Effects of bleomycin A5 on caspase-3, P53, bcl-2 expression and telomerase activity in vascular endothelial cells

Apelin Receptor Can Act as a Specific Marker and Promising Therapeutic Target for Infantile Hemangioma

Infantile hemangioma (IH), the most common benign tumor in infancy, is generally sensitive to propranolol treatment. However, the challenge remains because resistance or recurrence could occur in some patients, and the mechanism or target of propranolol remains unknown. Therefore, advancement in the drug development is needed. In this study, we explored whether apelin receptor (APJ) can become a candidate target. We found that APJ is expressed only in endothelial cells of IH (HemECs) but not in other vascular anomalies, and its antagonist, ML221, can negatively regulate cellular viability and functions of HemECs. This inhibitory effect could be replicated in a murine hemangioma model. Importantly, in vitro experiments also indicated that ML221 failed to affect the proliferation or angiogenesis of normal endothelial cells or APJ-knockout HemECs. Through analysis of the phosphoantibody microarray data, ML221 was revealed to have an inhibitory effect on HemECs by suppressing the activation of mitogen-activated protein kinase/extracellular signal-regulated kinase pathway. These results verified the distinctive expression of APJ in IH and specific inhibition of HemEC activity caused by ML221. In addition, APJ was also detected in propranolol-resistant IH. Collectively, we propose that APJ can act as a specific marker and a promising therapeutic target for IH, which will facilitate further drug development.

Computed Tomography Fluoroscopy-Guided Percutaneous Transhepatic Bleomycin/Ethiodized Oil Sclerotherapy for Symptomatic Giant Hepatic Hemangioma

PURPOSE

To determine the safety and efficacy of computed tomography (CT) fluoroscopy-guided percutaneous transhepatic sclerotherapy with a bleomycin/ethiodized oil emulsion for symptomatic giant hepatic hemangiomas.

MATERIALS AND METHODS

The procedure was performed on 22 patients with symptomatic giant hepatic hemangiomas in an outpatient setting between 2018 and 2020. All patients were followed clinically and underwent contrast-enhanced magnetic resonance imaging after 1 month and again at a mean time of 15 months ± 2. Adverse events were classified according to the Common Terminology Criteria for Adverse Events (CTCAE, v5.0), in which a severe adverse event was defined as an adverse event with a grade of ≥3. The desired radiologic response (volume and index size) and improvement of pain intensity (visual analog scale [VAS]) and other symptoms were recorded as outcomes.

RESULTS

Overall, patients showed a 36.4% ± 8.6 reduction in volume and a 14% ± 1.6 reduction in index size after 1 month, with P values of .002 and .001, respectively. The final follow-up volume and index size were 194.7 cm³ ± 25.8 and 77 mm ± 36, respectively. Moreover, a 53.0% ± 7 reduction in volume and 22% ± 3.7 reduction in index size during the final imaging were reported, with the P values of .001 and .001, respectively. Significant reductions in the mean pain intensity (90% of patients with lower VAS scores after intervention) and symptoms were reported. Four patients were classified as clinically unsuccessful, and were recommended further procedures for residual pain.

CONCLUSIONS

CT fluoroscopy-guided transhepatic sclerotherapy is an effective, safe, and minimally invasive method to manage giant hepatic hemangiomas in an outpatient setting.

Chlorogenic acid induces 4T1 breast cancer tumor's apoptosis via p53, Bax, Bcl-2, and caspase-3 signaling pathways in BALB/c mice

Despite all the new treatments, metastatic breast cancer (BC) causes many deaths. Chlorogenic acid (CGA) is a polyphenol compound with various pharmacological traits, such as anticancer properties. Targeting apoptotic death pathways has been propounded as the most effective therapeutic method in various cancers. In the current study, apoptotic agents such as p53, Bax, Bcl-2, and caspase-3 have been investigated. The experimental groups included saline, BC, CGA, protective (PR), and treatment (TM) groups. First, 4T1 mouse BC was established and then the effects of treatment with CGA were investigated through measurement of tumor weight and volume, metastatic nodules, liver biochemical tests, hematoxylin and eosin (H&E), immunohistochemistry (IHC) staining, and real-time reverse transcription-polymerase chain reaction (RT-PCR) in experimental groups. The findings showed that CGA reduced tumor weight and volume in the PR group (P < .05) and in the TM group (P < .001). Surprisingly, it eliminated the tumors in the TM group. Metastatic nodules in the PR and TM groups were significantly reduced as compared with the BC group (P < .001). The evaluation by H&E staining showed cell apoptosis in both the PR and TM groups. The results of real-time RT-PCR showed that CGA therapy increased the expression ratio of Bax/Bcl-2 (P < .001 and P < .05, respectively) and the expression of p53 (P < .001 and P < .05, respectively) and caspase-3 genes (P < .01) in the PR and TM groups. The IHC data regarding the Bax/Bcl-2 ratio confirmed the other results (P < .001). The findings demonstrate that CGA plays a significant role in the induction of apoptosis and the treatment of 4T1 BC tumors in BALB/c mice.

Transarterial Embolization in Neonatal Kasabach-Merritt Syndrome

Background: Kasabach-Merritt syndrome (KMS) is characterized by large hemangiomas and persistent thrombocytopenia, which may result in visceral hemorrhage and disseminated intravascular coagulation. This study aimed to evaluate the value of transarterial embolization (TAE) in neonatal KMS patients. Patients and Methods: The clinical course of 11 neonates with KMS who underwent TAE in the Department of Neonatology, Anhui Provincal Children's Hospital, Anhui Medical University, China, were reviewed retrospectively. Results: Eleven neonates with KMS (nine male and two female) were admitted to our hospital between the age of 1 h and 6 days. All were born with progressively enlarged hemangiomas and persistent thrombocytopenia. The largest lesion had its maximum size reached at 15 × 8 × 8 cm. Eight patients had cutaneous hemangiomas (1 right face, one oropharynx, one left upper arm, two back, one left lumbar, one right lower leg, and one right thigh), and three patients had liver hemangiomas. All 11 patients underwent TAE. Nine patients underwent two TAEs, and two patients underwent only one embolization procedure. They all obtained >80% devascularization of their lesions without a major complication. The platelet count increased at 2-5 days after treatment and reached normal count and coagulation profile at 18-28 days after the TAE. Conclusions: TAE is a safe and effective alternative therapy for neonatal KMS patients.

Effectiveness of Transarterial Embolization in Treatment of Symptomatic Hepatic Hemangiomas: Systematic Review and Meta-analysis

PURPOSE

To evaluate the current evidence for the effectiveness of transarterial embolization (TAE) in treatment of symptomatic hepatic hemangiomas.

MATERIALS AND METHODS

A systematic literature review was conducted in PubMed, CINAHL and Scopus databases to identify studies of hepatic hemangiomas treated with transarterial embolization. Main outcome was defined as the mean difference between pre- and post-TAE hemangioma diameters. Treatment agents were categorized as Lipiodol based [bleomycin (L + BE), pingyangmycin (L + PYG) or ethanol (L + ethanol)] and non-Lipiodol based (polyvinyl-alcohol-only). Conventional random-effect meta-analysis technique was applied to analyze data.

RESULTS

Of 3080 initially inspected publications, 21 studies were included in the meta-analysis comprising of 1450 patients with total of 1871 hemangiomas (36.2% male, mean age: 46.3 ± 3.6 years). One hundred and twenty-six, 1666, 41 and 38 lesions were treated with L + BE, L + PYG, L + ethanol and PVA, respectively. Median follow-up time after embolization was 12 months. Lipiodol-based treatments showed significant effect in reducing hemangioma size after TAE compared to PVA (P < 0.001). Pooled diameter reduction (cm) (95% confidence interval) was - 4.37( - 5.32, - 3.42), - 4.70( - 5.70, - 3.71), - 0.93( - 2.02, 0.16) for overall TAE treatment, Lipiodol-based and non-Lipiodol-based treatments, respectively. Main complications included post-embolization syndrome and transient liver enzyme elevation (pooled incidence for Lipiodol-based and non-Lipiodol-based techniques: 36% and 33%; and 37% and 0, respectively). No fatal complications were reported. Symptomatic improvement was reported in 63.3%-100% of the cases with majority of studies (15/21) reporting improvement in all cases (pooled response rate: 98%).

CONCLUSIONS

Transarterial embolization with bleomycin, pingyangmycin or ethanol in combination with Lipiodol is safe and associated with reduced size of hemangiomas resulting in symptoms alleviation.

Arachidonic acid activates extrinsic apoptotic pathway to enhance tumoricidal action of bleomycin against IMR-32 cells

Bleomycin is a commonly used anti-cancer drug in the management of a variety of cancers. Previously, we showed that arachidonic acid (AA) augmented the growth inhibitory action of bleomycin on IMR-32 (human neuroblastoma cells) in vitro by enhancing oxidative stress. Despite these results, the exact molecular mechanism of cytotoxic action of bleomycin and its augmentation by AA is not known. Our current study revealed that a combination of bleomycin and AA significantly enhanced the expression of FAS gene, which is involved in programmed cell death (apoptosis) and caspases 3 and 8 compared to either bleomycin or AA alone implying that activation of extrinsic apoptotic pathway plays a major role in their (bleomycin + AA) tumoricidal action. It is interesting to note that AA by itself enhanced the expression of FAS and caspases 3 and 8 compared to control. Since caspases have a role in inflammation, cell proliferation, tumour suppression, cell differentiation, neural development and axon guidance and ageing, this may explain pleiotropic actions of AA and their metabolites.

Inhibitory effect of miR-184 on the potential of proliferation and invasion in human glioma and breast cancer cells in vitro

MiR-184 was an important suppressor to tumor cells proliferation and invasion and some studies show that it was down-regulated in aggressive human tumor cells and a potential tumor therapy target through expression of miR-184 results in reduced tumor cell aggressiveness. In this study, miR-184 showed an inhibitive activity of glioma U87MG cell line and breast cancer MCF-7 cell line in proliferation and invasion by MTS and transwell assay. We found that the miR-184 also could arrest cell cycle and adhesion by up-regulating the expression of p53 and p21 and activity of caspase-3/8, suppressing the expression of SND1, MMP-2/9, CD44 and activity of AKT/NF-κB pathway. The results showed that miR-184 could be a potential target for glioma and breast cancer treatment.