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Redman RS, Bayley NC, Nylén ES. Salivary and serum biomarkers of inflammation in a man with metastatic medullary thyroid carcinoma and hyperreactive gingiva: a fourteen year odyssey. Biotech Histochem 2019; 94:389-397. [PMID: 31423894 DOI: 10.1080/10520295.2019.1649463] [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: 10/26/2022] Open
Abstract
A peripheral (gingival) fibroma, a gingival cyst and hyperplastic gingivitis occurred simultaneously in a man with metastatic medullary thyroid carcinoma (MCT). The gingival growths and hyperplasia appeared to be related to poor oral hygiene rather than to the MTC. Despite the patient's improved oral hygiene, the hyperplastic gingivitis and peripheral fibroma recurred, and a new peripheral fibroma and gingival cyst developed, which prompted reconsideration of a link with the MTC. MTC cells secrete calcitonin (CT), procalcitonin (ProCT) and growth factors; the patient's serum CT and ProCT were several fold higher than normal. The patient's salivary CT and ProCT also were elevated, but α-amylase and epidermal growth factor (EGF) were not, compared to three healthy controls. A possible link between the MTC and gingival hyper-reactivity due to CT and/or ProCT promoting inflammatory cytokines, and the utility of salivary ProCT as an indicator of periodontitis in this patient were explored further. Unstimulated whole saliva and serum were collected from the patient followed by a standard periodontal examination before periodontal treatment, and 3 weeks and 3 months after treatment. This cycle was repeated 7 months after the previous periodontal treatment. The saliva was assayed for ProCT and the serum was assayed for ProCT, high sensitivity C-reactive protein (CRP), interleukin-6 (IL-6) and proadrenomedullin (ProADM). The results were analyzed for correlations among the severity of periodontitis and the biomarkers/cytokines. Only the salivary ProCT was correlated with the severity of periodontitis, i.e. it was higher just before and lower at 3 weeks and 3 months after each periodontal treatment. The patient's salivary ProCT content also was much higher than reported elsewhere. The other biomarkers/cytokines were within normal ranges. Our findings indicate that salivary ProCT is independent of serum ProCT and therefore may be a useful marker for moderate to severe periodontitis in patients with MTC. The greatly elevated salivary and serum CT and ProCT, and a trend toward correlation between the serum CRP and ProCT suggest a pro-inflammatory link between the MTC and the hyperreactive gingiva in this patient. Further studies are warranted to determine whether hyperplastic gingivitis and gingival growths, such as cysts and fibromas, occur with unusual frequency in patients with MTC.
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Affiliation(s)
- R S Redman
- Department of Veterans Affairs Medical Center, Oral Pathology Research Laboratory , Washington , DC , USA
| | - N C Bayley
- Dental Service, Department of Veterans Affairs Medical Center, Oral and Maxillofacial Surgery Section , Washington , DC , USA
| | - E S Nylén
- Medical Service, Department of Veterans Affairs Medical Center, Endocrinology Section , Washington , DC , USA.,Department of Endocrinology, Medical School, George Washington University , Washington , DC , USA
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Abstract
Despite being approved by the Food and Drug Administration for over 30 years, calcitonin salmon has seen a dramatic increase in acquisition cost over the last few years. Being commonly used for the treatment of hypercalcemia of malignancy, health systems must implement stewardship strategies in order to curtail usage. This review is intended to provide a background on calcitonin usage for hypercalcemia of malignancy and associated strategies to ensure appropriateness of utilization within health systems.
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Affiliation(s)
| | - Kevin W. Davis
- Inpatient Operations Supervisor, University of Florida Health Jacksonville, Jacksonville, FL, USA
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Singh V, Gohil N, Ramírez-García R. New insight into the control of peptic ulcer by targeting the histamine H 2 receptor. J Cell Biochem 2017; 119:2003-2011. [PMID: 28817204 DOI: 10.1002/jcb.26361] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/15/2017] [Indexed: 11/09/2022]
Abstract
Peptic ulcer disease is one of the major challenges in public health globally and new evidence shows that it can be controlled by targeting the histamine H2 receptor (H2 R). Recently, a number of H2 R antagonists have been synthesized and used to block the action of histamine on the parietal cells in the stomach and decrease the acid production. In this study, we modeled the H2 R by homology modeling using the 3-D crystal structure and this model was validated based on free energy and amino acid residues present in the allowed regions of a Ramachandran plot. We used this 3-D model for screening of highly potent drugs using molecular docking. We found cimetidine, cimetex, and famotidine as the most potent drugs based on the binding affinity of drug-protein interactions. We also generated a cellular network for H2 R that could be useful for better understanding of cellular mechanism and drug targets. These findings provide a new insight into the development of suitable, specific, and effective anti-ulcer drugs for a most effective treatment of ulcerous diseases.
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Affiliation(s)
- Vijai Singh
- Department of Microbiology, Synthetic Biology Laboratory, School of Biological Sciences and Biotechnology, Institute of Advanced Research, Koba Institutional Area, Gandhinagar, India
| | - Nisarg Gohil
- Department of Microbiology, Synthetic Biology Laboratory, School of Biological Sciences and Biotechnology, Institute of Advanced Research, Koba Institutional Area, Gandhinagar, India
| | - Robert Ramírez-García
- Department of Microbiology, Synthetic Biology Laboratory, School of Biological Sciences and Biotechnology, Institute of Advanced Research, Koba Institutional Area, Gandhinagar, India
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Lee SM, Booe JM, Gingell JJ, Sjoelund V, Hay DL, Pioszak AA. N-Glycosylation of Asparagine 130 in the Extracellular Domain of the Human Calcitonin Receptor Significantly Increases Peptide Hormone Affinity. Biochemistry 2017; 56:3380-3393. [PMID: 28614667 DOI: 10.1021/acs.biochem.7b00256] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The calcitonin receptor (CTR) is a class B G protein-coupled receptor that is activated by the peptide hormones calcitonin and amylin. Calcitonin regulates bone remodeling through CTR, whereas amylin regulates blood glucose and food intake by activating CTR in complex with receptor activity-modifying proteins (RAMPs). These receptors are targeted clinically for the treatment of osteoporosis and diabetes. Here, we define the role of CTR N-glycosylation in hormone binding using purified calcitonin and amylin receptor extracellular domain (ECD) glycoforms and fluorescence polarization/anisotropy and isothermal titration calorimetry peptide-binding assays. N-Glycan-free CTR ECD produced in Escherichia coli exhibited ∼10-fold lower peptide affinity than CTR ECD produced in HEK293T cells, which yield complex N-glycans, or in HEK293S GnTI- cells, which yield core N-glycans (Man5GlcNAc2). PNGase F-catalyzed removal of N-glycans at N73, N125, and N130 in the CTR ECD decreased peptide affinity ∼10-fold, whereas Endo H-catalyzed trimming of the N-glycans to single GlcNAc residues had no effect on peptide binding. Similar results were observed for an amylin receptor RAMP2-CTR ECD complex. Characterization of peptide-binding affinities of purified N → Q CTR ECD glycan site mutants combined with PNGase F and Endo H treatment strategies and mass spectrometry to define the glycan species indicated that a single GlcNAc residue at CTR N130 was responsible for the peptide affinity enhancement. Molecular modeling suggested that this GlcNAc functions through an allosteric mechanism rather than by directly contacting the peptide. These results reveal an important role for N-linked glycosylation in the peptide hormone binding of a clinically relevant class B GPCR.
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Affiliation(s)
- Sang-Min Lee
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center , 975 NE 10th Street BRC 462B, Oklahoma City, Oklahoma 73104, United States
| | - Jason M Booe
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center , 975 NE 10th Street BRC 462B, Oklahoma City, Oklahoma 73104, United States
| | | | - Virginie Sjoelund
- Proteomics Division of the Laboratory for Molecular Biology and Cytometry Research, University of Oklahoma Health Sciences Center , 975 NE 10th Street, Oklahoma City, Oklahoma 73104, United States
| | | | - Augen A Pioszak
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center , 975 NE 10th Street BRC 462B, Oklahoma City, Oklahoma 73104, United States
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Tsuzuki S, Park SH, Eber MR, Peters CM, Shiozawa Y. Skeletal complications in cancer patients with bone metastases. Int J Urol 2016; 23:825-832. [PMID: 27488133 DOI: 10.1111/iju.13170] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/07/2016] [Indexed: 12/13/2022]
Abstract
As a result of significant improvements in current therapies, the life expectancy of cancer patients with bone metastases has dramatically improved. Unfortunately, these patients often experience skeletal complications that significantly impair their quality of life. The major skeletal complications associated with bone metastases include: cancer-induced bone pain, hypercalcemia, pathological bone fractures, metastatic epidural spinal cord compression and cancer cachexia. Once cancer cells invade the bone, they perturb the normal physiology of the marrow microenvironment, resulting in bone destruction, which is believed to be a direct cause of skeletal complications. However, full understanding of the mechanisms responsible for these complications remains unknown. In the present review, we discuss the complications associated with bone metastases along with matched conventional therapeutic strategies. A better understanding of this topic is crucial, as targeting skeletal complications can improve both the morbidity and mortality of patients suffering from bone metastases.
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Affiliation(s)
- Shunsuke Tsuzuki
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Sun Hee Park
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Matthew R Eber
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher M Peters
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Yusuke Shiozawa
- Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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Wootten D, Miller LJ, Koole C, Christopoulos A, Sexton PM. Allostery and Biased Agonism at Class B G Protein-Coupled Receptors. Chem Rev 2016; 117:111-138. [PMID: 27040440 DOI: 10.1021/acs.chemrev.6b00049] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Class B G protein-coupled receptors (GPCRs) respond to paracrine or endocrine peptide hormones involved in control of bone homeostasis, glucose regulation, satiety, and gastro-intestinal function, as well as pain transmission. These receptors are targets for existing drugs that treat osteoporosis, hypercalcaemia, Paget's disease, type II diabetes, and obesity and are being actively pursued as targets for numerous other diseases. Exploitation of class B receptors has been limited by difficulties with small molecule drug discovery and development and an under appreciation of factors governing optimal therapeutic efficacy. Recently, there has been increasing awareness of novel attributes of GPCR function that offer new opportunity for drug development. These include the presence of allosteric binding sites on the receptor that can be exploited as drug binding pockets and the ability of individual drugs to enrich subpopulations of receptor conformations to selectively control signaling, a phenomenon termed biased agonism. In this review, current knowledge of biased signaling and small molecule allostery within class B GPCRs is discussed, highlighting areas that have progressed significantly over the past decade, in addition to those that remain largely unexplored with respect to these phenomena.
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Affiliation(s)
- Denise Wootten
- Drug Discovery Biology and Department of Pharmacology, Monash Institute of Pharmaceutical Sciences, Monash University , Parkville 3052, Victoria, Australia
| | - Laurence J Miller
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic , Scottsdale, Arizona 85259, United States
| | - Cassandra Koole
- Drug Discovery Biology and Department of Pharmacology, Monash Institute of Pharmaceutical Sciences, Monash University , Parkville 3052, Victoria, Australia.,Laboratory of Chemical Biology and Signal Transduction, The Rockefeller University , New York, New York 10065, United States
| | - Arthur Christopoulos
- Drug Discovery Biology and Department of Pharmacology, Monash Institute of Pharmaceutical Sciences, Monash University , Parkville 3052, Victoria, Australia
| | - Patrick M Sexton
- Drug Discovery Biology and Department of Pharmacology, Monash Institute of Pharmaceutical Sciences, Monash University , Parkville 3052, Victoria, Australia
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Henriksen K, Bay-Jensen AC, Christiansen C, Karsdal MA. Oral salmon calcitonin--pharmacology in osteoporosis. Expert Opin Biol Ther 2010; 10:1617-29. [PMID: 20932224 DOI: 10.1517/14712598.2010.526104] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
IMPORTANCE OF THE FIELD Osteoporosis is a slow progressive disease with develops over decades, and where intervention is needed for an extended number of years. This highlights the need for safe intervention possibilities, which have sustained beneficial effects post-treatment. AREAS COVERED IN THIS REVIEW Articles on salmon calcitonin appearing on Pubmed from 1960 until today, with focus on a newly developed oral formulation showing increased exposure and efficacy compared with nasal formulation is reviewed. The second half focuses on long-term phenomena, such as bone quality and resolution effects. The final part discusses potential additional benefits of salmon calcitonin. WHAT THE READER WILL GAIN Insight into the clinical development of an orally formulated peptide, as well as a detailed understanding of why this approach could revive salmon calcitonin as a treatment for osteoporosis. TAKE HOME MESSAGE The oral formulation of salmon calcitonin provides additional benefits and increased efficacy on bone based on Phase I and II clinical trials data, as compared with the nasal formulation. Hence, the results on the ongoing Phase III fracture trial are awaited with great interest.
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Affiliation(s)
- Kim Henriksen
- Nordic Bioscience A/S, Herlev Hovedgade 207, DK-2730 Herlev, Denmark.
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Karsdal M, Henriksen K, Leeming D, Mitchell P, Duffin K, Barascuk N, Klickstein L, Aggarwal P, Nemirovskiy O, Byrjalsen I, Qvist P, Bay-Jensen A, Dam E, Madsen S, Christiansen C. Biochemical markers and the FDA Critical Path: How biomarkers may contribute to the understanding of pathophysiology and provide unique and necessary tools for drug development. Biomarkers 2009; 14:181-202. [DOI: 10.1080/13547500902777608] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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