1
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Brownell D, Kuo AH. Child with headache and small head. J Paediatr Child Health 2023. [PMID: 37926954 DOI: 10.1111/jpc.16513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/05/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Drew Brownell
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Anderson H Kuo
- Department of Radiology, Midland Memorial Hospital, Midland, Texas, USA
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2
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Le D, Trinh K, Das N, Kuo AH. T2-fluid attenuated inversion recovery mismatch in tumefactive multiple sclerosis. BJR Case Rep 2023; 9:20220138. [PMID: 36873238 PMCID: PMC9976723 DOI: 10.1259/bjrcr.20220138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 01/13/2023] Open
Abstract
The T2-fluid attenuated inversion recovery (FLAIR) mismatch sign has been suggested as an imaging marker of isocitrate dehydrogenase-mutant 1p/19q non-codeleted gliomas with 100% specificity. Tumefactive demyelination is a common mimic of neoplasm that has led to unnecessary biopsies and even resections. We report a case of tumefactive multiple sclerosis in a 46-year-old male without prior symptomatic demyelinating episodes that demonstrates the T2-FLAIR mismatch sign. Our findings suggest the T2-FLAIR mismatch sign should not be used as a differential feature between glioma and tumefactive demyelination. Because typical isocitrate dehydrogenase-mutant 1p/19q non-codeleted gliomas typically do not demonstrate significant enhancement, such diagnosis should be reserved when post-contrast images are unavailable.
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Affiliation(s)
- Duc Le
- Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | - Kelly Trinh
- Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | | | - Anderson H Kuo
- Department of Radiology, Midland Memorial Hospital, Midland, Texas, United States
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3
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Abstract
Multiple diverse pathologies result in the clinical presentation of myelopathy. The preferred way to image the spinal cord depends on clinical history, anatomic site of interest, and patient issues limiting certain imaging modalities. This radiology-focused article discusses pertinent physiological considerations, reviews basic and newer imaging techniques, and examines several distinct disease entities in order to highlight the key role of imaging in the work-up of myelopathy.
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Affiliation(s)
- Alice C Shea
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Anderson H Kuo
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Liangge Hsu
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
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4
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Nathanielsz PW, Huber HF, Li C, Clarke GD, Kuo AH, Zambrano E. The nonhuman primate hypothalamo-pituitary-adrenal axis is an orchestrator of programming-aging interactions: role of nutrition. Nutr Rev 2020; 78:48-61. [PMID: 33196092 PMCID: PMC7667468 DOI: 10.1093/nutrit/nuaa018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Developmental programming alters life-course multi-organ function and significantly affects life-course health. Recently, interest has developed in how programming may influence the rate of aging. This review describes interactions of nutrition and programming-aging interactions in hypothalamo-pituitary-adrenal (HPA) development and function from fetal development to old age. A full picture of these interactions requires data on levels of HPA activity relating to the hypothalamic, adrenal cortical, circulating blood, and peripheral cortisol metabolism. Data are provided from studies on our baboon, nonhuman primate model both across the normal life course and in offspring of maternal baboons who were moderately undernourished by a global 30% diet reduction during pregnancy and lactation. Sex differences in offspring outcomes in response to similar challenges are described. The data clearly show programming of increased HPA axis activity by moderate maternal undernutrition. Increased postnatal circulating cortisol concentrations are related to accelerated aging of the brain and cardiovascular systems. Future studies should address peripheral cortisol production and the influence of aging advantage in females. These data support the view that the HPA is an orchestrator of interactions of programming-aging mechanisms.
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Affiliation(s)
- Peter W Nathanielsz
- Texas Pregnancy & Life-course Health Center, University of Wyoming, Laramie, Wyoming, USA
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - Hillary F Huber
- Texas Pregnancy & Life-course Health Center, University of Wyoming, Laramie, Wyoming, USA
| | - Cun Li
- Texas Pregnancy & Life-course Health Center, University of Wyoming, Laramie, Wyoming, USA
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - Geoffrey D Clarke
- Southwest National Primate Research Center, San Antonio, Texas, USA
- Department of Radiology, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Anderson H Kuo
- Department of Radiology, University of Texas Health Science Center, San Antonio, Texas, USA
- Department of Radiology, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Elena Zambrano
- Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán
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5
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Kuo AH, Cho CH, Huang RY, Kim CJ, Lee TC. Target-specific yield rate and clinical utility of percutaneous tissue sampling in spinal infection. Clin Imaging 2020; 68:257-262. [DOI: 10.1016/j.clinimag.2020.08.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/04/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
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6
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Garrana SH, Dagogo-Jack I, Cobb R, Kuo AH, Mendoza DP, Zhang EW, Heeger A, Sequist LV, Digumarthy SR. Clinical and Imaging Features of Non-Small-Cell Lung Cancer in Young Patients. Clin Lung Cancer 2020; 22:23-31. [PMID: 33189594 DOI: 10.1016/j.cllc.2020.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Non-small-cell lung cancer (NSCLC) in young adult patients is rare, with scarce data available in patients aged < 40 years and even less in those aged < 35 years. Our goal was to determine the presenting symptoms, clinicopathologic characteristics, and imaging features of young patients with NSCLC at time of diagnosis and compare them to those of older adults. PATIENTS AND METHODS We retrospectively analyzed the medical records and imaging of young patients (≤ 40 years old) with NSCLC treated at our institution between 1998 and 2018. Patients < 35 years old were compared to those between 35 and 40 years old. Characteristics of patients ≤ 40 years old were compared to older patients (> 40 years) from publicly available data sets. RESULTS We identified 166 young patients with NSCLC (median age, 36.6 years; range, 18-40 years). Most presented with nonspecific respiratory symptoms and were diagnosed with pneumonia (84/136, 62%). Compared to patients < 35 years old, patients 35-40 years old were more likely to have malignancy detected incidentally (15% vs. 5%, P = .04). Patients < 35 years old were more likely to have central tumors (55% vs. 33%, P = .02) and to have bone (38% vs. 19%, P = .007) and lung (39% vs. 24%, P = .03) metastases. Compared to older patients (> 40 years), young patients were more likely to be never smokers (65.0% vs. 14.7%, P < .001) and to have advanced disease (88% vs. 66%, P < .001). CONCLUSION Young patients with NSCLC often present with nonspecific symptoms and have advanced disease at diagnosis, often mimicking other pathologies. Awareness of the clinical presentation and imaging features of NSCLC in young patients may help minimize delays in diagnoses.
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Affiliation(s)
- Sherief H Garrana
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Ibiayi Dagogo-Jack
- Harvard Medical School, Boston, MA; Department of Medicine, Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Rosemary Cobb
- Harvard Medical School, Boston, MA; Department of Medicine, Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Anderson H Kuo
- Harvard Medical School, Boston, MA; Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Dexter P Mendoza
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Eric W Zhang
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Allen Heeger
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Lecia V Sequist
- Harvard Medical School, Boston, MA; Department of Medicine, Cancer Center, Massachusetts General Hospital, Boston, MA
| | - Subba R Digumarthy
- Harvard Medical School, Boston, MA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA.
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7
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Kuo AH, Sakhuja RA, Hedgire SS. A Woman in Her 70s With Mitral Stenosis, Mitral Regurgitation, and Abnormal Morphology of the Mitral Valve. JAMA Cardiol 2020; 5:1191. [DOI: 10.1001/jamacardio.2020.2847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Anderson H. Kuo
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rahul A. Sakhuja
- Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sandeep S. Hedgire
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Kuo AH, Srivastava SD, Harrington SG, Hedgire SS. Not hepatic infarction: Cold quadrate sign. Clin Imaging 2020; 68:188-190. [PMID: 32846365 DOI: 10.1016/j.clinimag.2020.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/21/2020] [Indexed: 11/25/2022]
Abstract
A 50-year-old male presented with bilateral lower extremity plain is found to have a wedge-shape hypodense region in the hepatic quadrate lobe. The hypoenhancement was thought to be a result of systemic-portal venous shunting due to IVC obstruction, a "cold" version of the classically described hot quadrate sign. Follow-up CT confirmed the diagnosis. Venous drainage pathway for both hot and cold quadrate signs is discussed.
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Affiliation(s)
- Anderson H Kuo
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America
| | - Sunita D Srivastava
- Department of Vascular Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America
| | - Samantha G Harrington
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America
| | - Sandeep S Hedgire
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America.
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9
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Kuo AH, Nuñez DB. Giant Pituitary Adenoma With Inferior Petrosal Sinus, Jugular Foramen, and Hypoglossal Canal Extension. JAMA Otolaryngol Head Neck Surg 2020; 146:82-84. [PMID: 31556924 DOI: 10.1001/jamaoto.2019.2686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Anderson H Kuo
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Diego B Nuñez
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Abstract
Magnetic resonance angiography (MRA) denotes a unique option for the evaluation of peripheral vasculature due to its noninvasive nature, lack of ionizing radiation exposure, potential for non-contrast examination, and ability for generating volumetric representations that showcase vascular pathology. The constant evolution of the available MRA techniques, however, makes understanding and determining an optimal imaging protocol difficult. Here we present a brief overview of the major MRA sequence options, their major weaknesses and strengths, and related imaging considerations. Understanding the technical underpinnings of the various MRA methods helps with recognition of common imaging issues and artifacts and rendering clinically relevant interpretations.
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Affiliation(s)
- Anderson H Kuo
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Prashant Nagpal
- Department of Radiology, University of Iowa/Carver College of Medicine, Iowa City, USA
| | - Brian B Ghoshhajra
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Sandeep S Hedgire
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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11
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Huber HF, Kuo AH, Li C, Jenkins SL, Gerow KG, Clarke GD, Nathanielsz PW. Antenatal Synthetic Glucocorticoid Exposure at Human Therapeutic Equivalent Doses Predisposes Middle-Age Male Offspring Baboons to an Obese Phenotype That Emerges With Aging. Reprod Sci 2019; 26:591-599. [PMID: 29871548 PMCID: PMC6728579 DOI: 10.1177/1933719118778794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Women threatening premature delivery receive synthetic glucocorticoids (sGC) to accelerate fetal lung maturation, reducing neonatal mortality and morbidity. Few investigations have explored potential long-term offspring side effects. We previously reported increased pericardial fat and liver lipids in 10-year-old (human equivalent 40 years) male baboons exposed to 3 antenatal sGC courses. We hypothesized middle-aged sGC male offspring show obesity-related morphometric changes. METHODS Pregnant baboons received courses of 2 betamethasone injections (175 μg·kg-1·d-1 intramuscular) at 0.6, 0.64, and 0.68 gestation. At 10 to 12.5 years, we measured morphometrics and serum lipids in 5 sGC-exposed males and 10 age-matched controls. We determined whether morphometric parameters predicted amount of pericardial fat or lipids. Life-course serum lipids were measured in 25 males (7-23 years) providing normal regression formulas to compare sGC baboons' lipid biological and chronological age. RESULTS Birth weights were similar. When studied, sGC-exposed males showed a steeper weight increase from 8 to 12 years and had increased waist and hip circumferences, neck and triceps skinfolds, and total and low-density lipoprotein cholesterol. Triceps skinfold correlated with apical and midventricular pericardial fat thickness, hip and waist circumferences with insulin. CONCLUSIONS Triceps skinfold and waist and hip circumferences are useful biomarkers for identifying individuals at risk for obesity and metabolic dysregulation following fetal sGC exposure. Prenatal sGC exposure predisposes male offspring to internal adiposity, greater body size, and increased serum lipids. Results provide further evidence for developmental programming by fetal sGC exposure and call attention to potential emergence of adverse life-course effects.
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Affiliation(s)
| | - Anderson H. Kuo
- Radiology, University of Texas Health Science Center at San Antonio, San
Antonio, TX, USA
| | - Cun Li
- Animal Science, University of Wyoming, Laramie, WY, USA
- Southwest National Primate Research Center and Texas Biomedical Research
Institute, San Antonio, TX, USA
| | | | | | - Geoffrey D. Clarke
- Radiology, University of Texas Health Science Center at San Antonio, San
Antonio, TX, USA
- Southwest National Primate Research Center and Texas Biomedical Research
Institute, San Antonio, TX, USA
| | - Peter W. Nathanielsz
- Animal Science, University of Wyoming, Laramie, WY, USA
- Southwest National Primate Research Center and Texas Biomedical Research
Institute, San Antonio, TX, USA
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Kuo AH, Li C, Huber HF, Clarke GD, Nathanielsz PW. Intrauterine growth restriction results in persistent vascular mismatch in adulthood. J Physiol 2018; 596:5777-5790. [PMID: 29098705 PMCID: PMC6265527 DOI: 10.1113/jp275139] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/31/2017] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Intrauterine growth restriction (IUGR) increases offspring risk of chronic diseases later in life, including cardiovascular dysfunction. Our prior studies suggest biventricular cardiac dysfunction and vascular impairment in baboons who were IUGR at birth because of moderate maternal nutrient reduction. The current study reveals changes in artery sizes, distensibility, and blood flow pattern in young adult IUGR baboons, which may contribute to cardiac stress. The pattern of abnormality observed suggests that vascular redistribution seen with IUGR in fetal life may continue into adulthood. ABSTRACT Maternal nutrient reduction induces intrauterine growth restriction (IUGR), increasing risks of chronic diseases later in life, including cardiovascular dysfunction. Using ultrasound, we determined regional blood flow, blood vessel sizes, and distensibility in IUGR baboons (8 males, 8 females, 8.8 years, similar to 35 human years) and controls (12 males, 12 females, 9.5 years). The measured blood vessels were larger in size in the males compared to females before but not after normalization to body surface area. Smaller IUGR normalized blood vessel sizes were observed in the femoral and external iliac arteries but not the brachial or common carotid arteries and not correlated significantly with birth weight. Mild decrease in distensibility in the IUGR group was seen in the iliac but not the carotid arteries without between-sex differences. In IUGR baboons there was increased carotid arterial blood flow velocity during late systole and diastole. Overall, our findings support the conclusion that region specific vascular and haemodynamic changes occur with IUGR, which may contribute to the occurrence of later life cardiac dysfunction. The pattern of alteration observed suggests vascular redistribution efforts in response to challenges in the perinatal period may persist into adulthood. Further studies are needed to determine the life course progression of these changes.
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Affiliation(s)
- Anderson H. Kuo
- Department of Radiology and Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Cun Li
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
- Southwest National Primate Research CenterSan AntonioTXUSA
| | | | - Geoffrey D. Clarke
- Department of Radiology and Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Southwest National Primate Research CenterSan AntonioTXUSA
| | - Peter W. Nathanielsz
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
- Southwest National Primate Research CenterSan AntonioTXUSA
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Kuo AH, Li C, Huber HF, Nathanielsz PW, Clarke GD. Ageing changes in biventricular cardiac function in male and female baboons (Papio spp.). J Physiol 2018; 596:5083-5098. [PMID: 30144074 PMCID: PMC6209749 DOI: 10.1113/jp276338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/06/2018] [Indexed: 12/13/2022] Open
Abstract
KEY POINTS Life course changes in cardiovascular function in a non-human primate have been comprehensively characterized. Age-related declines in normalized left ventricular stroke volume and cardiac output were found with corresponding decreases in biventricular ejection fractions and filling rates. There were age-related decreases in male and female baboon normalized left ventricular myocardial mass index, which declined at similar rates. Systolic functional declines in right ventricular function were observed with age, similar to the left ventricle. Sex differences were found in the rates and directions of right ventricular volume changes along with decreased end-systolic right ventricular sphericity. The results validate the baboon as an appropriate model for translational studies of cardiovascular functional decline with ageing. ABSTRACT Previous studies reported cardiac function declines with ageing. This study determined changes in biventricular cardiac function in a well-characterized baboon model. Cardiac magnetic resonance imaging measured key biventricular parameters in 47 baboons (22 female, age 4-23 years). ANCOVA assessed sex and age changes with P < 0.05 deemed significant. Stroke volume, cardiac output and other cardiac functional parameters were normalized to body surface area. There were similar, age-related rates of decrease in male (M) and female (F) normalized left ventricular (LV) myocardial mass index (M: -1.2 g m-2 year-1 , F: -0.9 g m-2 year-1 ). LV ejection fraction declined at -0.96% year-1 (r = -0.43, P = 0.002) and right ventricular (RV) ejection fraction decreased at -1.2% year-1 (r = -0.58, P < 0.001). Normalized LV stroke volume fell at -1.1 ml m-2 year-1 (r = -0.47, P = 0.001), normalized LV ejection rate at -3.8 ml s-1 m-2 year-1 (r = -0.43, P < 0.005) and normalized LV filling rate at -4.1 ml s-1 m-2 year-1 (r = -0.44, P < 0.005). Also, RV wall thickening fraction decreased with age (slope = -1% year-1 , P = 0.008). RV ejection rate decreased at -3.6 ml s-1 m-2 year-1 (P = 0.002) and the normalized average RV filling rate dropped at -3.7 ml s-1 m-2 year-1 (P < 0.0001). End-systolic RV sphericity index also dropped with age (r = -0.33, P = 0.02). Many observed changes parallel previously reported data in human and animal studies. These measured biventricular functional declines in hearts with ageing from the closest experimental primate species to man underscore the utility of the baboon model for investigating mechanisms related to heart ageing.
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Affiliation(s)
- Anderson H. Kuo
- Radiology DepartmentUniversity of Texas Health Science CenterSan AntonioTXUSA
| | - Cun Li
- University of WyomingLaramieWYUSA
- Southwest Primate Research CenterSan AntonioTXUSA
| | | | - Peter W. Nathanielsz
- University of WyomingLaramieWYUSA
- Southwest Primate Research CenterSan AntonioTXUSA
| | - Geoffrey D. Clarke
- Radiology DepartmentUniversity of Texas Health Science CenterSan AntonioTXUSA
- Southwest Primate Research CenterSan AntonioTXUSA
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Kuo AH, Li C, Mattern V, Huber HF, Comuzzie A, Cox L, Schwab M, Nathanielsz PW, Clarke GD. Sex-dimorphic acceleration of pericardial, subcutaneous, and plasma lipid increase in offspring of poorly nourished baboons. Int J Obes (Lond) 2018; 42:1092-1096. [PMID: 29463919 PMCID: PMC6019612 DOI: 10.1038/s41366-018-0008-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/27/2017] [Accepted: 12/07/2017] [Indexed: 01/09/2023]
Abstract
Developmental programming by reduced maternal nutrition alters function in multiple offspring physiological systems, including lipid metabolism. We have shown that intrauterine growth restriction (IUGR) leads to offspring cardiovascular dysfunction with an accelerated aging phenotype in our nonhuman primate, baboon model. We hypothesized age-advanced pericardial fat and blood lipid changes. In pregnancy and lactation, pregnant baboons ate ad lib (control) or 70% ad lib diet (IUGR). We studied baboon offspring pericardial lipid deposition with magnetic resonance imaging at 5-6 years (human equivalent 20-24 years), skinfold thickness, and serum lipid profile at 8-9 years (human equivalent 32-36 years), comparing values with a normative life-course baboon cohort, 4-23 years. Increased pericardial fat deposition occurred in IUGR males but not females. Female but not male total cholesterol, low-density lipoprotein, and subcutaneous fat were increased with a trend of triglycerides increase. When comparing IUGR changes to values in normal older baboons, the increase in male apical pericardial fat was equivalent to advancing age by 6 years and the increase in female low-density lipoprotein to an increase of 3 years. We conclude that reduced maternal diet accelerates offspring lipid changes in a sex-dimorphic manner. The interaction between programming and accelerated lipogenesis warrants further investigation.
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Affiliation(s)
- Anderson H Kuo
- Department of Radiology and Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Cun Li
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
- Southwest National Primate Research Center, San Antonio, TX, USA
| | - Vicki Mattern
- Southwest National Primate Research Center, San Antonio, TX, USA
| | - Hillary F Huber
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | | | - Laura Cox
- Southwest National Primate Research Center, San Antonio, TX, USA
| | - Matthias Schwab
- Hans Berger Department for Neurology, University Hospital, Jena, Germany
| | - Peter W Nathanielsz
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
- Southwest National Primate Research Center, San Antonio, TX, USA
| | - Geoffrey D Clarke
- Department of Radiology and Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Southwest National Primate Research Center, San Antonio, TX, USA
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15
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Abstract
The ability of the aorta to buffer blood flow and provide diastolic perfusion (Windkessel function) is a determinant of cardiovascular health. We have reported cardiac dysfunction indicating downstream vascular abnormalities in young adult baboons who were intrauterine growth restricted (IUGR) at birth as a result of moderate maternal nutrient reduction. Using 3 T MRI, we examined IUGR offspring (eight male, eight female; 5.7 years; human equivalent 25 years) and age-matched controls (eight male, eight female; 5.6 years) to quantify distal descending aortic cross-section (AC) and distensibility (AD). ANOVA showed decreased IUGR AC/body surface area (0.9±0.05 cm2/m2 v. 1.2±0.06 cm2/m2, M±s.e.m., P<0.005) and AD (1.7±0.2 v. 4.0±0.5×10-3/mmHg, P<0.005) without sex difference or group-sex interaction, suggesting intrinsic vascular pathology and impaired development persisting in adulthood. Future studies should evaluate potential consequences of these changes on coronary perfusion, afterload and blood pressure.
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Affiliation(s)
- A H Kuo
- 1Department of Radiology and Research Imaging Institute,University of Texas Health Science Center at San Antonio,San Antonio,TX,USA
| | - J Li
- 2Xiangya School of Medicine,Central South University,Changsha,Hunan,China
| | - C Li
- 3Department of Animal Science,University of Wyoming,Laramie,Wyoming
| | - H F Huber
- 3Department of Animal Science,University of Wyoming,Laramie,Wyoming
| | - P W Nathanielsz
- 3Department of Animal Science,University of Wyoming,Laramie,Wyoming
| | - G D Clarke
- 1Department of Radiology and Research Imaging Institute,University of Texas Health Science Center at San Antonio,San Antonio,TX,USA
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Abstract
Pulmonary blastomas are rare malignancies, representing 0.25% to 0.5% of all primary lung neoplasms with often aggressive progression and poor prognosis. Clinical management of pulmonary blastomas depends on histologic subtype, staging, and presentation, and may consist of surgery, chemotherapy, and radiation. Biphasic pulmonary blastoma is a subtype of pulmonary blastoma that exhibits biphasic histology, with both epithelial and mesenchymal malignant elements. We report a case of biphasic pulmonary blastoma in a 33-year-old female with 1 pack per day history of smoking for approximately 16 years, who presented with left-sided pleuritic chest pain on deep inspiration without otherwise significant pat medical history. Imaging evaluation using chest radiography, computed tomography, and magnetic resonance imaging identified a heterogenous, well-circumscribed, left lower lobe mass with extensive necrosis and hemorrhage. No lymphadenopathy or distant metastasis was detected through imaging evaluation. Surgical resection of the tumor followed by histopathological analysis confirmed a biphasic pulmonary blastoma.
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Affiliation(s)
- Fadi Nemeh
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Anderson H Kuo
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Jenny Ross
- Department of Pathology, University of Texas Health and Science Center, San Antonio, Texas, USA
| | - Carlos S Restrepo
- Department of Radiology, University of Texas Health and Science Center, San Antonio, Texas, USA
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Kuo AH, Li C, Huber HF, Schwab M, Nathanielsz PW, Clarke GD. Maternal nutrient restriction during pregnancy and lactation leads to impaired right ventricular function in young adult baboons. J Physiol 2017; 595:4245-4260. [PMID: 28439937 PMCID: PMC5491873 DOI: 10.1113/jp273928] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/03/2017] [Indexed: 01/25/2023] Open
Abstract
KEY POINTS Maternal nutrient restriction induces intrauterine growth restriction (IUGR) and leads to heightened cardiovascular risks later in life. We report right ventricular (RV) filling and ejection abnormalities in IUGR young adult baboons using cardiac magnetic resonance imaging. Both functional and morphological indicators of poor RV function were seen, many of which were similar to effects of ageing, but also with a few key differences. We observed more pronounced RV changes compared to our previous report of the left ventricle, suggesting there is likely to be a component of isolated RV abnormality in addition to expected haemodynamic sequelae from left ventricular dysfunction. In particular, our findings raise the suspicion of pulmonary hypertension after IUGR. This study establishes that IUGR also leads to impairment of the right ventricle in addition to the left ventricle classically studied. ABSTRACT Maternal nutrient restriction induces intrauterine growth restriction (IUGR), increasing later life chronic disease including cardiovascular dysfunction. Our left ventricular (LV) CMRI studies in IUGR baboons (8 M, 8 F, 5.7 years - human equivalent approximately 25 years), control offspring (8 M, 8 F, 5.6 years), and normal elderly (OLD) baboons (6 M, 6 F, mean 15.9 years) revealed long-term LV abnormalities in IUGR offspring. Although it is known that right ventricular (RV) function is dependent on LV health, the IUGR right ventricle remains poorly studied. We examined the right ventricle with cardiac magnetic resonance imaging in the same cohorts. We observed decreased ejection fraction (49 ± 2 vs. 33 ± 3%, P < 0.001), cardiac index (2.73 ± 0.27 vs. 1.89 ± 0.20 l min-1 m-2 , P < 0.05), early filling rate/body surface area (BSA) (109.2 ± 7.8 vs. 44.6 ± 7.3 ml s-1 m-2 , P < 0.001), wall thickening (61 ± 3 vs. 44 ± 5%, P < 0.05), and longitudinal shortening (26 ± 3 vs. 15 ± 2%, P < 0.01) in IUGR animals with increased chamber volumes. Many, but not all, of these changes share similarities to normal older animals. Our findings suggest IUGR-induced pulmonary hypertension should be further investigated and that atrial volume, pulmonic outflow and interventricular septal motion may provide valuable insights into IUGR cardiovascular physiology. Overall, our findings reaffirm that gestational and neonatal challenges can result in long-term programming of poor offspring cardiovascular health. To our knowledge, this is the first study reporting IUGR-induced programmed adult RV dysfunction in an experimental primate model.
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Affiliation(s)
- Anderson H. Kuo
- Department of Radiology and Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Cun Li
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
- Southwest National Primate Research CenterSan AntonioTXUSA
| | | | - Matthias Schwab
- Hans Berger Department for NeurologyUniversity HospitalJenaGermany
| | - Peter W. Nathanielsz
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
- Southwest National Primate Research CenterSan AntonioTXUSA
| | - Geoffrey D. Clarke
- Department of Radiology and Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Southwest National Primate Research CenterSan AntonioTXUSA
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18
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Franke K, Clarke GD, Dahnke R, Gaser C, Kuo AH, Li C, Schwab M, Nathanielsz PW. Premature Brain Aging in Baboons Resulting from Moderate Fetal Undernutrition. Front Aging Neurosci 2017; 9:92. [PMID: 28443017 PMCID: PMC5386978 DOI: 10.3389/fnagi.2017.00092] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/20/2017] [Indexed: 11/13/2022] Open
Abstract
Contrary to the known benefits from a moderate dietary reduction during adulthood on life span and health, maternal nutrient reduction during pregnancy is supposed to affect the developing brain, probably resulting in impaired brain structure and function throughout life. Decreased fetal nutrition delivery is widespread in both developing and developed countries, caused by poverty and natural disasters, but also due to maternal dieting, teenage pregnancy, pregnancy in women over 35 years of age, placental insufficiency, or multiples. Compromised development of fetal cerebral structures was already shown in our baboon model of moderate maternal nutrient reduction. The present study was designed to follow-up and evaluate the effects of moderate maternal nutrient reduction on individual brain aging in the baboon during young adulthood (4–7 years; human equivalent 14–24 years), applying a novel, non-invasive neuroimaging aging biomarker. The study reveals premature brain aging of +2.7 years (p < 0.01) in the female baboon exposed to fetal undernutrition. The effects of moderate maternal nutrient reduction on individual brain aging occurred in the absence of fetal growth restriction or marked maternal weight reduction at birth, which stresses the significance of early nutritional conditions in life-long developmental programming. This non-invasive MRI biomarker allows further longitudinal in vivo tracking of individual brain aging trajectories to assess the life-long effects of developmental and environmental influences in programming paradigms, aiding preventive and curative treatments on cerebral atrophy in experimental animal models and humans.
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Affiliation(s)
- Katja Franke
- Structural Brain Mapping Group, Department of Neurology, University Hospital JenaJena, Germany
| | - Geoffrey D Clarke
- Radiology, University of Texas Health Science Center San AntonioSan Antonio, TX, USA
| | - Robert Dahnke
- Structural Brain Mapping Group, Department of Neurology, University Hospital JenaJena, Germany
| | - Christian Gaser
- Structural Brain Mapping Group, Department of Neurology, University Hospital JenaJena, Germany.,Department of Psychiatry, University Hospital JenaJena, Germany
| | - Anderson H Kuo
- Radiology, University of Texas Health Science Center San AntonioSan Antonio, TX, USA
| | - Cun Li
- Texas Pregnancy and Life Course Health Research Center, Southwest National Primate Research Center, Texas Biomedical Research InstituteSan Antonio, TX, USA.,Animal Science, University of WyomingLaramie, WY, USA
| | - Matthias Schwab
- Department of Neurology, University Hospital JenaJena, Germany
| | - Peter W Nathanielsz
- Texas Pregnancy and Life Course Health Research Center, Southwest National Primate Research Center, Texas Biomedical Research InstituteSan Antonio, TX, USA.,Animal Science, University of WyomingLaramie, WY, USA
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19
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Kuo AH, Li J, Li C, Huber HF, Schwab M, Nathanielsz PW, Clarke GD. Prenatal steroid administration leads to adult pericardial and hepatic steatosis in male baboons. Int J Obes (Lond) 2017; 41:1299-1302. [PMID: 28337030 PMCID: PMC5548625 DOI: 10.1038/ijo.2017.82] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/18/2017] [Accepted: 03/15/2017] [Indexed: 11/18/2022]
Abstract
Developmental programming studies indicate that glucocorticoids modify
fetal development. We hypothesized that administration of the synthetic
glucocorticoid (sGC) betamethasone to pregnant baboons at doses and stages of
fetal life equivalent to human obstetric practice to decrease premature
offspring morbidity and mortality, programs lipid metabolism. In 10-year-old
male baboons (human equivalent 40) exposed in fetal life to betamethasone or
saline, we quantified pericardial fat and hepatic lipid content with magnetic
resonance imaging and spectroscopy. sGC offspring delivered at term as do most
sGC exposed human neonates. Pericardial fat thickness (7.7 ± 3.6 mm vs.
3.1 ± 1.1 mm, M ± SD; p = 0.022; n=5) and
hepatic fatty acids (13.3 ± 11.0 % vs. 2.5 ± 2.2
%; p = 0.046; n=5) increased following sGC without birth
weight or current body morphometric differences. Our results indicate that
antenatal sGC therapy caused abnormal fat deposition and adult body composition
in mid-life primate offspring. The concern raised is that this degree of
pericardial and hepatic lipid accumulation can lead to harmful local
lipotoxicity. In summary, developmental programing by sGC produces a mid-life
metabolically obese but normal weight phenotype. Prior studies show sexually
dimorphic responses to some programming challenges thus female studies are
necessary.
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Affiliation(s)
- A H Kuo
- Department of Radiology and Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - J Li
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - C Li
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA.,Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - H F Huber
- Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - M Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - P W Nathanielsz
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA.,Department of Animal Science, University of Wyoming, Laramie, WY, USA
| | - G D Clarke
- Department of Radiology and Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
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Kuo AH, Li C, Li J, Huber HF, Nathanielsz PW, Clarke GD. Cardiac remodelling in a baboon model of intrauterine growth restriction mimics accelerated ageing. J Physiol 2017; 595:1093-1110. [PMID: 27988927 PMCID: PMC5309359 DOI: 10.1113/jp272908] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/15/2016] [Indexed: 12/15/2022] Open
Abstract
KEY POINTS Rodent models of intrauterine growth restriction (IUGR) successfully identify mechanisms that can lead to short-term and long-term detrimental cardiomyopathies but differences between rodent and human cardiac physiology and placental-fetal development indicate a need for models in precocial species for translation to human development. We developed a baboon model for IUGR studies using a moderate 30% global calorie restriction of pregnant mothers and used cardiac magnetic resonance imaging to evaluate offspring heart function in early adulthood. Impaired diastolic and systolic cardiac function was observed in IUGR offspring with differences between male and female subjects, compared to their respective controls. Aspects of cardiac impairment found in the IUGR offspring were similar to those found in normal controls in a geriatric cohort. Understanding early cardiac biomarkers of IUGR using non-invasive imaging in this susceptible population, especially taking into account sexual dimorphisms, will aid recognition of the clinical presentation, development of biomarkers suitable for use in humans and management of treatment strategies. ABSTRACT Extensive rodent studies have shown that reduced perinatal nutrition programmes chronic cardiovascular disease. To enable translation to humans, we developed baboon offspring cohorts from mothers fed ad libitum (control) or 70% of the control ad libitum diet in pregnancy and lactation, which were growth restricted at birth. We hypothesized that intrauterine growth restriction (IUGR) offspring hearts would show impaired function and a premature ageing phenotype. We studied IUGR baboons (8 male, 8 female, 5.7 years), control offspring (8 male, 8 female, 5.6 years - human equivalent approximately 25 years), and normal elderly (OLD) baboons (6 male, 6 female, mean 15.9 years). Left ventricular (LV) morphology and systolic and diastolic function were evaluated with cardiac MRI and normalized to body surface area. Two-way ANOVA by group and sex (with P < 0.05) indicated ejection fraction, 3D sphericity indices, cardiac index, normalized systolic volume, normalized LV wall thickness, and average filling rate differed by group. Group and sex differences were found for normalized LV wall thickening and normalized myocardial mass, without interactions. Normalized peak LV filling rate and diastolic sphericity index were not correlated in control but strongly correlated in OLD and IUGR baboons. IUGR programming in baboons produces myocardial remodelling, reduces systolic and diastolic function, and results in the emergence of a premature ageing phenotype in the heart. To our knowledge, this is the first demonstration of the specific characteristics of cardiac programming and early life functional decline with ageing in an IUGR non-human primate model. Further studies across the life span will determine progression of cardiac dysfunction.
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Affiliation(s)
- Anderson H. Kuo
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Cun Li
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
| | - Jinqi Li
- Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | | | - Peter W. Nathanielsz
- Department of Animal ScienceUniversity of WyomingLaramieWYUSA
- Southwest National Primate CenterSan AntonioTXUSA
| | - Geoffrey D. Clarke
- Department of RadiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Research Imaging InstituteUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
- Southwest National Primate CenterSan AntonioTXUSA
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21
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Zhou Y, Rodgers ZB, Kuo AH. Cerebrovascular reactivity measured with arterial spin labeling and blood oxygen level dependent techniques. Magn Reson Imaging 2015; 33:566-76. [PMID: 25708263 DOI: 10.1016/j.mri.2015.02.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 01/17/2015] [Accepted: 02/16/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare cerebrovascular reactivity (CVR) quantified with pseudo-continuous arterial spin labeling (pCASL) and blood oxygen level dependent (BOLD) fMRI techniques. MATERIALS AND METHODS Sixteen healthy volunteers (age: 37.8±14.3years; 6 women and 10 men; education attainment: 17±2.1years) were recruited and completed a 5% CO2 gas-mixture breathing paradigm at 3T field strength. ASL and BOLD images were acquired for CVR determination assuming that mild hypercapnia does not affect the cerebral metabolic rate of oxygen. Both CVR quantifications were derived as the ratio of the fractional cerebral blood flow (CBF) or BOLD signal change over the change in end-tidal CO2 pressure. RESULTS The absolute CBF, BOLD and CVR measures were consistent with literature values. CBF derived CVR was 5.11±0.87%/mmHg in gray matter (GM) and 4.64±0.37%/mmHg in parenchyma. BOLD CVR was 0.23±0.04%/mmHg and 0.22±0.04%/mmHg for GM and parenchyma respectively. The most significant correlations between BOLD and CBF-based CVRs were also in GM structures, with greater vascular response in occipital cortex than in frontal and parietal lobes (6.8%/mmHg versus 4.5%/mmHg, 50% greater). Parenchymal BOLD CVR correlated significantly with the fractional change in CBF in response to hypercapnia (r=0.61, P=0.01), suggesting the BOLD response to be significantly flow driven. GM CBF decreased with age in room air (-5.58mL/100g/min per decade for GM; r=-0.51, P=0.05), but there was no association of CBF with age during hypercapnia. A trend toward increased pCASL CVR with age was observed, scaling as 0.64%/mmHg per decade for GM. CONCLUSION Consistent with previously reported CVR values, our results suggest that BOLD and CBF CVR techniques are complementary to each other in evaluating neuronal and vascular underpinning of hemodynamic processes.
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Affiliation(s)
- Yongxia Zhou
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104.
| | - Zachary B Rodgers
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104
| | - Anderson H Kuo
- Department of Radiology, University of Texas South Medical Center, San Antonio, TX
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Kuo AH, Stoica GE, Riegel AT, Wellstein A. Recruitment of insulin receptor substrate-1 and activation of NF-kappaB essential for midkine growth signaling through anaplastic lymphoma kinase. Oncogene 2006; 26:859-69. [PMID: 16878150 DOI: 10.1038/sj.onc.1209840] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Anaplastic lymphoma kinase (ALK) is a transmembrane receptor tyrosine kinase in the insulin receptor superfamily. We recently demonstrated that the growth factors pleiotrophin (PTN) and midkine (MK) are ligands for ALK and that upon ALK activation, insulin receptor substrate-1 (IRS-1) and other substrates are phosphorylated. Here, the role of IRS-1 in ligand-mediated ALK signaling is investigated in interleukin-3 (IL-3)-dependent 32D murine myeloid cells. These cells do not express ALK and IRS family members, and do not respond to exogenously added PTN or MK. We show that expression of ALK plus IRS-1 renders these cells independent of IL-3 owing to the activation of ALK by endogenous MK. Mutational analysis reveals that this transformed phenotype of 32D cells requires kinase-active ALK as well as the interaction of ALK with IRS-1. Furthermore, 32D/IRS-1/ALK cells display an enhanced activation of mitogen-activated protein kinase and PI3-kinase pathways, and a selective transcriptional activation of nuclear factor (NF)-kappaB. Small interfering RNA-mediated knockdown of the endogenous MK or p65/NF-kappaB revealed that both these are rate limiting for the transformed phenotype induced by ALK plus IRS-1. We conclude that the recruitment of IRS-1 to activated ALK and the activation of NF-kappaB are essential for the autocrine growth and survival signaling of MK.
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Affiliation(s)
- A H Kuo
- Department of Oncology, Lombardi Cancer Center, Georgetown University, Washington, DC 20007, USA
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Enyedy IJ, Lee SL, Kuo AH, Dickson RB, Lin CY, Wang S. Structure-based approach for the discovery of bis-benzamidines as novel inhibitors of matriptase. J Med Chem 2001; 44:1349-55. [PMID: 11311057 DOI: 10.1021/jm000395x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Matriptase, a trypsin-like serine protease, which may be involved in tissue remodeling, cancer invasion, and metastasis. Potent and selective matriptase inhibitors not only would be useful pharmacological tools for further elucidation of the role of matriptase in these processes but also could have therapeutic potential for the treatment and/or prevention of cancers. We report herein the structure-based approach for the discovery of bis-benzamidines as a novel class of potent matriptase inhibitors. The lead compound, hexamidine (1), inhibits not only the proteolytic activity of matriptase, (K(i) = 924 nM) but also of thrombin K(i) = 224 nM). By testing several available analogues, we identified a new analogue (7) that has a K(i) = 208 nM against matriptase and has only weak inhibitory activity against thrombin (K(i) = 2670 nM), thus displaying a 13-fold selectivity toward matriptase. Our results demonstrated that structure-based database screening is effective in the discovery of matriptase inhibitors and that bis-benzamidines represent a class of promising matriptase inhibitors that can be used for further drug design studies. Finally, our study suggested that there is sufficient structural differences between matriptase and its closely related serine proteases, such as thrombin, for the design of potent and selective matriptase inhibitors.
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Affiliation(s)
- I J Enyedy
- Structural Biology and Cancer Drug Discovery Program, Lombardi Cancer Center, and Department of Oncology, Georgetown University Medical Center, 3900 Reservoir Road, Washington DC 20007, USA
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Abstract
The proliferative kinetics of the leukemic cells in the cerebrospinal fluid (CSF) were studied in three adults with CNS leukemia after 18 and 8 months while receiving an intensive treatment regimen. One (J.L.) had acute myeloblastic leukemia and developed CNS disease after 5 years' treatment with arabinosylcytosine and 6-thioguanine. All were in marrow remission at the time of study. G.H. had had no therapy for CNS disease, A.K. had had intrathecal methotrexate 2 months previously, and J.L. had recently completed radiotherapy (1900 R) to the head. An Ommaya reservoir was placed in a lateral ventricle and 3H-thymidine was injected into the resrvoir every 12 hours for 10 days; samples of cells were obtained by lumbar puncture periodically for autoradiography. In all patients the flash 3H-thymidine labeling index (LI) of the leukemic cells was less than 2% (determined in vitro) and the mitotic index less than 0.1%. After 10 days of 3H-thymidine injections in vivo, the LIs of the leukemic cells were 55%, 36%, and 21% in G.H., A.K., and J.L., respectively. These findings indicate that leukemic cells may proliferate very slowly in the CNS, and stress the difficulty of eradicating CNS leukemia with chemotherapeutic agents which are only active against proliferating cells.
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