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Maltseva A, Kalinchuk A, Chernorubashkina N, Sisakyan V, Lots I, Gofman A, Anzhiganova Y, Martynova E, Zukov R, Aleksandrova E, Kolomiets L, Tashireva L. Predicting Response to Immunotargeted Therapy in Endometrial Cancer via Tumor Immune Microenvironment: A Multicenter, Observational Study. Int J Mol Sci 2024; 25:3933. [PMID: 38612743 PMCID: PMC11011874 DOI: 10.3390/ijms25073933] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024] Open
Abstract
Only one-third of patients with advanced MSS/pMMR endometrial cancer exhibit a lasting response to the combination treatment of Pembrolizumab and Lenvatinib. The combined administration of these two drugs is based on Lenvatinib's ability to modulate the tumor microenvironment, enabling Pembrolizumab to exert its effect. These findings underscore the importance of exploring tumor microenvironment parameters to identify markers that can accurately select candidates for this type of therapy. An open non-randomized observational association study was conducted at six clinical centers, involving a total of 28 patients with advanced MSS/pMMR endometrial cancer who received Pembrolizumab and Lenvatinib therapy. Using TSA-associated multiplex immunofluorescence, we analyzed the proportion of CD8+ T lymphocytes, CD20+ B lymphocytes, FoxP3+ T regulatory lymphocytes, and CD163+ macrophages in tumor samples prior to immunotargeted therapy. The percentage of CD20+ B lymphocytes and the CD8-to-CD20 lymphocytes ratio was significantly higher in patients who responded to treatment compared to non-responders (responders vs. non-responders: 0.24 (0.1-1.24)% vs. 0.08 (0.00-0.15)%, p = 0.0114; 1.44 (0.58-2.70) arb. unit vs. 19.00 (3.80-34.78) arb. unit, p = 0.0031). The sensitivity and specificity of these biomarkers were 85.71% and 70.59%, and 85.71% and 85.71%, respectively. The proportion of CD20+ B lymphocytes and the CD8-to-CD20 lymphocytes ratio in the stroma of endometrial cancer serves as both a prognostic marker of response to immunotargeted therapy and a prognostic factor for progression-free survival in patients.
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Affiliation(s)
- Anastasia Maltseva
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634050, Russia; (A.M.); (A.K.); (L.K.)
| | - Anna Kalinchuk
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634050, Russia; (A.M.); (A.K.); (L.K.)
| | | | - Virab Sisakyan
- Novosibirsk Regional Clinical Oncology Center, 2 Plakhotnogo St., Novosibirsk 630108, Russia; (V.S.); (I.L.)
| | - Igor Lots
- Novosibirsk Regional Clinical Oncology Center, 2 Plakhotnogo St., Novosibirsk 630108, Russia; (V.S.); (I.L.)
| | - Alina Gofman
- Altai Regional Oncological Dispensary, 110 Zmeinogorsky tr., Barnaul 656000, Russia;
| | - Yulia Anzhiganova
- Krasnoyarsk Regional Clinical Oncological Dispensary Named after A. I. Kryzhanovsky, 16 1-ya Smolenskaya St., Krasnoyarsk 660133, Russia; (Y.A.); (R.Z.)
| | - Elizaveta Martynova
- Krasnoyarsk Regional Clinical Oncological Dispensary Named after A. I. Kryzhanovsky, 16 1-ya Smolenskaya St., Krasnoyarsk 660133, Russia; (Y.A.); (R.Z.)
| | - Ruslan Zukov
- Krasnoyarsk Regional Clinical Oncological Dispensary Named after A. I. Kryzhanovsky, 16 1-ya Smolenskaya St., Krasnoyarsk 660133, Russia; (Y.A.); (R.Z.)
| | - Elena Aleksandrova
- Yakut Republican Oncology Center, Build. 1, 81 Stadukhina St., Yakutsk 677005, Russia
| | - Larisa Kolomiets
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634050, Russia; (A.M.); (A.K.); (L.K.)
| | - Liubov Tashireva
- Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634050, Russia; (A.M.); (A.K.); (L.K.)
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Yang C, Kalinchuk A, Jacobson KA, Winston S, McKenna JT, McCarley RW, Strecker RE, Basheer R, Brown RE. 0099 INFUSION OF A PURINERGIC P2 RECEPTOR AGONIST INTO THE BASAL FOREBRAIN BY REVERSE MICRODIALYSIS ATTENUATES HOMEOSTATIC SLEEP REBOUND. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gvilia I, Suntsova N, Kostin A, Kalinchuk A, McGinty D, Basheer R, Szymusiak R. The role of adenosine in the maturation of sleep homeostasis in rats. J Neurophysiol 2016; 117:327-335. [PMID: 27784808 DOI: 10.1152/jn.00675.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 08/23/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Sleep homeostasis in rats undergoes significant maturational changes during postweaning development, but the underlying mechanisms of this process are unknown. In the present study we tested the hypothesis that the maturation of sleep is related to the functional emergence of adenosine (AD) signaling in the brain. We assessed postweaning changes in 1) wake-related elevation of extracellular AD in the basal forebrain (BF) and adjacent lateral preoptic area (LPO), and 2) the responsiveness of median preoptic nucleus (MnPO) sleep-active cells to increasing homeostatic sleep drive. We tested the ability of exogenous AD to augment homeostatic responses to sleep deprivation (SD) in newly weaned rats. In groups of postnatal day (P)22 and P30 rats, we collected dialysate from the BF/LPO during baseline (BSL) wake-sleep, SD, and recovery sleep (RS). HPLC analysis of microdialysis samples revealed that SD in P30 rats results in significant increases in AD levels compared with BSL. P22 rats do not exhibit changes in AD levels in response to SD. We recorded neuronal activity in the MnPO during BSL, SD, and RS at P22/P30. MnPO neurons exhibited adult-like increases in waking neuronal discharge across SD on both P22 and P30, but discharge rates during enforced wake were higher on P30 vs. P22. Central administration of AD (1 nmol) during SD on P22 resulted in increased sleep time and EEG slow-wave activity during RS compared with saline control. Collectively, these findings support the hypothesis that functional reorganization of an adenosinergic mechanism of sleep regulation contributes to the maturation of sleep homeostasis. NEW & NOTEWORTHY Brain mechanisms that regulate the maturation of sleep are understudied. The present study generated first evidence about a potential mechanistic role for adenosine in the maturation of sleep homeostasis. Specifically, we demonstrate that early postweaning development in rats, when homeostatic response to sleep loss become adult like, is characterized by maturational changes in wake-related production/release of adenosine in the brain. Pharmacologically increased adenosine signaling in developing brain facilitates homeostatic responses to sleep deprivation.
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Affiliation(s)
- Irma Gvilia
- Research Service (151A3), Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California; .,Department of Medicine, University of California, Los Angeles, California.,Ilia State University, Tbilisi, Georgia; and
| | - Natalia Suntsova
- Research Service (151A3), Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California.,Department of Medicine, University of California, Los Angeles, California
| | - Andrey Kostin
- Research Service (151A3), Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California
| | - Anna Kalinchuk
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Dennis McGinty
- Research Service (151A3), Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California.,Department of Psychology, University of California, Los Angeles, California
| | - Radhika Basheer
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Ronald Szymusiak
- Research Service (151A3), Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California.,Department of Medicine, University of California, Los Angeles, California
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Porkka-Heiskanen T, Kalinchuk A, Alanko L, Huhtaniemi I, Stenberg D. Orexin A and B levels in the hypothalamus of female rats: the effects of the estrous cycle and age. Eur J Endocrinol 2004; 150:737-42. [PMID: 15132733 DOI: 10.1530/eje.0.1500737] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Orexins have been implicated in the regulation of several physiological functions including reproduction, energy balance and vigilance state. For successful reproduction, the precisely timed hormonal secretions of the estrous cycle must be combined with appropriate nutritional and vigilance states. The steroid- and nutritional state-dependent modulation of LH release by orexins, as well as an increase of vigilance, suggest that orexins may co-ordinate these functions in the course of the estrous cycle. DESIGN We studied the brain tissue levels of orexins in the course of the estrous cycle in young and middle-aged rats. Young cycling rats (3 months old) and irregularly/non-cycling (7-9 months old) female rats were inspected for vaginal smears and serum hormone levels. METHODS Tissue concentrations of orexin A and B were measured in the hypothalamus and lateral hypothalamus on different days of the estrous cycle. RESULTS Orexin A concentration in the hypothalamus of young cycling rats was higher on the day of proestrus 5-6 h after the lights were switched on than on the other days of the estrous cycle at the same circadian time. Orexin B concentration was higher on both the day of proestrus and the day of estrus as compared with the days of diestrus. The hypothalamic concentrations of both orexin A and B in the non-cycling middle-aged rats were lower than those in cycling rats on the days of proestrus and estrus. CONCLUSIONS We have concluded that the high hypothalamic concentration of orexins on the day of proestrus may contribute to the LH and prolactin surges. High orexin A levels may also contribute to the decreased amount of sleep on the day of proestrus.
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Affiliation(s)
- T Porkka-Heiskanen
- Institute of Biomedicine, Department of Physiology, Biomedicum Helsinki, PO Box 63, 00014 University of Helsinki, Helsinki, Finland.
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Porkka-Heiskanen T, Alanko L, Kalinchuk A, Heiskanen S, Stenberg D. The effect of age on prepro-orexin gene expression and contents of orexin A and B in the rat brain. Neurobiol Aging 2004; 25:231-8. [PMID: 14749141 DOI: 10.1016/s0197-4580(03)00043-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Orexin A and B (hypocretin 1 and 2) are hypothalamic peptides, which are synthesized in the lateral hypothalamus. Orexins participate in the regulation energy balance, food intake, vigilance and several endocrine and autonomic functions. The widespread projections of the orexin neurons suggest that they may have a role in coordination of different brain activities. The effects of ageing on the orexin system have not been studied previously. Prepro-orexin gene expression in the lateral hypothalamus, and the contents of orexin A and B peptides in the lateral hypothalamus and hypothalamus were measured in young, middle-aged and old (3, 12 and 24 months) rats. In the course of ageing, the expression of the prepro-orexin gene and the levels of orexin A and B decreased; the main decrease occurred by 12 months. Sleep deprivation for 6h increased slightly the expression of prepro-orexin gene in young rats. Deterioration of the orexin system may play a role in the phenomenon associated with aging, e.g. decreased consolidation of vigilance states, endocrine changes and dysfunctions of autonomic nervous system.
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Affiliation(s)
- Tarja Porkka-Heiskanen
- Institute of Biomedicine, University of Helsinki, P.O. Box 63, 000014 Helsinki, Finland.
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Abstract
While the exact function of sleep remains unknown, it is evident that sleep was developed early in phylogenesis and represents an ancient and vital strategy for survival. Several pieces of evidence suggest that the function of sleep is associated with energy metabolism, saving of energy, and replenishment of energy stores. Prolonged wakefulness induces signs of energy depletion in the brain, while experimentally induced, local energy depletion induces increase in sleep, similarly as would a period of prolonged wakefulness. The key molecule in the induction of sleep appears to be adenosine, which induces sleep locally in the basal forebrain.
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Abstract
Adenosine is directly linked to the energy metabolism of cells. In the central nervous system an increase in neuronal activity enhances energy consumption as well as extracellular adenosine concentrations. In most brain areas high extracellular adenosine concentrations, through A(1) adenosine receptors, decrease neuronal activity and thus the need for energy. Adenosine seems to act as a direct negative feed-back inhibitor of neuronal activity. Hypoxia and ischemia induce very high extracellular adenosine levels, which may limit further brain damage. In brain areas that regulate cortical vigilance, particularly in the basal forebrain, high extracellular adenosine concentrations, induced by prolonged wakefulness, decrease the activity of presumably cholinergic cells and via this mechanism promote sleep. Our hypothesis is that in the cholinergic basal forebrain prolonged wakefulness induces local energy depletion that generates increases in extracellular adenosine concentrations in this area. In addition to the immediate effects, high extracellular adenosine concentrations also induce intracellular changes in signal transduction and transcription, e.g. increase in A(1) receptor expression and NF-kappaB binding activity. These changes may at least partially mediate the long term effects of prolonged wakefulness. Adenosine may also be a common mediator of the effects of several other sleep-inducing factors.
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