Multiple Pharmacological Properties of a Novel Parthenin Analog P16 as Evident by its Cytostatic and Antiangiogenic Potential Against Pancreatic Adenocarcinoma PANC -1 Cells

Pancreatic ductal adenocarcinoma (PDA) remains one of the deadliest types of cancers. Median survival rate is very poor with the currently available chemotherapeutical regimens. Therefore, discovery of new antineoplastic agents against PDA is one of the focused areas of contemporary research. The present study was undertaken to explore the antitumour activity of a potent parthenin analog P16. Among PANC-1, Mia PaCa-2 and AsPC-1 pancreatic cancer cells, PANC-1 showed highest sensitivity to P16 with an IC50 value of 3.4 μM. Time dependent cell cycle studies revealed that P16 suppressed the growth of PANC-1 cells by arresting the progression through the cell cycle in G2/M phase via downregulation of cyclin B1 and cyclin A. However, P16 did not alter the expressions of CDK-1 and CDC25C in PANC-1 cells. The P16 induced cell cycle arrest, which consequently, led to induction of apoptosis, which was accompanied by activation of caspase-9 and -3. Interestingly, PANC-1 cells displayed increasing loss of mitochondrial potential, which seemed to be correlated to the activation of caspase-3. Additionally, P16 was also able to down-regulate the cell migration in PANC-1 cells. Furthermore, P16 treatment of hypoxic PANC-1 cells strongly suppressed the expression of proangiogenic factors VEGFR-2, HIF1α and HIF1β. Antiangiogenic ability of P16 was also reflected in the human umbilical vascular endothelial cells (HUVECs), where it effectively suppressed the migration and inhibited the formation of the tube in a matrigel based assay. Therefore, cytostatic and antiangiogenic properties of P16 against pancreatic adenocarcinoma cells make it a suitable candidate for further investigation.

Mutational analysis of the MTHFR gene in breast cancer patients of Pakistani population

OBJECTIVES

Since methylenetetrahydrofolate reductase (MTHFR) maintains the balance of circulating folate and methionine and blocks the formation of homocysteine, its regulation in relation to different cancers has extensively been studied in different populations. However, information on Pakistani breast cancer patients is lacking. The MTHFR gene has two most common mutations that are single nucleotide additions which result in change of amino acids C677T to Ala222val and A1298C to Glu429Ala.

METHODOLOGY

110 sporadic breast patients with no prior family history of cancer or any other type of genetic disorders along with 110 normal individuals were screened for mutations in exons 1 to exon 9 using single strand conformational polymorphism, RFLP and sequencing analyzer.

RESULTS

The p values for the 677CC, 677CT, and 677TT genotypes were 0.223, 0.006, and 0.077, respectively. Those for the 1298AA, 1298AC, and 1298CC genotypes were 0.555, 0.009, and 0.003, respectively.

CONCLUSIONS

We found an overall a significant, weak inverse association between breast cancer risk and the 677TT genotype and an inverse association with the 1298C variant. These results for MTHFR polymorphism might be population specific in sporadic breast cancer affected patients but many other factors need to be excluded before making final conclusions including folate intake, population and disease heterogeneity.

Expressional alterations and transcript isoforms of metastasis suppressor genes (KAI1 and KiSS1) in breast cancer patients

BACKGROUND

Metastasis suppressor genes are involved in the inhibition of a cancer cell's ability to metastasize. Down expression of such genes may contribute to pathogenesis of breast cancer. The aim of current study was firstly to evaluate expression of two examples, KAI1 and KISS1, and then to determine relationships with stages of breast cancer in a Pakistani population.

METHODOLOGY

Fresh biopsy tissues were collected from different hospitals and oncology research institutes. The semi quantitative reverse transcriptase polymerase chain reaction was used to investigate KAI1 and KISS1 expression in 25 breast tumor tissues and 25 normal tissues. Statistical analysis was performed to explore its association with breast cancer risk.

RESULTS

The present study revealed that KAI1 and KISS1 mRNA expression was markedly reduced in tissues of breast cancer compared to adjacent normal tissue. In present study a splice variant of KAI1 during a screen for its expression analysis was also observed. This splice variant has not been reported previously.

CONCLUSIONS

Metastasis suppressor genes demonstrate reduced expression in breast cancers in Pakistan.

Lack of influence of glutathione S-transferase gene deletions in sporadic breast cancer in Pakistan

Glutathione S-transferases constitute the phase II detoxification enzymes involved in the metabolism and detoxification of a wide range of potential environmental carcinogens. GSTM1 and GSTT1 are polymorphic and their deletions have been found to be associated with breast cancer risk in some of the world populations. The current study was aimed at evaluation of GSTM1 and GSTT1 gene deletions in 150 unrelated breast cancer patients and 150 healthy controls from Pakistani population. Multiplex PCR assay along with CYP1A1 exon 7 as an internal control was used. Our sampled patients and controls had a mean age of 48 (+11.8) and 45 (+7.9) years respectively. The analysis suggested that only 2% breast cancer patient and 8% controls had homozygous GSTM1 gene deletions (OR 0.23, 95% CI 0.06-0.85). A total of 8.7% patients and 18.6% controls had homozygous GSTT1 deletion (OR 0.41, 95% CI 0.25-0.83). The statistical analysis suggest that a non significant number (P>0.05) of individuals compared to controls have GSTM1 and GSTT1 gene deletions. Deletion in both genes was not observed in any of the patients or controls. The present case control study suggests no association of GSTM1 and GSTT1 gene deletions with sporadic form of breast cancer in Pakistani population.

Association of GSTM1 and GSTT1 gene deletions with risk of head and neck cancer in Pakistan: a case control study

Polymorphic deletions of GSTM1 and GSTT1 genes involved in the detoxification of potentially carcinogenic agents may be risk factors for various cancers, including head and neck cancer (HNC). In the present case-control study we aimed to access possible associations of HNC with GSTM1 and GSTT1 null genotypes in a Pakistani population. DNA was extracted from leukocytes of 388 cancer patients and 150 healthy controls by phenol-chloroform procedure. GSTM1 and GSTT1 deletion variants were genotyped by multiplex PCR assay with CYP1A1 as an internal control and further analyzed by primer specific PCR assay and sequencing. Mean age of cases and controls was 48 (±16.6) years with a male to female ratio of 1:1. Cancer of the oral cavity (57%) was most prevalent in the sampled population followed by pharynx and larynx (30% and 13% respectively). A statistically significant (P<0.05) association was observed for both null genotypes in contribution to HNC as compared with the controls. The odds ratio (OR) for the GSTM1 null genotype was 2.3 with a 95% CI of 1.5-5.5 and for GSTT1 OR was 2.04 with 95% CI of 1.3-3.1. These results suggest that the GSTM1 and GSTT1 null genotypes are risk factors for HNC development among the Pakistani population.

Expression of sonic hedgehog and correlation with aggressiveness in breast cancer

Abstract #2055

Introduction&#x2028; The Hedgehog pathway is an important regulatory pathway in the embryo development, particular in the development of mammary gland. It has been indicated to be a potential target in the therapies in cancers. Activation of the pathway has been shown to result in disease progression in certain solid tumours by possibly affecting the fate of cancer cells. The present study investigated the impact of modification of the expression of one of the Hedgehog pathway molecule, Sonic Hedgehog (SHH) on the cellular function in breast cancer and explored the expression pattern of SHH protein in human mammary tissues.&#x2028; Materials and methods.&#x2028; The study employed two human breast cancer cell lines, MCF-7 and MDA MB-231, both being positive in SHH expression. Three transgenes specifically targeting human Sonic Hedgehog (SHH) were constructed using an expression vector, each of the transgenes targeting different location of the SHH transcript. Stable tranfection strains were verified and established and designated as MCF7ΔSHH1/2/3 and MDA231ΔSHH1/2/3, respectively. Cellular functions in the wild type, control and SHH modified cells were analysed. Cell migration assay was based on a wounding assay using time lapse video recording. Matrix adhesion was assessed using a Matrigel coated culture surface. Invasiveness of the cells was determined using a transwell in vitro invasion assay. Cell growth assay was based on a colorimetric method. The presence and localisation of SHH protein in human mammary tissues were investigated using immunohistochemical method (n=32 pairs of normal and tumour tissues).&#x2028; Results.&#x2028; SHH transcripts were successfully knocked down by all three transgenes in both cell lines, as revealed by RT-PCR and quantitative RT-PCR analyses. Loss of SHH transcript in the cells lead to a significant reduction of migration using a wounding assay (migration distance over a 45 minute perid being 19.6±7.1µm for control cells and 1.6±7.6µm in MCF7ΔSHH cells, p=0.0035). Similarly, cells with reduced SHH expression displayed a significant reduction in their adherence to matrix protein (number of adherent cells for control MDA231 being 140.9±14.1 vs 80.8±13.0 for MDA231ΔSHH, p&lt;0.001, MCF7 being 80.2±11.7 and for MCF7ΔSHH 41.2±12.6, p&lt;0.001). The reduction of SHH was seen to be associated with significantly decreased invasiveness in both cells (p&lt;0.01 when comparing control and transfected stains for both cells). In mammary tissues, SHH protein was seen to be faintly stained in the cytoplasmic region of normal epithelial cells. Little staining was seen in stromal cells. In tumour tissues, however, breast cancer cells showed a marked increase in the staining. Nucleus staining was occasionally observed.&#x2028; In conclusion, SHH in breast cancer cells is correlated with the aggressiveness of the cells. Together with the increase expression of SHH protein in breast tumour tissues, SHH may present a therapeutic target in breast cancer.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2055.

Strengthening primary health care and family planning services in Pakistan: some critical issues

OBJECTIVE

The Lady Health Workers (LHWs) under the Ministry of Health and the Village-based Family Planning Workers (VBFPWs) under the Ministry of Population Welfare are mandated to bring services to the people and are often the only health care resource available particularly for women. This study was conducted to understand the problems faced by the LHWs and VBFPWs in their routine work.

STUDY DESIGN

A situational analysis followed by focus group discussions conducted with a cross-section of LHWs and VBFPWs in four districts, one from each province.

RESULTS

Findings reveal that LHWs and VBFPWs are faced with a number of problems that severely limit their effectiveness. Findings suggest that the population/health worker ratios vary considerably from one district to another. Moreover, these two categories of workers differ considerably in terms of level of education, training and skills. There is lack of well-designed client record cards, proper training and backup support, including emergency obstetric care, to cover the range of essential services demanded by the consumers and a lack of information feedback.

CONCLUSION

These issues need to be recognized and addressed to further strengthen primary health care and family planning services in the country. The paper presents some of the important findings of the survey and focus group discussions conducted by the Community Health Sciences Department of the Aga Khan University as part of a broader study funded by the United Nations Population Fund. These findings have serious implications for future primary health care and family planning policies in Pakistan.

Role of traditional birth attendants in improving reproductive health: lessons from the family health project, Sindh

OBJECTIVE

PURPOSE OF THE STUDY

Despite strenuous efforts, the maternal mortality rate in Pakistan remains high. The national figure of 340 maternal deaths per 100,000 live births tends to hide the fact that in some rural areas it is as high as 700 per 100,000 live births. Not surprisingly, in Pakistan only 20% of births are attended by a trained health professional. In most rural areas, home to almost 70% of the population, traditional birth attendants (TBAs) deliver 90% of the births. TBAs, therefore, play a crucial role in the delivery of maternal health care in Pakistan. Realizing the importance of TBAs, the Family Health Project (FHP) of the Department of Health Sindh, financed by the World Bank, tried to enhance their knowledge and skills through comprehensive training programs. FHP provided training to 650 TBAs in 10 districts. The training was provided by the Department of Community Health Sciences (CHS) of the Aga Khan University (AKU) who acted as technical consultant to the project.

STUDY DESIGN

A community-based qualitative post-intervention survey.

RESULTS

Post-intervention survey of this seven-year project (1992-1999) revealed that (a) the training enhanced the knowledge and skills of the TBAs, (b) the trained TBAs provide more broader health care services and (c) they enjoy greater community acceptance and provide greater consumer satisfaction. It also showed that the TBAs remain the most available and accessible health resource in most rural settings.

CONCLUSION

It is imperative that TBAs and their continuing training should remain central to any reproductive health intervention along with an effective referral system linking them to well-equipped emergency obstetric care facilities. However, the assessment clearly demonstrated that an integrated referral system backed by effective emergency obstetric care is essential to the success of the TBA training program.

Ki-1 large cell anaplastic lymphoma--a clinicopathological study

Ki-1 large cell anaplastic lymphoma is a recently described variant of malignant lymphoma. A retrospective study of 10 cases of Ki-1 lymphoma was carried out at the Armed Forces Institute of Pathology (AFIP) Rawalpindi to document its clinical and morphological features. The morphological features were evaluated by a study of paraffin embedded sections stained with haematoxylin and eosin stains. Immunohistochemical stains for BER-H2 and leucocyte common antigen (LCA) were performed in all cases. The age of the patients ranged from 2 to 60 years and male to female ratio was 2.3:1. Cervical lymphadenopathy was the most common presentation. Histologically, there was a complete effacement of the lymph node architecture in 8 cases. The Reed-Sternberg like cells were seen in 2 and histiocyte like cells in 7 cases. Immunohistochemically all cases were positive for BER-H2. It is suggested that the possibility of Ki-1 lymphoma should be considered in all cases of lymphoma with pleomorphic morphology.