest that PA- and ER-induced changes in inflammatory and immune mediators may contribute to the cancer prevention effects of these interventions. A systematic literature search was conducted to identify studies that evaluated the impact of PA and ER on tumor and immune outcomes in humans and animal models. A total of 97 eligible studies were identified (68 studies reporting PA interventions and 30 studies reporting ER interventions). Thirty-one studies investigated the effect of PA on cancer immune outcomes using preclinical cancer models of breast (n=17, 55%), gastrointestinal (n=6, 19%), melanoma (n=4, 13%), and several other cancer types (n=4, 13%). Despite the heterogeneity in study designs, the majority of studies (n=23, 74%) reported positive effects of PA on tumor outcomes. Thirty-seven clinical studies investigated the effect of PA on cancer immune outcomes. None reported tumor outcomes, thus only immune outcomes were evaluated in these studies. PA studies were conducted in patients with breast (n=22, 59%), gastrointestinal (n=5, 14%), prostate (n=2, 5%), esophageal (n=1, 3%), lung (n=1, 3%) cancer, leukemia (n=1, 3%), or mixed cancer types (n=5, 14%). Twenty-two studies investigated the effect of ER interventions on cancer immune outcomes using preclinical cancer models including breast (n=5, 23%), gastrointestinal (n=5, 23%), lung (n=2, 9%), liver (n=2, 9%), pancreatic (n=2, 9%), and several other cancer types (n=6, 27%). Positive effects of ER on tumor outcomes were reported in 21 of 22 studies. Six clinical studies investigated the effect of ER (in combination with PA) on tumor immune outcomes in cancer patients with overweight or obesity. Five were conducted in breast cancer patients, and one recruited patients of a mix of cancer types. A wide range of immunological parameters including immune cell phenotype and function, cytokines, and other immune and inflammatory markers were assessed in multiple tissue compartments (blood, spleen, lymph nodes and tumor) in the included studies. Results from preclinical and clinical studies suggest that both PA and ER exert heterogeneous effects on circulating factors and systemic immune responses. PA + ER alters the gene expression profile and immune infiltrates in the tumor which may result in a reduction in immune suppressive factors. However, additional studies are needed to better understand the effect of PA and/or ER on immunomodulation, particularly in the tumor microenvironment (TME).
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Affiliation(s)
- Yitong Xu
- Intercollege Graduate Degree Program in Integrative and Biomedical Physiology, Huck Institutes of the Life Sciences, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Connie J. Rogers
- Department of Nutritional Sciences, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, USA
- Center for Molecular Immunology and Infectious Disease, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, USA
- Penn State Cancer Institute, Hershey, PA, USA
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Lee JJ, Beak S, Ahn SH, Moon BS, Kim J, Lee KP. Suppressing breast cancer by exercise: consideration to animal models and exercise protocols. Phys Act Nutr 2020; 24:22-29. [PMID: 32698258 PMCID: PMC7451835 DOI: 10.20463/pan.2020.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Exercise is thought to have a significant effect on chemotherapy, and previous studies have reported that exercise can increase patient survival. Thus, in this review, we aimed to summarize various animal models to analyze the effects of exercise on breast cancer. METHODS We summarized types of breast cancer animal models from various reports and analyzed the effects of exercise on anti-cancer factors in breast cancer animal models. RESULTS This review aimed to systematically investigate if exercise could aid in suppressing breast cancer. Our study includes (a) increase in survival rate through exercise; (b) the intensity of exercise should be consistent and increased; (c) a mechanism for inhibiting carcinogenesis through exercise; (d) effects of exercise on anti-cancer function. CONCLUSION This review suggested the necessity of a variety of animal models for preclinical studies prior to breast cancer clinical trials. It also provides evidence to support the view that exercise plays an important role in the prevention or treatment of breast cancer by influencing anticancer factors.
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Affiliation(s)
- Jea Jun Lee
- Laboratory Animal Center, Osong Medical Innovation Foundation, CheongjuRepublic of Korea
| | - Suji Beak
- Research and Development Center, UMUST R&D Corporation, SeoulRepublic of Korea
| | - Sang Hyun Ahn
- Department of Anatomy, Semyung University, JecheonRepublic of Korea
| | - Byung Seok Moon
- Department of Nuclear Medicine, Ewha Womans University College of Medicine, SeoulRepublic of Korea
| | - Jisu Kim
- Physical Activity and Performance Institute, Konkuk University, SeoulRepublic of Korea
| | - Kang Pa Lee
- Research and Development Center, UMUST R&D Corporation, SeoulRepublic of Korea
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Kim TW, Baek KW, Yu HS, Ko IG, Hwang L, Park JJ. High-intensity exercise improves cognitive function and hippocampal brain-derived neurotrophic factor expression in obese mice maintained on high-fat diet. J Exerc Rehabil 2020; 16:124-131. [PMID: 32509696 PMCID: PMC7248433 DOI: 10.12965/jer.2040050.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022] Open
Abstract
We wanted to find the intensity of exercise that could increase brain- derived neurotrophic factor (BDNF) expression and improve spatial learning and memory without dietary control. C57BL/6 mice were fed a 60% high-fat diet (HFD) for 6 weeks to induce obesity. Obesity-induced mice were exercised on a treadmill for 8 weeks at various exercise in-tensities: HFD-control (n=7), HFD-low-intensity exercise (HFD-LIE, n= 7, 12 m/min for 75 min), HFD-middle intensity exercise (HFD-MIE, n=7, 15 m/min for 60 min) and HFD-high-intensity exercise (HFD-HIE, n=7, 18 m/min for 50 min). One week before sacrificing mice, the Morris wa-ter maze test was performed, and the hippocampus was immediately removed after sacrifice. The expression levels of BDNF (encoded by the gene Bdnf) and tropomyosin receptor kinase B (TrkB) in the hippo-campus were analyzed by quantitative real-time reverse transcription- polymerase chain reaction and western blot. In the last probe test of the Morris water maze test, occupancy in the target quadrant was sig-nificantly higher in the HFD-HIE group (P<0.05) than in the other groups. In addition, mRNA expression from the Bdnf promoter region was found to be significantly higher in the HFD-HIE group than in the other groups (P<0.001). Although there were some differences in the levels of signifi-cance, the expression levels of both BDNF and TrkB were significantly higher in the HFD-HIE group than in the other groups. Therefore, rela-tively high-intensity aerobic exercise can resist the adverse effects of a high-fat diet on the brain without dietary control.
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Affiliation(s)
- Tae-Won Kim
- Division of Sport Science, Pusan National University, Busan, Korea
| | - Kyung-Wan Baek
- Division of Sport Science, Pusan National University, Busan, Korea
- Department of Parasitology and Tropical Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Hak Sun Yu
- Department of Parasitology and Tropical Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Il-Gyu Ko
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Lakkyong Hwang
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Korea
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Modern Aspects of Immunotherapy with Checkpoint Inhibitors in Melanoma. Int J Mol Sci 2020; 21:ijms21072367. [PMID: 32235439 PMCID: PMC7178114 DOI: 10.3390/ijms21072367] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/15/2022] Open
Abstract
Although melanoma is one of the most immunogenic tumors, it has an ability to evade anti-tumor immune responses by exploiting tolerance mechanisms, including negative immune checkpoint molecules. The most extensively studied checkpoints represent cytotoxic T lymphocyte-associated protein-4 (CTLA-4) and programmed cell death protein 1 (PD-1). Immune checkpoint inhibitors (ICI), which were broadly applied for melanoma treatment in the past decade, can unleash anti-tumor immune responses and result in melanoma regression. Patients responding to the ICI treatment showed long-lasting remission or disease control status. However, a large group of patients failed to respond to this therapy, indicating the development of resistance mechanisms. Among them are intrinsic tumor properties, the dysfunction of effector cells, and the generation of immunosuppressive tumor microenvironment (TME). This review discusses achievements of ICI treatment in melanoma, reasons for its failure, and promising approaches for overcoming the resistance. These methods include combinations of different ICI with each other, strategies for neutralizing the immunosuppressive TME and combining ICI with other anti-cancer therapies such as radiation, oncolytic viral, or targeted therapy. New therapeutic approaches targeting other immune checkpoint molecules are also discussed.
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