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Un H, Ugan RA, Gurbuz MA, Bayir Y, Kahramanlar A, Kaya G, Cadirci E, Halici Z. Phloretin and phloridzin guard against cisplatin-induced nephrotoxicity in mice through inhibiting oxidative stress and inflammation. Life Sci 2020; 266:118869. [PMID: 33309722 DOI: 10.1016/j.lfs.2020.118869] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/13/2022]
Abstract
AIM Cisplatin (Cis) is widely used chemotherapeutic and has some serious side effects as nephrotoxicity. Phloretin (PH) and Phloridzin (PZ) are known their anti-oxidant anti-inflammatory effects. We aimed to examine the protective effects of PH and PZ on cisplatin-induced nephrotoxicity. MAIN METHODS Totally, 48 Balb/C female mice were separated into eight groups (n = 6). First day, single dose of cisplatin (20 mg/kg intraperitoneal) was administered to induce toxicity. PH and PZ were given (50 and 100 mg/kg orally) to treatment groups during 3 days. After the experimental procedures serum renal function enzymes (BUN and Creatinine), oxidative parameters (SOD, GSH and MDA), nuclear agent NFKβ, inflammatory cytokines (Tnf-α and IL1β) and HSP70 expressions and histopathological assessments were analyzed. KEY FINDINGS Serum enzymes, tissue cytokines and oxidative stress were increased after the Cis treatment. PH and PZ treatments normalized all parameters compared to Cis administrated group. After the treatments, SOD activities and GSH levels were increased while MDA levels were decreased. PH and PZ treatments decreased Tnf-α, IL1β and NFKβ mRNA expressions. Cis significantly increased the HSP70 expression while PH and PZ administrations significantly decreased. Similar the biochemical and molecular results, PH and PZ showed positive effects on tissue pathological parameters. Cisplatin cause a lot of abnormal structures as tubular and glomeruli damages on the kidney. SIGNIFICANCE PH and PZ play important physiological roles in the prevention of nephrotoxicity. Antioxidant and anti-inflammatory effects of PH and PZ demonstrated visible protective effects in the cisplatin-induced nephrotoxicity model.
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Affiliation(s)
- Harun Un
- Agri Ibrahim Cecen University, Faculty of Pharmacy, Department of Biochemistry, Agri, Turkey.
| | - Rustem Anil Ugan
- Ataturk University, Faculty of Pharmacy, Department of Pharmacology, Erzurum, Turkey
| | - Muhammet Ali Gurbuz
- Ataturk University, Faculty of Medicine, Department of Histology and Embryology, Erzurum, Turkey
| | - Yasin Bayir
- Ataturk University, Faculty of Pharmacy, Department of Biochemistry, Erzurum, Turkey
| | - Aysenur Kahramanlar
- Ataturk University, Faculty of Pharmacy, Department of Biochemistry, Erzurum, Turkey
| | - Gokce Kaya
- Ataturk University, Faculty of Medicine, Department of Pharmacology, Erzurum, Turkey
| | - Elif Cadirci
- Ataturk University, Faculty of Medicine, Department of Pharmacology, Erzurum, Turkey; Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, Turkey
| | - Zekai Halici
- Ataturk University, Faculty of Medicine, Department of Pharmacology, Erzurum, Turkey; Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, Turkey
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Bakke KM, Meltzer S, Grøvik E, Negård A, Holmedal SH, Gjesdal KI, Bjørnerud A, Ree AH, Redalen KR. Sex Differences and Tumor Blood Flow from Dynamic Susceptibility Contrast MRI Are Associated with Treatment Response after Chemoradiation and Long-term Survival in Rectal Cancer. Radiology 2020; 297:352-360. [PMID: 32870132 DOI: 10.1148/radiol.2020200287] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background MRI is the standard tool for rectal cancer staging. However, more precise diagnostic tests that can assess biologic tumor features decisive for treatment outcome are necessary. Tumor perfusion and hypoxia are two important features; however, no reference methods that measure these exist in clinical use. Purpose To assess the potential predictive and prognostic value of MRI-assessed rectal cancer perfusion, as a surrogate measure of hypoxia, for local treatment response and survival. Materials and Methods In this prospective observational cohort study, 94 study participants were enrolled from October 2013 to December 2017 (ClinicalTrials.gov: NCT01816607). Participants had histologically confirmed rectal cancer and underwent routine diagnostic MRI, an extended diffusion-weighted sequence, and a multiecho dynamic contrast agent-based sequence. Predictive and prognostic values of dynamic contrast-enhanced, dynamic susceptibility contrast (DSC), and intravoxel incoherent motion MRI were investigated with response to neoadjuvant treatment, progression-free survival, and overall survival as end points. Secondary objectives investigated potential sex differences in MRI parameters and relationship with lymph node stage. Statistical methods used were Cox regression, Student t test, and Mann-Whitney U test. Results A total of 94 study participants (mean age, 64 years ± 11 [standard deviation]; 61 men) were evaluated. Baseline tumor blood flow from DSC MRI was lower in patients who had poor local tumor response to neoadjuvant treatment (96 mL/min/100 g ± 33 for ypT2-4, 120 mL/min/100 g ± 21 for ypT0-1; P = .01), shorter progression-free survival (hazard ratio = 0.97; 95% confidence interval: 0.96, 0.98; P < .001), and shorter overall survival (hazard ratio = 0.98; 95% confidence interval: 0.98, 0.99; P < .001). Women had higher blood flow (125 mL/min/100 g ± 27) than men (74 mL/min/100 g ± 26, P < .001) at stage 4. Volume transfer constant and plasma volume from dynamic contrast-enhanced MRI as well as ΔR2* peak and area under the curve for 30 and 60 seconds from DSC MRI were associated with local malignant lymph nodes (pN status). Median area under the curve for 30 seconds was 0.09 arbitrary units (au) ± 0.03 for pN1-2 and 0.19 au ± 0.12 for pN0 (P = .001). Conclusion Low tumor blood flow from dynamic susceptibility contrast MRI was associated with poor treatment response in study participants with rectal cancer. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Kine M Bakke
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Sebastian Meltzer
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Endre Grøvik
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Anne Negård
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Stein H Holmedal
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Kjell-Inge Gjesdal
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Atle Bjørnerud
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Anne H Ree
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
| | - Kathrine R Redalen
- From the Department of Oncology, Akershus University Hospital, Epigen, Akershus Universitetssykehus HF, 1478 Lørenskog, Norway (K.M.B., S.M., K.I.G., A.H.R., K.R.R.); Department of Physics (K.M.B., A.B.) and Institute of Clinical Medicine (A.N., A.H.R.), University of Oslo, Oslo, Norway; Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway (E.G., A.B.); Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway (E.G.); Department of Radiology, Akershus University Hospital, Lørenskog, Norway (A.N., S.H.H.); Sunnmøre MR-Klinikk, Ålesund, Norway (K.I.G.); and Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway (K.R.R.)
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Kalanxhi E, Risberg K, Barua IS, Dueland S, Waagene S, Andersen SN, Pettersen SJ, Lindvall JM, Redalen KR, Flatmark K, Ree AH. Induction of Apoptosis in Intestinal Toxicity to a Histone Deacetylase Inhibitor in a Phase I Study with Pelvic Radiotherapy. Cancer Res Treat 2016; 49:374-386. [PMID: 27488871 PMCID: PMC5398387 DOI: 10.4143/crt.2016.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 06/28/2016] [Indexed: 12/24/2022] Open
Abstract
Purpose When integrating molecularly targeted compounds in radiotherapy, synergistic effects of the systemic agent and radiation may extend the limits of patient tolerance, increasing the demand for understanding the pathophysiological mechanisms of treatment toxicity. In this Pelvic Radiation and Vorinostat (PRAVO) study, we investigated mechanisms of adverse effects in response to the histone deacetylase (HDAC) inhibitor vorinostat (suberoylanilide hydroxamic acid, SAHA) when administered as a potential radiosensitiser. Materials and Methods This phase I study for advanced gastrointestinal carcinoma was conducted in sequential patient cohorts exposed to escalating doses of vorinostat combined with standard-fractionated palliative radiotherapy to pelvic target volumes. Gene expression microarray analysis of the study patient peripheral blood mononuclear cells (PBMC) was followed by functional validation in cultured cell lines and mice treated with SAHA. Results PBMC transcriptional responses to vorinostat, including induction of apoptosis, were confined to the patient cohort reporting dose-limiting intestinal toxicities. At relevant SAHA concentrations, apoptotic features (annexin V staining and caspase 3/7 activation, but not poly-(ADP-ribose)-polymerase cleavage) were observed in cultured intestinal epithelial cells. Moreover, SAHA-treated mice displayed significant weight loss. Conclusion The PRAVO study design implemented a strategy to explore treatment toxicity caused by an HDAC inhibitor when combined with radiotherapy and enabled the identification of apoptosis as a potential mechanism responsible for the dose-limiting effects of vorinostat. To the best of our knowledge, this is the first report deciphering mechanisms of normal tissue adverse effects in response to an HDAC inhibitor within a combined-modality treatment regimen.
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Affiliation(s)
- Erta Kalanxhi
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway
| | - Karianne Risberg
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway
| | - Imon S Barua
- Institute of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Svein Dueland
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Stein Waagene
- Department of Tumour Biology, Oslo University Hospital, Oslo, Norway
| | - Solveig Norheim Andersen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pathology, Akershus University Hospital, Lørenskog, Norway
| | | | - Jessica M Lindvall
- Institute of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway
| | | | - Kjersti Flatmark
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Tumour Biology, Oslo University Hospital, Oslo, Norway.,Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne Hansen Ree
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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8
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Kalanxhi E, Hektoen HH, Meltzer S, Dueland S, Flatmark K, Ree AH. Circulating proteins in response to combined-modality therapy in rectal cancer identified by antibody array screening. BMC Cancer 2016; 16:536. [PMID: 27461255 PMCID: PMC4962367 DOI: 10.1186/s12885-016-2601-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/22/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The increasingly complex programs of contemporary cancer therapy emphasize the need for biological indicators of both therapeutic response and adverse effects. One example is combined-modality treatment aimed at improving long-term outcome in patients with locally advanced rectal cancer, which commonly comes at the price of extended limits of patient tolerance. METHODS In a prospective study with intensified neoadjuvant treatment of rectal cancer patients, using an antibody array, the profiling of approximately 500 proteins was performed in serial serum samples collected at different stages of the treatment course. RESULTS The small number of proteins whose levels significantly changed after induction neoadjuvant chemotherapy (NACT) expanded substantially following the sequential chemoradiotherapy (CRT) and persisted four weeks later at treatment evaluation before pelvic surgery. Serum levels of proteins selected for validation of the experimental design, lipocalin-2 and matrix metalloproteinase-9, declined after NACT and gradually reverted to baseline values during the remaining neoadjuvant course. Of note, the greater the decline in post-NACT and post-CRT matrix metalloproteinase-9 levels, the more favorable progression-free survival. No correlation was found, however, with diarrhea scores, the clinical correlate of adverse therapeutic effects. CONCLUSIONS Even though the findings were indicative of only tumor and not normal tissue effects, multiplex immunoassay analysis of circulating proteins in patients undergoing combined-modality therapy may in principle dissect the contribution of the individual modalities to overall systemic responses in patient outcome and tolerance. TRIAL REGISTRATION ClinicalTrials.gov NCT00278694 ; registration date: January 16, 2006, retrospective to enrollment of the first 10 patients of the current report.
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Affiliation(s)
- Erta Kalanxhi
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Molecular Biology, Akershus University Hospital, P.O. Box 1000, 1478, Lørenskog, Norway
| | - Helga Helseth Hektoen
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, 0318, Oslo, Norway.,Department of Tumor Biology, Oslo University Hospital - Norwegian Radium Hospital, Oslo, Norway
| | - Sebastian Meltzer
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, 0318, Oslo, Norway
| | - Svein Dueland
- Department of Oncology, Oslo University Hospital - Norwegian Radium Hospital, Oslo, Norway
| | - Kjersti Flatmark
- Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, 0318, Oslo, Norway.,Department of Tumor Biology, Oslo University Hospital - Norwegian Radium Hospital, Oslo, Norway.,Department of Gastroenterological Surgery, Oslo University Hospital - Norwegian Radium Hospital, P.O. Box 4950, Nydalen, 0424, Oslo, Norway
| | - Anne Hansen Ree
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway. .,Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, 0318, Oslo, Norway.
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