Loss of Cadherin-11 in pancreatic ductal adenocarcinoma alters tumor-immune microenvironment

Pancreatic ductal adenocarcinoma (PDAC) is one of the top five deadliest forms of cancer with very few treatment options. The 5-year survival rate for PDAC is 10% following diagnosis. Cadherin 11 (Cdh11), a cell-to-cell adhesion molecule, has been suggested to promote tumor growth and immunosuppression in PDAC, and Cdh11 inhibition significantly extended survival in mice with PDAC. However, the mechanisms by which Cdh11 deficiency influences PDAC progression and anti-tumor immune responses have yet to be fully elucidated. To investigate Cdh11-deficiency induced changes in PDAC tumor microenvironment (TME), we crossed p48-Cre; LSL-KrasG12D/+; LSL-Trp53R172H/+ (KPC) mice with Cdh11+/- mice and performed single-cell RNA sequencing (scRNA-seq) of the non-immune (CD45-) and immune (CD45+) compartment of KPC tumor-bearing Cdh11 proficient (KPC-Cdh11+/+) and Cdh11 deficient (KPC-Cdh11+/-) mice. Our analysis showed that Cdh11 is expressed primarily in cancer-associated fibroblasts (CAFs) and at low levels in epithelial cells undergoing epithelial-to-mesenchymal transition (EMT). Cdh11 deficiency altered the molecular profile of CAFs, leading to a decrease in the expression of myofibroblast markers such as Acta2 and Tagln and cytokines such as Il6, Il33 and Midkine (Mdk). We also observed a significant decrease in the presence of monocytes/macrophages and neutrophils in KPC-Cdh11+/- tumors while the proportion of T cells was increased. Additionally, myeloid lineage cells from Cdh11-deficient tumors had reduced expression of immunosuppressive cytokines that have previously been shown to play a role in immune suppression. In summary, our data suggests that Cdh11 deficiency significantly alters the fibroblast and immune microenvironments and contributes to the reduction of immunosuppressive cytokines, leading to an increase in anti-tumor immunity and enhanced survival.

Incidence of sex chromosome aneuploidy in a prenatal population: 27-year longitudinal study in Northern Italy

OBJECTIVES

The availability of cell-free (cf) DNA as a prenatal screening tool affords an opportunity for non-invasive identification of sex chromosome aneuploidy (SCA). The aims of this longitudinal study were to investigate the evolution and frequency of both invasive prenatal diagnostic testing, using amniocentesis and chorionic villus sampling (CVS), and the detection of SCA in cfDNA samples from a large unselected cohort in Northern Italy.

METHODS

The results of genetic testing from CVS and amniotic fluid samples received from public and private centers in Italy from 1995 to 2021 were collected. Chromosomal analysis was performed by routine Q-banding karyotype. Regression analyses and descriptive statistics were used to determine population data trends regarding the frequency of prenatal diagnostic testing and the identification of SCA, and these were compared with the changes in indication for prenatal diagnostic tests and available screening options.

RESULTS

Over a period of 27 years, there were 13 939 526 recorded births and 231 227 invasive procedures were performed, resulting in the prenatal diagnosis of 933 SCAs. After the commercial introduction of cfDNA use in 2015, the frequency of invasive procedures decreased significantly (P = 0.03), while the frequency of prenatal SCA detection increased significantly (P = 0.007). Between 2016 and 2021, a high-risk cfDNA result was the indication for 31.4% of detected sex chromosome trisomies, second only to advanced maternal age.

CONCLUSIONS

Our findings suggest that the inclusion of SCA in prenatal cfDNA screening tests can increase the prenatal diagnosis of affected individuals. As the benefits of early ascertainment are increasingly recognized, it is essential that healthcare providers are equipped with comprehensive and evidence-based information regarding the associated phenotypic differences and the availability of targeted effective interventions to improve neurodevelopmental and health outcomes for affected individuals. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Immediate effects of acute Mars mission equivalent doses of SEP and GCR radiation on the murine gastrointestinal system-protective effects of curcumin-loaded nanolipoprotein particles (cNLPs)

Introduction

Missions beyond low Earth orbit (LEO) will expose astronauts to ionizing radiation (IR) in the form of solar energetic particles (SEP) and galactic cosmic rays (GCR) including high atomic number and energy (HZE) nuclei. The gastrointestinal (GI) system is documented to be highly radiosensitive with even relatively low dose IR exposures capable of inducing mucosal lesions and disrupting epithelial barrier function. IR is also an established risk factor for colorectal cancer (CRC) with several studies examining long-term GI effects of SEP/GCR exposure using tumor-prone APC mouse models. Studies of acute short-term effects of modeled space radiation exposures in wildtype mouse models are more limited and necessary to better define charged particle-induced GI pathologies and test novel medical countermeasures (MCMs) to promote astronaut safety.

Methods

In this study, we performed ground-based studies where male and female C57BL/6J mice were exposed to γ-rays, 50 MeV protons, or 1 GeV/n Fe-56 ions at the NASA Space Radiation Laboratory (NSRL) with histology and immunohistochemistry endpoints measured in the first 24 h post-irradiation to define immediate SEP/GCR-induced GI alterations.

Results

Our data show that unlike matched γ-ray controls, acute exposures to protons and iron ions disrupts intestinal function and induces mucosal lesions, vascular congestion, epithelial barrier breakdown, and marked enlargement of mucosa-associated lymphoid tissue. We also measured kinetics of DNA double-strand break (DSB) repair using gamma-H2AX- specific antibodies and apoptosis via TUNEL labeling, noting the induction and disappearance of extranuclear cytoplasmic DNA marked by gamma-H2AX only in the charged particle-irradiated samples. We show that 18 h pre-treatment with curcumin-loaded nanolipoprotein particles (cNLPs) delivered via IV injection reduces DSB-associated foci levels and apoptosis and restore crypt villi lengths.

Discussion

These data improve our understanding of physiological alterations in the GI tract immediately following exposures to modeled space radiations and demonstrates effectiveness of a promising space radiation MCM.

Genetic characterization of the zoonotic parasite Ancylostoma caninum in the central and eastern United States

Ancylostoma caninum is the most common nematode parasite of dogs in the United States. The present study aimed to describe the molecular epidemiology of A. caninum isolates from the central and eastern states of the United States using the partial mitochondrial cytochrome oxidase (cox1) gene and to compare them with those reported globally. We isolated eggs from faecal samples of dogs and characterized each isolate based on cox1 sequences. A total of 60 samples originating from Kansas, Iowa, New York, Florida and Massachusetts were included. 25 haplotypes were identified in the United States dataset with high haplotype diversity (0.904). Sequence data were compared to sequences from other world regions available in GenBank. Global haplotype analysis demonstrated 35 haplotypes with a haplotype diversity of 0.931. Phylogenetic and network analysis provide evidence for the existence of moderate geographical structuring of A. caninum haplotypes. Our results provide an updated summary of A. caninum haplotypes and data for neutral genetic markers with utility for tracking hookworm populations. Sequences have been deposited in GenBank (ON980650-ON980674). Further studies of isolates from other regions are essential to understand the genetic diversity of this parasite.

Curcumin Nanodiscs Improve Solubility and Serve as Radiological Protectants against Ionizing Radiation Exposures in a Cell-Cycle Dependent Manner

Curcumin, a natural polyphenol derived from the spice turmeric (Curcuma longa), contains antioxidant, anti-inflammatory, and anti-cancer properties. However, curcumin bioavailability is inherently low due to poor water solubility and rapid metabolism. Here, we further refined for use curcumin incorporated into "biomimetic" nanolipoprotein particles (cNLPs) consisting of a phospholipid bilayer surrounded by apolipoprotein A1 and amphipathic polymer scaffolding moieties. Our cNLP formulation improves the water solubility of curcumin over 30-fold and produces nanoparticles with ~350 µg/mL total loading capacity for downstream in vitro and in vivo applications. We found that cNLPs were well tolerated in AG05965/MRC-5 human primary lung fibroblasts compared to cultures treated with curcumin solubilized in DMSO (curDMSO). Pre-treatment with cNLPs of quiescent G0/G1-phase MRC-5 cultures improved cell survival following ¹³⁷Cs gamma ray irradiations, although this finding was reversed in asynchronously cycling log-phase cell cultures. These findings may be useful for establishing cNLPs as a method to improve curcumin bioavailability for administration as a radioprotective and/or radiomitigative agent against ionizing radiation (IR) exposures in non-cycling cells or as a radiosensitizing agent for actively dividing cell populations, such as tumors.

Single-cell RNA-Seq reveals changes in immune landscape in post-traumatic osteoarthritis

Osteoarthritis (OA) is the most common joint disease, affecting over 300 million people world-wide. Accumulating evidence attests to the important roles of the immune system in OA pathogenesis. Understanding the role of various immune cells in joint degeneration or joint repair after injury is vital for improving therapeutic strategies for treating OA. Post-traumatic osteoarthritis (PTOA) develops in ~50% of individuals who have experienced an articular trauma like an anterior cruciate ligament (ACL) rupture. Here, using the high resolution of single-cell RNA sequencing, we delineated the temporal dynamics of immune cell accumulation in the mouse knee joint after ACL rupture. Our study identified multiple immune cell types in the joint including neutrophils, monocytes, macrophages, B cells, T cells, NK cells and dendritic cells. Monocytes and macrophage populations showed the most dramatic changes after injury. Further characterization of monocytes and macrophages reveled 9 major subtypes with unique transcriptomics signatures, including a tissue resident Lyve1hiFolr2hi macrophage population and Trem2hiFcrls+ recruited macrophages, both showing enrichment for phagocytic genes and growth factors such as Igf1, Pdgfa and Pdgfc. We also identified several genes induced or repressed after ACL injury in a cell type-specific manner. This study provides new insight into PTOA-associated changes in the immune microenvironment and highlights macrophage subtypes that may play a role in joint repair after injury.

IL-17A Increases Doxorubicin Efficacy in Triple Negative Breast Cancer

Due to lack of targetable receptors and intertumoral heterogeneity, triple negative breast cancer (TNBC) remains particularly difficult to treat. Doxorubicin (DOX) is typically used as nonselective neoadjuvant chemotherapy, but the diversity of treatment efficacy remains unclear. Comparable to variability in clinical response, an experimental model of TNBC using a 4T1 syngeneic mouse model was found to elicit a differential response to a seven-day treatment regimen of DOX. Single-cell RNA sequencing identified an increase in T cells in tumors that responded to DOX treatment compared to tumors that continued to grow uninhibited. Additionally, compared to resistant tumors, DOX sensitive tumors contained significantly more CD4 T helper cells (339%), γδ T cells (727%), Naïve T cells (278%), and activated CD8 T cells (130%). Furthermore, transcriptional profiles of tumor infiltrated T cells in DOX responsive tumors revealed decreased exhaustion, increased chemokine/cytokine expression, and increased activation and cytotoxic activity. γδ T cell derived IL-17A was identified to be highly abundant in the sensitive tumor microenvironment. IL-17A was also found to directly increase sensitivity of TNBC cells in combination with DOX treatment. In TNBC tumors sensitive to DOX, increased IL-17A levels lead to a direct effect on cancer cell responsiveness and chronic stimulation of tumor infiltrated T cells leading to improved chemotherapeutic efficacy. IL-17A’s role as a chemosensitive cytokine in TNBC may offer new opportunities for treating chemoresistant breast tumors and other cancer types.

Abstract 3136: Molecular characterization of the effects of cancer-derived exosomes on murine lung cancer tumors

Lung cancer is the second most diagnosed type of cancer and is the leading cause of cancer-related deaths in both men and women. An estimated 235,760 new cases of lung cancer and 131,880 lung cancer deaths are expected this year accounting for 12% of new cancer cases and 22% of cancer deaths in the United States. Exosomes are secreted vesicles that contain selectively packaged biomaterials (protein, lipids, and RNA) and serve as a form of extracellular communication between cells in the tumor microenvironment. Previous studies have shown the effects of cancer-derived exosomes on specific cell types or gross tumor response in vivo yet, the competitive nature and dynamics of exosomal uptake in the tumor microenvironment remains largely unknown. This work seeks to identify molecular responses induced by cancer-derived exosomes on cells residing in the tumor microenvironment.

In order to control tumor cell exposure to cancer-derived exosomes, heterogeneous ex vivo cultures derived from subcutaneous Lewis lung carcinoma (LLC) tumors in C57BL6 mice were exposed to fluorescently dyed LLC exosomes for up to 72 hours. Flow cytometric analysis was performed to identify preferential uptake of cancer exosomes into the stromal subpopulations of tumor cells. Increased uptake was observed throughout the duration of the exposure and preferential uptake was observed into neutrophils, macrophages, and endothelial cells while cancer cells, fibroblasts, and lymphocytes were underrepresented in the exosome uptaken population. Additionally, single cell RNA-sequencing was performed 24 hours post-exosomal exposure to identify transcriptional changes promoted by cancer exosome uptake. We found tumor-derived cancer cells to up-regulate transcripts associated with proliferation and down-regulated genes associated with interferon signaling in response to exosome uptake.

These preliminary findings suggest that cancer-derived exosomes have targeted effects on specific cell types in the tumor microenvironment. Specifically in cancer cells, exosomal uptake can elicit protumor (cancer proliferation and immune suppression via decreased interferon signaling) effects that may serve as mediators of disease progression. An understanding of both cancer and host-derived exosomal response to disease progression may identify novel biomarkers and potential therapeutic targets previously undiscovered using canonical discovery methods.

This study received funding from LLNL LDRD grant 21-LW-028. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344). LLNL-ABS-829271

Citation Format: Nicholas R. Hum, Nicole F. Leon, Aimy Sebastian, Kelly A. Martin, Gabriela G. Loots. Molecular characterization of the effects of cancer-derived exosomes on murine lung cancer tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3136.

Abstract 2516: Loss of cadherin 11 in pancreatic cancer induces altered immune cell infiltration

Pancreatic ductal adenocarcinoma (PDAC) is one of the top five deadliest forms of cancer with very few treatment options. The 5-year survival rate for PDAC is 10% following diagnosis. Preclinical murine models have been developed that leverage key driver mutations and have significantly contributed to our understanding of PDAC. One such genetically engineered mouse model (GEMM) that has emerged as an important tool is the KPC mouse (LSL-KrasG12D/+;LSL-Trp53R172H/+; p48-Cre) that spontaneously develops pancreatic tumors at ~14-16 weeks of age. Cadherin-11 (Cdh11), a cell-to-cell adhesion molecule has been suggested to play a role in development of the desmoplastic stroma in PDAC, that leads to difficulties in drug accessibility and has been hypothesized to contribute to chemotherapeutic resistance and correlate with poor prognosis. However, the mechanisms by which Cdh11 deficiency in the stromal microenvironment of PDAC-bearing KPC mice influences tumor infiltrating immune cells, has yet to be fully understood. Single-cell RNA sequencing (scRNAseq) of the immune (CD45+) compartment of tumor bearing Cdh11 proficient (KPC/Cdh11+/+), tumor bearing Cdh11 deficient (KPC/Cdh11+/-), non-tumor bearing Cdh11 deficient (Cdh11+/-) and wildtype (Cdh11+/+) mice was performed. We observed a sharp decrease in the presence of myeloid/monocyte lineage cells (CD14+) in KPC/Cdh11+/- tumors and also an increase in T, B and plasma cells, compared to KPC/Cdh11+/+ tumors. Genes upregulated in infiltrating T- and NK cells specific to a Cdh11 deficient background include Cd8a, Nkg7, Maf. Additionally, genes found to be upregulated in B cell clusters in Cdh11 deficient mice include those related to B cell differentiation/activation such as Lgals1, Id2, Itgb1, Rgs1. The increase in B and T cell infiltration was specific to the Cdh11 deficient background, since both pancreata from KPC/Cdh11+/+and Cdh11+/- mice had elevated levels of infiltration. Immunohistochemical validation of these findings has confirmed these changes in tumor infiltrating immune cells. Additionally of note, an increase in antibody-producing plasma cells was observed specifically in a Cdh11 deficient background. Igkc, an immunoglobulin found to be enriched in plasma cells was highly expressed in this group of immune cells. We also observed that KPC/Cdh11+/-had significantly more Igkc expressing cells than KPC/Cdh11+/+. Future work is needed to clearly define the role of Cdh11 in modulating B, T and plasma cell behavior and subsequent contributions to PDAC outcome. This study received funding by LDRD 19-SI-003. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344), LLNL-ABS-820889. This work was supported by AACR-AstraZeneca Fellowship in Immunooncology Research, grant 17-40-12-PERA; The Ruesch Center for the Cure of Gastrointestinal Cancers grant award; NIH R01 CA170653; and NIH Cancer Center Support Grant P30 CA051008.

Citation Format: Kelly A. Martin, Aimy Sebastian, Nicholas Hum, Ivana Peran, Stephen Byers, Elizabeth Wheeler, Matthew Coleman, Gabriela Loots. Loss of cadherin 11 in pancreatic cancer induces altered immune cell infiltration [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2516.

Synthetic antibacterial minerals: harnessing a natural geochemical reaction to combat antibiotic resistance

The overuse of antibiotics in clinical and livestock settings is accelerating the selection of multidrug resistant bacterial pathogens. Antibiotic resistant bacteria result in increased mortality and financial strain on the health care and livestock industry. The development of new antibiotics has stalled, and novel strategies are needed as we enter the age of antibiotic resistance. Certain naturally occurring clays have been shown to have antimicrobial properties and kill antibiotic resistant bacteria. Harnessing the activity of compounds within these clays that harbor antibiotic properties offers new therapeutic opportunities for fighting the potentially devastating effects of the post antibiotic era. However, natural samples are highly heterogenous and exhibit variable antibacterial effectiveness, therefore synthesizing minerals of high purity with reproducible antibacterial activity is needed. Here we describe for the first time synthetic smectite clay minerals and Fe-sulfide microspheres that reproduce the geochemical antibacterial properties observed in natural occurring clays. We show that these mineral formulations are effective at killing the ESKAPE pathogens (Enterococcus sp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter sp., Pseudomonas aeruginosa and Enterobacter sp.) by maintaining Fe2+ solubility and reactive oxygen species (ROS) production while buffering solution pH, unlike the application of metals alone. Our results represent the first step in utilizing a geochemical process to treat antibiotic resistant topical or gastrointestinal infections in the age of antibiotic resistance.

Abstract 2741: Loss of Cadherin-11 in PDAC induces altered immune cell infiltration and remodels stromal landscape

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal forms of cancer with very few treatment options. Less than 10 percent of patients diagnosed with PDAC survive 5 years post diagnosis. Mutations in CDKN2A, SMAD4, KRAS and P53 have been well linked to the development of PDAC. Preclinical murine models have been developed that leverage key driver mutations and have significantly contributed to our understanding of PDAC. One such genetically engineered mouse model (GEMM) that has emerged as an important tool in PDAC investigations is the KPC mouse (LSL-KrasG12D/+LSL-Trp53R172H/+Pdx-1-Cre) that spontaneously develops pancreatic tumors at ~14-16 weeks of age. Cadherin-11 (Cdh11), a cell-to-cell adhesion molecule, is highly expressed in desmoplastic stroma, a characteristic of PDAC, that leads to difficulties in drug accessibility and has been hypothesized to contribute to chemotherapeutic resistance. However, the mechanisms by which Cdh11 deficiency in the stromal microenvironment of PDAC-bearing mice (KPC) influences therapeutic outcomes, has yet to be fully understood. Single-cell RNA sequencing (scRNAseq) of both the non-immune (CD45-) and immune (CD45+) cellular compartments of tumor bearing (KPC/Cdh11+/+), tumor bearing Cdh11 deficient (KPC/Cdh11+/-), non-tumor bearing Cdh11 deficient (Cdh11-/+) and wildtype (KP) were performed. We observed changes in the abundance and types of infiltrating immune cells (T-cells, B-cells, myeloid lineage cells) of KPC/Cdh11+/- tumors when compared to tumors harvested from KPC/Cdh11+/+ mice. KPC/Cdh11+/+ pancreata had significantly more myeloid cells while KPC/Cdh11+/- tumors favored an increase in the numbers of infiltrating B- and T- cells. Genes upregulated in infiltrating T-cells specific to KPC/Cdh11+/+ mice include Spp1, Ifi30, Apoe, Ifitm3, Fn1. The increase in B and T cell infiltration was specific to the Cdh11-/+ deficient background, since both pancreata from KPC/Cdh11+/- and Cdh11-/+ mice had elevated levels of infiltration, compared to the KPC group. We also observed a decrease in the number of antigen-presenting cancer associated fibroblasts (apCAFs) in Cdh11-/+ and KPC/Cdh11+/- pancreata, denoted by the lack of CD74+ fibroblasts. Further validation of these findings will help to define the role of Cdh11-/+ in modulating B and T-cell behavior in addition to providing insight into Cdh11-/+ as a therapeutic target for PDAC through altering the tumor microenvironment.

Citation Format: Kelly A. Martin, Aimy Sebastian, Nicholas Hum, Ivana Peran, Stephen Byers, Elizabeth K. Wheeler, Matthew A. Coleman, Gabriela Loots. Loss of Cadherin-11 in PDAC induces altered immune cell infiltration and remodels stromal landscape [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2741.

Cadherin 11 Promotes Immunosuppression and Extracellular Matrix Deposition to Support Growth of Pancreatic Tumors and Resistance to Gemcitabine in Mice

BACKGROUND & AIMS

Pancreatic ductal adenocarcinomas (PDACs) are characterized by fibrosis and an abundance of cancer-associated fibroblasts (CAFs). We investigated strategies to disrupt interactions among CAFs, the immune system, and cancer cells, focusing on adhesion molecule CDH11, which has been associated with other fibrotic disorders and is expressed by activated fibroblasts.

METHODS

We compared levels of CDH11 messenger RNA in human pancreatitis and pancreatic cancer tissues and cells with normal pancreas, and measured levels of CDH11 protein in human and mouse pancreatic lesions and normal tissues. We crossed p48-Cre;LSL-Kras^G12D/+;LSL-Trp53^R172H/+ (KPC) mice with CDH11-knockout mice and measured survival times of offspring. Pancreata were collected and analyzed by histology, immunohistochemistry, and (single-cell) RNA sequencing; RNA and proteins were identified by imaging mass cytometry. Some mice were given injections of PD1 antibody or gemcitabine and survival was monitored. Pancreatic cancer cells from KPC mice were subcutaneously injected into Cdh11^+/+ and Cdh11^-/- mice and tumor growth was monitored. Pancreatic cancer cells (mT3) from KPC mice (C57BL/6), were subcutaneously injected into Cdh11^+/+ (C57BL/6J) mice and mice were given injections of antibody against CDH11, gemcitabine, or small molecule inhibitor of CDH11 (SD133) and tumor growth was monitored.

RESULTS

Levels of CDH11 messenger RNA and protein were significantly higher in CAFs than in pancreatic cancer epithelial cells, human or mouse pancreatic cancer cell lines, or immune cells. KPC/Cdh11^+/- and KPC/Cdh11^-/- mice survived significantly longer than KPC/Cdh11^+/+ mice. Markers of stromal activation entirely surrounded pancreatic intraepithelial neoplasias in KPC/Cdh11^+/+ mice and incompletely in KPC/Cdh11^+/- and KPC/Cdh11^-/- mice, whose lesions also contained fewer FOXP3⁺ cells in the tumor center. Compared with pancreatic tumors in KPC/Cdh11^+/+ mice, tumors of KPC/Cdh11^+/- mice had increased markers of antigen processing and presentation; more lymphocytes and associated cytokines; decreased extracellular matrix components; and reductions in markers and cytokines associated with immunosuppression. Administration of the PD1 antibody did not prolong survival of KPC mice with 0, 1, or 2 alleles of Cdh11. Gemcitabine extended survival of KPC/Cdh11^+/- and KPC/Cdh11^-/- mice only or reduced subcutaneous tumor growth in mT3 engrafted Cdh11^+/+ mice when given in combination with the CDH11 antibody. A small molecule inhibitor of CDH11 reduced growth of pre-established mT3 subcutaneous tumors only if T and B cells were present in mice.

CONCLUSIONS

Knockout or inhibition of CDH11, which is expressed by CAFs in the pancreatic tumor stroma, reduces growth of pancreatic tumors, increases their response to gemcitabine, and significantly extends survival of mice. CDH11 promotes immunosuppression and extracellular matrix deposition, and might be developed as a therapeutic target for pancreatic cancer.

Abstract PO065: Single cell transcriptomics of triple negative breast cancer allografts following chemotherapy treatment reveals increased T cell abundance in doxorubicin-sensitive tumors

The contribution of stromal cells on drug response in primary tumors remains unclear. To determine how individual cells within the stroma of triple negative breast cancer (TNBC) allografts respond to chemotherapy, we used single cell sequencing to profile cells present in murine tumors with or without exposure to doxorubicin. Doxorubicin is a chemotherapeutic agent commonly used to treat TNBC by inhibiting cancer cell proliferation through intercalation of DNA and preventing topoisomerase II activity. In this study, murine TNBC 4T1 cell line was utilized to generate allograft tumors in immunocompetent BALB/c mice. Syngeneic 4T1 tumors exhibit a range of responsiveness to doxorubicin treatment. Tumor growth rates were monitored throughout the chemotherapeutic regiment then stratified into sensitive or resistant response. Cellular composition and behavior were then analyzed via single cell RNA sequencing (scRNA-seq) and flow cytometry 8 days post-doxorubicin chemotherapeutic administration mimicking clinical treatment. ScRNA-seq revealed decreases in tumor infiltrating lymphocytes after doxorubicin exposure. Furthermore, an increase in T cell abundance was discovered in tumors sensitive to doxorubicin treatment. This finding was further supported by flow cytometric analysis showing a tumor specific increase in all, CD4+, and CD8+ T cell populations relative to resistant tumors. Additionally, T-cell differentiation, exhaustion, and activation states were further examined from scRNA-seq data providing insights into functional properties of the tumor residing T cell populations undergoing chemotherapeutic treatment. Future work will focus on analyzing prognostic value of specific T-cell populations in disease regression following doxorubicin treatment. This study received funding from LLNL LDRD grant 19-SI-003. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344).

Citation Format: Nicholas R. Hum, Aimy Sebastian, Sean F. Gilmore, David M. Gravano, Naiomy D. Rios-Arce, Kelly A. Martin, Elizabeth K. Wheeler, Matthew A. Coleman, Gabriela G. Loots. Single cell transcriptomics of triple negative breast cancer allografts following chemotherapy treatment reveals increased T cell abundance in doxorubicin-sensitive tumors [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2020 Oct 19-20. Philadelphia (PA): AACR; Cancer Immunol Res 2021;9(2 Suppl):Abstract nr PO065.

Abstract 2757: Analysis of stromal myofibroblasts identifies secreted proteins that promote pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is one of the most incurable types of cancer. Cancer that develops in the acinar cells of the pancreas is typically not diagnosed until later stages, such as stage 3 or 4. As such, this form of cancer is particularly lethal with only 9% of patients reaching 5-year survival. PDAC is known to have a particularly dense extracellular matrix composed of fibroblasts, which have been previously shown to play an important role in promoting resistance to drug therapy. Characterization of the stromal networks involved in PDAC tumor development as well as protein markers of fibroblast subpopulations within the tumor stroma are critical to developing new fibroblast-targeted therapeutic approaches as well as understanding key signaling molecules that ultimately promote tumor progression and drug resistance. Single-cell RNA sequencing (scRNAseq) was utilized to analyze cancer-associated fibroblasts (CAFs) from KPC mouse-derived, MT3 subcutaneous murine allografts along with two fibroblast lines derived from human PDAC tumors: CRC-811 and IA-1340. Single cell gene expression profiling and subsequent analysis of MT3-derived CAFs resulted in the identification of three CAF subpopulations including a myofibroblast subpopulation that expressed high levels of smooth muscle actin (Acta2), which was also observed in both human samples. Fibroblast subpopulations enriched in Acta2 expression, expressed high levels of Wnt5a along with several other secreted factors including Tgfb1, Tgfb2 and Ctgf. Wnt5a is a secreted protein that activates non-canonical Wnt signaling pathways and is known to regulate normal developmental processes, including proliferation, differentiation, migration, adhesion and polarity. However Wnt5a is not natively expressed in MT3 cancer cells derived from syngeneic tumors, but potentially in the stroma. We hypothesize it is exclusively derived from fibroblasts. Previously it has been shown that Wnt5a inhibition suppressed gastric cancer metastasis, therefore further validation of the role of myofibroblast-derived Wnt5a on PDAC disease progression is warranted. This study received funding by LDRD 19-SI-003. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344). IM Release Number: LLNL-ABS-798442.

Citation Format: Kelly A. Martin, Aimy Sebastian, Nicholas R. Hum, Stephen Byers, Elizabeth K. Wheeler, Matthew A. Coleman, Gabriela G. Loots. Analysis of stromal myofibroblasts identifies secreted proteins that promote pancreatic ductal adenocarcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2757.

Abstract 2810: Epithelial-mesenchymal hybrid population changes from monolayer, spheroid, and tumoroid ex vivo culture of syngeneic murine mammary tumors

Epithelial to mesenchymal transition (EMT) of cancer cells during tumor progression has been implicated in tumor initiation, growth, invasion, metastasis, colonization and resistance to therapy. In building a successful in vitro tumor model, it is critical to recapitulate in vivo cancer cell heterogeneity inclusive of both cell types and transition state present. This study investigates the EMT hybrid states of mouse triple negative breast cancer cells during ex vivo culturing across multiple methodologies.

Mouse mammary carcinoma (4T1) tumors were harvested from syngeneic, orthotopic mice and subsequently cultured using various methods over the course of 12 days. Ex vivo cultures were first assessed for retention of tumor cellular heterogeneity using endogenous Thy1.1 (CD90.1) expression via flow cytometry to distinguish 4T1 cancer cells from stromal derived cells. Cancer cell populations rapidly became the majority of cells in culture. After 3 days of ex vivo culture, we found the cancer cell population to have significantly expanded ~2-3 fold compared to the original tumor population, while other stromal cellular subtypes decreased. Additionally, monolayer culture of ex vivo cells contained significantly more cancer cells relative to the spheroid or tumoroid (tumor fragment) culturing techniques.

Cancer cells from each culturing technique were also evaluated for loss of Epcam expression and mesenchymal cell fate in reference to the initial EMT distribution at time of isolation. 4T1 cells cast into hydrogel retained high proportions of cells undergoing EMT, evidenced by fewer cells expressing Epcam. However, all other in vitro conditions favored the expansion of cancer cells in an epithelial state compared to in vivo tumors. Subsequent analysis of EMT populations for transitional hybrid states based on CD51, CD61, and CD106 expression was conducted using flow cytometric analysis. We found that in vitro culturing promoted mesenchymal character and this selection was time dependent. Additionally, we found that spheroids cultured in hydrogel for 7 days most closely resembled early hybrid EMT cell states ratios found in vivo

Future research aims to optimize ex vivo culturing methodologies to best retain cancer cell characteristics and behavior of tumors obtained from human biopsies. Alterations in growth conditions and identifying critical stromal populations of interest will be critical in development of optimized preclinical ex vivo tumor culture models for drug discovery or personalized treatment.

This study received funding from LLNL LDRD grant 19-SI-003. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344). IM: LLNL-ABS-798441

Citation Format: Nicholas R. Hum, Kelly A. Martin, Elizabeth Wheeler, Matthew A. Coleman, Gabriela G. Loots. Epithelial-mesenchymal hybrid population changes from monolayer, spheroid, and tumoroid ex vivo culture of syngeneic murine mammary tumors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2810.

Single-Cell Transcriptomic Analysis of Tumor-Derived Fibroblasts and Normal Tissue-Resident Fibroblasts Reveals Fibroblast Heterogeneity in Breast Cancer

Cancer-associated fibroblasts (CAFs) are a prominent stromal cell type in solid tumors and molecules secreted by CAFs play an important role in tumor progression and metastasis. CAFs coexist as heterogeneous populations with potentially different biological functions. Although CAFs are a major component of the breast cancer stroma, molecular and phenotypic heterogeneity of CAFs in breast cancer is poorly understood. In this study, we investigated CAF heterogeneity in triple-negative breast cancer (TNBC) using a syngeneic mouse model, BALB/c-derived 4T1 mammary tumors. Using single-cell RNA sequencing (scRNA-seq), we identified six CAF subpopulations in 4T1 tumors including: 1) myofibroblastic CAFs, enriched for α-smooth muscle actin and several other contractile proteins; 2) ‘inflammatory’ CAFs with elevated expression of inflammatory cytokines; and 3) a CAF subpopulation expressing major histocompatibility complex (MHC) class II proteins that are generally expressed in antigen-presenting cells. Comparison of 4T1-derived CAFs to CAFs from pancreatic cancer revealed that these three CAF subpopulations exist in both tumor types. Interestingly, cells with inflammatory and MHC class II-expressing CAF profiles were also detected in normal breast/pancreas tissue, suggesting that these phenotypes are not tumor microenvironment-induced. This work enhances our understanding of CAF heterogeneity, and specifically targeting these CAF subpopulations could be an effective therapeutic approach for treating highly aggressive TNBCs.

Abstract 5157: Comparison of exosomes shed by breast cancer cell lines with varying metastatic potential

Exosomes are endosomal secreted vesicles containing a variety of genetic and non-genetic material that can be transferred between cells (DNA, RNA, protein, lipid, etc.). Cancer derived exosomes have been implicated in a wide range of cancer mechanisms such as promotion of tumor growth, tumor angiogenesis, immune evasion, drug resistance, and metastasis. In addition to functional significance, cancer exosomes may possess novel biomarkers with potential uses for non-invasive liquid biopsies for cancer detection and monitoring of disease progression. Here we examined differences that may exist in extracellular vesicles or exosomes (EVs) shed by cancer cell lines with various metastatic potential (MDA-MB-231, highly metastatic; MCF-7, weakly metastatic; MCF-10a, normal breast epithelial cells). Morphological analysis of EVs was performed using fluorescent Nanosight Tracking Analysis and revealed decreased mean diameter of EVs derived from MCF-7 cells compared to the other two cell lines, there was also increased exosome particle yield in this cell line. Small RNAs from EVs cargo were also analyzed via sequencing (exoRNA-Seq). The majority of sequenced RNA aligned to coding regions of the human genome (~60%) across all cell lines. Non-coding RNA classification also showed little variability across cell lines examined regardless of metastatic potential, with ~38% of RNA reads corresponding to non-coding RNAs. Pairwise comparison of these cell lines demonstrated that each line packaged unique cargos into their shed exosomes. The non-coding regions corresponded to a variety of small RNAs (miRNA, snoRNA, snRNA, miscRNA, rRNA) but included other RNA features such as pseudogenes and antisense RNAs. We found 304 genes significantly up-regulated and 150 genes significantly down-regulated when comparing metastatic cancer exosomes (MCF-7 and MDA-MB-231) to normal, non-tumorigenic exosomes (MCF-10A). Among examined microRNAs we found several miRNAs associated with metastatic behavior that have previously been implicated in cancer biology, which will be prioritized for validation. Also, 21 RNAs were upregulated at high levels in exosomes shed by metastatic cells, and their expression level was directly proportional with the metastatic character, suggesting that these RNAs may be tested for their potential as biomarkers. Future research will expand upon these newly identified genetic signatures of metastatic exosomal cargo and further validate their influence in driving metastasis.

This study received funding from DOD grant BC151687. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344). IM number: LLNL-POST-758941

Citation Format: Kelly A. Martin, Nicholas R. Hum, Aimy Sebastian, Gabriela G. Loots. Comparison of exosomes shed by breast cancer cell lines with varying metastatic potential [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5157.

Tracking Tumor Colonization in Xenograft Mouse Models Using Accelerator Mass Spectrometry

Here we introduce an Accelerator Mass Spectrometry (AMS)-based high precision method for quantifying the number of cancer cells that initiate metastatic tumors, in xenograft mice. Quantification of ¹⁴C per cell prior to injection into animals, and quantification of ¹⁴C in whole organs allows us to extrapolate the number of cancer cells available to initiate metastatic tumors. The ¹⁴C labeling was optimized such that 1 cancer cell was detected among 1 million normal cells. We show that ~1–5% of human cancer cells injected into immunodeficient mice form subcutaneous tumors, and even fewer cells initiate metastatic tumors. Comparisons of metastatic site colonization between a highly metastatic (PC3) and a non-metastatic (LnCap) cell line showed that PC3 cells colonize target tissues in greater quantities at 2 weeks post-delivery, and by 12 weeks post-delivery no ¹⁴C was detected in LnCap xenografts, suggesting that all metastatic cells were cleared. The ¹⁴C-signal correlated with the presence and the severity of metastatic tumors. AMS measurements of ¹⁴C-labeled cells provides a highly-sensitive, quantitative assay to experimentally evaluate metastasis and colonization of target tissues in xenograft mouse models. This approach can potentially be used to evaluate tumor aggressiveness and assist in making informed decisions regarding treatment.

Abstract 2136: Transcriptome analysis of osteoblasts fused with cancer-derived exosomes

Breast cancer tumors have a high rate of metastasis and certain aggressive subtypes favor the bone environment. Clinically, it is estimated that metastatic breast cancer has a prevalence of up to 70% of bone tumors. Exosomes are important in cell-cell communication, and are increasingly being recognized as key contributors for priming targeted tissues for metastasis. Despite numerous advances in exosome detection and cargo characterization, transcriptional effects of cancer exosomes on targeted cells remain difficult to characterize at physiologically relevant levels. This is largely due to a combination of limited exosome secretion/uptake and an inability to segregate affected cells from the population. Conventional approaches to circumvent these limitations include spiking cell environments with exosome quantities far in excess of physiological concentrations.

We sought to analyze the transcriptional effect of cancer exosomes on cells that have uptaken cancer-derived exosomes in a dynamic co-culture environment. In order to accomplish this, we first engineered a human breast cancer cell line (MDA-MB-231) to express GFP labeled exosomes. This novel cell line expresses three GFP fusion proteins for tetraspanin exosome markers (CD9, CD63, and CD81) known to be found on exosomes derived from MDA-MB-231 cells. Stable, intrinsic, fluorescent labeling of three exosome markers allows for an improved, more sensitive method for the analysis of exosome transfer. We can now examine transfer representing a more diverse pool of exosomes requiring no manipulation post exosome isolation prior to visualization.

To investigate breast cancer exosome-mediated alterations on gene expression in bone cells to mimic breast cancer bone metastasis, this GFP exosome expressing line (MDA-MB-231 exo-GFP) was co-cultured with a mouse osteoblast cell line (MC3T3) then analyzed via flow cytometry to quantify the uptake of cancer exosomes in target cell population over time. MC3T3 cells that become GFP positive, indicative of exosome mediated transfer, increased from 0.91% of the population on day 3 post co-culture to 17.3% on day 14. Subsequent cell sorting and RNA-seq of GFP positive MC3T3 populations yielded novel insights into the progressive transcriptional effect of cancer exosomes on target cells. Future research will expand upon this approach to examine the effects on bone cells non-metastatic and metastatic cancer cell lines have on the metastatic niche through exosome-mediated signaling. This approach introduces a novel method for prolonged transcriptional analysis of cancer and target cell co-culture allowing the segregation of exosome affected and unaffected subpopulations of target cells.

This study was funded by DOD grant BC151687. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344).

Citation Format: Nicholas H. Hum, Kelly A. Martin, Gabriela G. Loots. Transcriptome analysis of osteoblasts fused with cancer-derived exosomes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2136.

Abstract 908: Overexpression of nicotinamide N-methyltransferase confers gemcitabine resistance in bladder cancer

Bladder cancer is among the top ten most common cancers diagnosed, with about ~380,000 new cases and ~150,000 deaths per year reported worldwide. Platinum-based chemotherapy in combination with gemcitabine, a nucleoside analog, is a widely used treatment option for advanced bladder cancer. It has been shown that only ~50% of the patients with advanced bladder cancer respond to platinum-based therapy. Cancer cells often become non-responsive to therapy that once proved efficacious and are now drug resistant. Drug resistance represents a significant, ongoing challenge in eradicating cancer.

We have employed a patient-derived bladder cancer xenograft (PDX) platform to further investigate the molecular mechanisms that contribute to gemcitabine-induced drug resistance in advanced bladder cancer. Transcriptome profiling of passage 4 bladder cancer xenograft tumors from 2 gemcitabine sensitive PDX lines (BL0440 & BL0293) was performed using RNA sequencing (RNAseq) analysis, before and after a 21-day cisplatin/gemcitabine drug treatment regimen. Key regulatory pathways and genes contributing to drug resistant bladder cancer have been identified and validated by overexpression in a 5637 bladder cancer cell line.

RNA sequencing data has indicated significant differences between the transcriptional profiles of drug-sensitive and drug-resistant tumors. PDXs retained morphology and shared 92-97% of genetic alterations of parental cancer cells. We identified 106 genes >1.5 fold up-regulated and 45 genes >1.5 fold down-regulated in the drug resistant tumors compared to their drug sensitive counterparts. Of the genes that were significantly upregulated, two methyltransferase enzymes were further validated: Nicotinamide N-methyltransferase (NNMT) and methionine methyltransferase 1A (MAT1A). These genes were found to be contributors to gemcitabine-mediated drug resistance. 5637 cells overexpressing NNMT yielded a 200-fold increase in gemcitabine resistance relative to parental strain. In conclusion, chemoresistance to gemcitabine is associated with differential expression of genes and alteration of downstream signaling pathways. Upregulation of NNMT & MAT1A can potentially be used as novel biomarkers for subpopulations of drug resistant bladder cancer for which improved therapeutics can be developed. Future direction will likely include studies to elucidate exact molecular mechanisms by which cancer cells utilize methyltransferases to no longer respond to gemcitabine therapy.

This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344).

Citation Format: Kelly A. Martin, Aimy Sebastian, Nicholas R. Hum, Deepa K. Murugesh, Chong-xian Pan, Ai-Hong Ma, Ralph W. de Vere White, Gabriela G. Loots. Overexpression of nicotinamide N-methyltransferase confers gemcitabine resistance in bladder cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 908.

Abstract 97: RNA sequencing of bladder cancer patient-derived xenograft models identifies genes associated with chemoresistance

Background: Bladder cancer is among the top ten most common cancers, with about ~380,000 new cases and ~150,000 deaths per year worldwide. Platinum-based combination chemotherapy is commonly used to treat advanced bladder cancer. It has been shown that only ~50% of the patients with advanced bladder cancer respond to platinum-based therapy.

Methods: We have utilized a patient-derived bladder cancer xenograft (PDX) platform to characterize the molecular mechanisms that contribute to resistance of gemcitabine-cisplatin combination therapy in advanced bladder cancer. We have also identified key regulatory pathways in our PDX models that can be targeted to treat chemotherapy resistant bladder cancer using RNAseq analysis. Transcriptome profiling of P0 (passage 0) bladder cancer xenograft tumors from 4 PDX lines (2 gemcitabine-cisplatin resistant lines and 2 drug sensitive lines) was performed by RNA-Seq analysis, before and after a 21-day cisplatin/gemcitabine drug treatment regimen.

Results: The RNA-seq data has indicated significant differences between the transcriptional profiles of drug-sensitive and drug-resistant tumors. PDXs retained morphology and shared 92-97% of genetic alterations of parental cancer cells. We identified 333 genes >2 fold up or down regulated in the drug resistant tumors compared to the drug sensitive tumors. Significantly up-regulated genes in drug resistant tumors analyzed include metabolic enzymes ALDH2, ALDH3A1, ALDH4A1 and ALDH7A1, transporter proteins ABCA1, SLC1A4, SLC2A5, SLC30A1, SLC39A6, SLC7A5 and SLC9A3, Notch ligand JAG2, Growth hormone receptor GHR and transmembrane protein GPNMB. Consistent with the change of cell surface proteins such as GHR and GPNMB, the MAPK and the PI3K-AKT pathways were upregulated when PDXs became resistant to cisplatin treatment. Additional changes in gene expression based on RNA-seq data before and after drug treatment were also found.

Conclusion: Chemoresistance to gemcitabine and cisplatin is associated with altered expression of several cell surface proteins and upregulation of the downstream signaling pathways. Targeting these cell surface proteins can possibly be harnessed to overcome chemoresistance. GPNMB is a type I transmembrane protein that has previously been shown to be up-regulated in many metastatic cancers including breast cancer. Potentially targeting GPNMB with glembatumumab vedotin, an antibody-drug-conjugate has shown promising results in treating several cancers including breast cancer and osteosarcoma. Further studies will elucidate whether targeting GPNMB is an effective strategy for the treatment of chemotherapy resistant bladder cancer.

This study received funding by a developmental grant from the UCDCC. This work was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344). IM number: LLNL-688318

Citation Format: Kelly A. Martin, Nicholas R. Hum, Aimy Sebastian, Deepa K. Murugesh, Chong-Xian Pan, Ai-Hong Ma, Ralph de Vere White, Gaby Loots. RNA sequencing of bladder cancer patient-derived xenograft models identifies genes associated with chemoresistance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 97. doi:10.1158/1538-7445.AM2017-97

Abstract 1977: Tracking cancer colonization in xenografts using ultrasensitive accelerator mass spectrometry methods

Background: The inability to effectively treat metastases is the main reason for the limited progress in reducing the rates of cancer morbidity and mortality. One major drawback is the lack of quantitative assays for assessing the size and tissue prevalence of tumors in newly diagnosed individuals. Current methods for quantifying tumor burden are mainly qualitative and include measuring the gross weight of the affected organ, counting tumors on the surface of the organ, or evaluating a small sample of the organ using histologic sections. These methods are crude measures of tumor burden and size distribution, and in the case of histology, they are time consuming, difficult to process an adequate sample size and non-quantitative.

Methods: Animal models of metastasis have been useful in identifying genes that regulate susceptibility to the development and progression of metastasis and have helped to highlight potential novel targets for drug development. In particular several small animal imaging technologies including magnetic resonance imaging, high frequency ultrasound, and optical imaging have been recently applied to this task. Each of these methods may be useful for specific research projects, based on their unique combination of resolution, image acquisition time, animal throughput, and cost-effectiveness, yet none of these modalities adequately address the need for rapid quantification of tumors across the entire organism, nor do they assess therapeutic effectiveness in eradicating cancer in xenograft models. We have developed an Accelerator Mass Spectrometry (AMS)-based high precision quantitative method for assessing the metastatic potential of primary tumors isolated from newly diagnosed patients.

Results: Our AMS-based methodology to study metastasis uses xenograft cancer cells labeled with 14C-labeled thymidine that are delivered intravenously into NSG mice and allowed to develop metastatic cancer over the course of up to 10 weeks. At the end of the experiment, all vital organs are collected; the DNA is isolated and is examined by AMS for the presence of 14C-signal. The labeling was optimized to achieve sufficient signal such that a tumor derived from a single cell could be detected by AMS, in secondary tumors, in vivo, independent of histological data.

Conclusions: Using this approach we have determined that tissue colonization by tumor cells is a very rare event, where most metastatic tumors are initiated by less than 10 cells delivered into NSG mice. Further optimization of these techniques will allow us to explore the metastatic potential of primary tumors, isolated from biopsies and expanded in Avatar mice.

This study was supported in part by NIH P41MI03483 and was conducted under the auspices of the USDOE by LLNL (DE-AC52-07NA27344). IM number: LLNL-678306

Citation Format: Nicholas R. Hum, Kelly A. Martin, Michael Malfatti, Kurt Haack, Bruce A. Buchholz, Gabriela G. Loots. Tracking cancer colonization in xenografts using ultrasensitive accelerator mass spectrometry methods [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1977. doi:10.1158/1538-7445.AM2017-1977

Abstract 3891: Development of quantitative methods for assessing metastatic potential of human primary tumors

Background: The inability to effectively treat metastases is the main reason for the limited progress in reducing the rates of cancer morbidity and mortality. One major drawback is the lack of quantitative assays for assessing the size and tissue prevalence of tumors in newly diagnosed individuals. Current methods for quantifying tumor burden are mainly qualitative and include measuring the gross weight of the affected organ, counting tumors on the surface of the organ, or evaluating a small sample of the organ using histologic sections. These methods are crude measures of tumor burden and size distribution, and in the case of histology, they are time consuming, difficult to process an adequate sample size and non-quantitative.

Methods: Animal models of metastasis have been useful in identifying genes that regulate susceptibility to the development and progression of metastasis and helped highlight potential novel targets for drug development. In particular several small animal imaging technologies including magnetic resonance imaging, high frequency ultrasound, and optical imaging have been recently applied to this task. Each of these methods may be useful for specific research projects, based on their unique combination of resolution, image acquisition time, animal throughput, and cost-effectiveness, yet none of these modalities adequately address the need for rapid quantification of tumors across the entire organism, nor do they assess therapeutic effectiveness in eradicating cancer in xenograft models. We have developed an Accelerator Mass Spectrometry (AMS)-based high precision quantitative method for assessing the metastatic potential of primary tumors isolated from newly diagnosed patients.

Results: Our Accelerator Mass Spectrometry-based methodology to study metastasis uses xenograft cancer cells labeled with 14C-labeled thymidine that are delivered intravenously into NSG mice and allowed to develop metastatic cancer over the course of up to 10 weeks. At the end of the experiment, all vital organs are collected; the DNA is isolated and is examined by AMS for the presence of 14C-signal. The labeling was optimized to achieve sufficient signal such that a tumor derived from a single cell could be detected by AMS, in secondary tumors, in vivo, independent of histological data.

Conclusions: Using this novel approach we have evaluated the metastatic potential of several prostate cancer cell lines, characterized stem-cell like sublines derived from prostate cancer cell lines [PC3] and examined tissue tropism of cancer sublines derived from kidney and liver metastatic tumors. Further optimization of these techniques will allow us to explore the metastatic potential of primary tumors, isolated from biopsies and expanded in Avatar mice.

Citation Format: Kelly A. Martin, Nicholas Hum, Kurt W. Haack, Bruce A. Buchholz, Gabriela G. Loots. Development of quantitative methods for assessing metastatic potential of human primary tumors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3891.

Abstract 2106: Transcriptome analysis of patient-derived bladder cancer xenografts identifies genes associated with chemoresistance

Background: Bladder cancer is among the ten most common cancers, with about ∼380,000 new cases and ∼150,000 deaths per year worldwide. Platinum-based combination chemotherapy is commonly used to treat advanced bladder cancer. It has been shown that only ∼50% of the patients with advanced bladder cancer respond to platinum-based therapy.

Methods: We employed a patient-derived bladder cancer xenograft (PDX) platform to characterize the molecular mechanisms contributing to resistance to gemcitabine-cisplatin combination therapy in advanced bladder cancer and to identify novel candidates that can be targeted to treat chemotherapy resistant bladder cancer. Transcriptome profiling of P0 (passage 0) bladder cancer xenograft tumors from 4 PDX lines (2 gemcitabine-cisplatin resistant lines and 2 drug sensitive lines) was performed by RNA-Seq analysis.

Results: PDXs retained the morphology fidelity and shared 92-97% of genetic alterations of parental cancer cells. The RNA-seq data suggested the presence of significant differences between the transcription profiles of drug-sensitive and drug-resistant tumors. We identified 333 genes >2 fold up or down regulated in the drug resistant tumors compared to the drug sensitive tumors. Genes down-regulated in drug resistant tumors include tight junction protein CLDN3 and regulators of G-protein signaling RGS2 and RGS3. Significantly up-regulated genes include metabolic enzymes ALDH2, ALDH3A1, ALDH4A1 and ALDH7A1, transporter proteins ABCA1, SLC1A4, SLC2A5, SLC30A1, SLC39A6, SLC7A5 and SLC9A3, Notch ligand JAG2, Growth hormone receptor GHR and transmembrane glycoprotein GPNMB. Consistent with the change of cell surface proteins such as GHR and GPNMB, the MAPK and the PI3K-AKT pathways were upregulated when PDXs became resistant to cisplatin treatment.

Conclusion: Chemoresistance to gemcitabine and cisplatin is associated with altered expression of several cell surface proteins and upregulation of the downstream signaling pathways. Targeting these cell surface proteins can possibly be harnessed to overcome chemoresistance. GPNMB, a type I transmembrane protein highly up-regulated in the drug resistant tumors, has previously been shown to be over-expressed in various cancers. Targeting GPNMB with an antibody-drug-conjugate, glembatumumab vedotin, has shown promising results in treating several cancers including breast cancer and osteosarcoma. Further studies will elucidate whether targeting GPNMB is an effective strategy for the treatment of chemotherapy resistant bladder cancer.

Citation Format: Aimy Sebastian, Kelly A. Martin, Chong-xian Pan, Ai-hong Ma, Ralph W. deVere White, Gabriela G. Loots. Transcriptome analysis of patient-derived bladder cancer xenografts identifies genes associated with chemoresistance. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2106.

Pharmacogenetics of obesity drug therapy

As the prevalence and severity of obesity and its complications have risen significantly in worldwide populations, behavioral interventions alone have been inconsistent in promoting sufficient, sustained weight loss. Consequently, there has been intense interest in the development of anti-obesity medications as treatment strategies. When coupled with structured lifestyle modifications, pharmacotherapy can enhance weight loss. While less efficacious than bariatric surgery, drug therapy may be an alternative to surgery for some obese patients, and is an emerging strategy for weight maintenance. The goal of pharmacogenetics is to help identify patients who will benefit most from drug therapies while minimizing the risk of adverse effects. In this review, we summarize the pharmacogenetic literature on obesity drugs of the past (sibutramine, rimonabant), present (orlistat, lorcaserin, phentermine, topiramate), and future (buprioprion/naltrexone).

Discovery of N-benzyl-2-[(4S)-4-(1H-indol-3-ylmethyl)-5-oxo-1-phenyl-4,5-dihydro-6H-[1,2,4]triazolo[4,3-a][1,5]benzodiazepin-6-yl]-N-isopropylacetamide, an orally active, gut-selective CCK1 receptor agonist for the potential treatment of obesity

We describe the design, synthesis, and structure-activity relationships of triazolobenzodiazepinone CCK1 receptor agonists. Analogs in this series demonstrate potent agonist activity as measured by in vitro and in vivo assays for CCK1 agonism. Our efforts resulted in the identification of compound 4a which significantly reduced food intake with minimal systemic exposure in rodents.

Prostacyclin, atherothrombosis, and cardiovascular disease

Prostacyclin (PGI(2)) is a major product of COX-2 catalyzed metabolism of arachidonic acid in the endothelium. Recent studies have demonstrated that PGI(2) protects against atherothrombosis. The prostacyclin receptor knockout mice exhibit increased atherosclerosis, enhanced thrombosis, and enhanced proliferative response to carotid vascular injury with increased intima to media ratios [1-3]. Moreover, the recent withdrawal of rofecoxib (Vioxx) due to increased cardiovascular events further supports the critical role of prostacyclin in inhibiting atherothrombosis in humans. Such studies have paralleled intense chemical biology studies to develop more stable prostacyclin analogues. Indeed a number of these analogues are currently being successfully used for the treatment of pulmonary hypertension. In this review we will summarize the current literature on some principles of prostacyclin analogue development, our current understanding of the receptor, and recent developments which implicate prostacyclin in atherothrombotic protection. More than 68 million Americans suffer from cardiovascular disease, which causes more deaths, disability and economic loss than any other group of diseases. Further clinical investigations of orally stable prostacyclin analogues for treatment of cardiovascular diseases other than pulmonary hypertension may now be warranted.

Discovery of potent and orally bioavailable heterocycle-based β3-adrenergic receptor agonists, potential therapeutics for the treatment of obesity

A novel series of heterocycle-based analogs were prepared and evaluated for their in vitro and in vivo biological activity as human beta(3)-adrenergic receptor (AR) agonists. Several analogs demonstrated potent agonist activity at the beta(3)-AR, functional selectivity against beta(1)- and beta(2)-ARs, and favorable pharmacokinetic profiles in vivo. Compound 17 increased oxygen consumption in rats, a measure of energy expenditure, with an ED(20%) of 2mg/kg.

Rapamycin inhibits cell motility by suppression of mTOR-mediated S6K1 and 4E-BP1 pathways

Rapamycin, an inhibitor of the mammalian target of rapamycin (mTOR), inhibits tumor cell motility. However, the underlying mechanism is poorly understood. Here, we show that rapamycin inhibited type I insulin-like growth factor (IGF-I)-stimulated motility of a panel of cell lines. Expression of a rapamycin-resistant mutant of mTOR (mTORrr) prevented rapamycin inhibition of cell motility. However, cells expressing a kinase-dead mTORrr remained sensitive to rapamycin. Downregulation of raptor or rictor by RNA interference (RNAi) decreased cell motility. However, only downregulation of raptor mimicked the effect of rapamycin, inhibiting phosphorylation of S6 kinase 1 (S6K1) and 4E-BP1. Cells infected with an adenovirus expressing constitutively active and rapamycin-resistant mutant of p70 S6K1, but not with an adenovirus expressing wild-type S6K1, or a control virus, conferred to resistance to rapamycin. Further, IGF-I failed to stimulate motility of the cells, in which S6K1 was downregulated by RNAi. Moreover, downregulation of eukaryotic initiation factor 4E (eIF4E)-binding protein 1 (4E-BP1) by RNAi-attenuated rapamycin inhibition of cell motility. In contrast, expression of constitutively active 4E-BP1 dramatically inhibited IGF-I-stimulated cell motility. The results indicate that both S6K1 and 4E-BP1 pathways, regulated by TORC1, are required for cell motility. Rapamycin inhibits IGF-I-stimulated cell motility, through suppression of both S6K1 and 4E-BP1/eIF4E-signaling pathways, as a consequence of inhibition of mTOR kinase activity.

Potent and selective, sulfamide-based human β3-adrenergic receptor agonists

A series of sulfamide-based analogs related to L-796568 were prepared and evaluated for their biological activity at the human beta(3)-adrenergic receptor (AR). This modification allows for a significant reduction in molecular weight, while maintaining single-digit nanomolar potencies at the beta(3)-AR and high selectivities versus the beta(2)- or beta(3)-AR.

Isozyme-nonselective N-substituted bipiperidylcarboxamide acetyl-CoA carboxylase inhibitors reduce tissue malonyl-CoA concentrations, inhibit fatty acid synthesis, and increase fatty acid oxidation in cultured cells and in experimental animals

Inhibition of acetyl-CoA carboxylase (ACC), with its resultant inhibition of fatty acid synthesis and stimulation of fatty acid oxidation, has the potential to favorably affect the multitude of cardiovascular risk factors associated with the metabolic syndrome. To achieve maximal effectiveness, an ACC inhibitor should inhibit both the lipogenic tissue isozyme (ACC1) and the oxidative tissue isozyme (ACC2). Herein, we describe the biochemical and acute physiological properties of CP-610431, an isozyme-nonselective ACC inhibitor identified through high throughput inhibition screening, and CP-640186, an analog with improved metabolic stability. CP-610431 inhibited ACC1 and ACC2 with IC50s of approximately 50 nm. Inhibition was reversible, uncompetitive with respect to ATP, and non-competitive with respect to bicarbonate, acetyl-CoA, and citrate, indicating interaction with the enzymatic carboxyl transfer reaction. CP-610431 also inhibited fatty acid synthesis, triglyceride (TG) synthesis, TG secretion, and apolipoprotein B secretion in HepG2 cells (ACC1) with EC50s of 1.6, 1.8, 3.0, and 5.7 microm, without affecting either cholesterol synthesis or apolipoprotein CIII secretion. CP-640186, also inhibited both isozymes with IC50sof approximately 55 nm but was 2-3 times more potent than CP-610431 in inhibiting HepG2 cell fatty acid and TG synthesis. CP-640186 also stimulated fatty acid oxidation in C2C12 cells (ACC2) and in rat epitrochlearis muscle strips with EC50s of 57 nm and 1.3 microm. In rats, CP-640186 lowered hepatic, soleus muscle, quadriceps muscle, and cardiac muscle malonyl-CoA with ED50s of 55, 6, 15, and 8 mg/kg. Consequently, CP-640186 inhibited fatty acid synthesis in rats, CD1 mice, and ob/ob mice with ED50s of 13, 11, and 4 mg/kg, and stimulated rat whole body fatty acid oxidation with an ED50 of approximately 30 mg/kg. Taken together, These observations indicate that isozyme-nonselective ACC inhibition has the potential to favorably affect risk factors associated with the metabolic syndrome.

In vitro and in vivo characterization of 3-[2-[6-(2-tert-butoxyethoxy)pyridin-3-yl]-1H-imidazol-4-yl]benzonitrile hydrochloride salt, a potent and selective NPY5 receptor antagonist

To investigate the anorectic potential of NPY5 receptor antagonists, we have profiled the in vitro and in vivo properties of 3-[2-[6-(2-tert-butoxyethoxy)pyridin-3-yl]-1H-imidazol-4-yl]benzonitrile hydrochloride salt (1). This compound was found to have excellent NPY5 receptor affinity and selectivity, potent functional antagonism, and good peripheral and central nervous system exposure in rats. This compound attenuated bovine pancreatic polypeptide induced food intake in rats but failed to demonstrate anorectic activity in rodent natural feeding models.

Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being

STUDY DESIGN

Randomized controlled trial of exercise training in persons with spinal cord injury.

OBJECTIVE

The purpose of this study was to examine the effects of 9 months of twice-weekly exercise training on strength, arm ergometry performance, and indices of psychological well-being and quality of life.

SETTING

Centre for Health Promotion and Rehabilitation, McMaster University, Hamilton, Ontario, Canada.

METHODS

Thirty-four men and women (aged 19-65 years) with traumatic spinal cord injury (C4-L1; ASIA A-D) of 1-24 years duration volunteered to participate, and were randomized into exercise (EX; n=21) and control (CON; n=13) groups. Twenty-three subjects (11 EX; 12 CON) successfully completed the 9-month study. Subjects were assessed for one repetition maximum (1RM) strength, arm ergometry performance, and several indices of quality of life and psychological well-being at baseline, 3, 6, and 9 months.

RESULTS

At baseline, there were no significant differences between groups in age, submaximal arm ergometry performance, muscle strength, or psychological well-being. Following training, the EX group had significant increases in submaximal arm ergometry power output (81%; P<0.05), and significant increases in upper body muscle strength (19-34%; P<0.05); no significant changes occurred in CON. Participants in EX reported significantly less pain, stress and depression after training, and scored higher than CON in indices of satisfaction with physical function, level of perceived health and overall quality of life (P<0.05). Exercise adherence (per cent of prescribed sessions attended) in those subjects who completed the 9 months of training was 82.5%.

CONCLUSIONS

These results demonstrate that long-term twice-weekly exercise training in this population is feasible, and results in significant gains in both physical and psychological well-being.

Discovery of potent, nonsteroidal, and highly selective glucocorticoid receptor antagonists

An approach to the computer-assisted, pharmacophore design of nonsteroidal templates for the glucocorticoid receptor (GR) that contained an element of pseudo-C2 symmetry was developed. The enatiomer of the initial design, 1Ra, and not the designed molecule, 1S, showed the desired ligand binding to the GR. The pseudo-C2 symmetry of the template allowed for rapid improvements in GR activity resulting in potent, selective, nonsteroidal GR antagonists, CP-394531 and CP-409069.

Does bouton morphology optimize axon length?

The total length of cortical axons could be reduced if the parent axons maintained straight trajectories and simply connected to dendritic shafts via spine-like terminaux boutons and to dendritic spines via bead-like en passant boutons. Cortical axons from cat area 17 were reconstructed from serial electron micrographs and their bouton morphology was correlated with their synaptic targets. En passant or terminaux boutons did not differ in the proportion of synapses they formed with dendritic spines and shafts, and thus, the two morphological variants of synaptic bouton do not contribute directly to optimizing axon length.

Aetiology, previous menstrual function and patterns of neuro-endocrine disturbance as prognostic indicators in hypothalamic amenorrhoea

BACKGROUND

Hypothalamic amenorrhoea (HA) is a syndrome associated with infertility and osteopenia in reproductive-age women.

METHODS

To understand better the natural history of this disorder, 28 women participated in a retrospective, questionnaire-based analysis to elucidate factors associated with spontaneous recovery.

RESULTS

54% of subjects developed HA related to an eating disorder, 21% related to stress +/- weight loss, and 25% without obvious contributing factors (idiopathic). HA associated with a clear precipitant had a better prognosis than idiopathic HA (71 versus 29% recovery; P < 0.05). Reversal of the inciting factor appeared necessary but not sufficient for recovery (83% recovery if factor reversed). Normal menarche occurred in 61% of subjects, oligomenorrhoea in 32%, and primary amenorrhoea in 7%. Oligomenorrhoea and normal menarche showed a trend toward better prognosis than primary amenorrhoea (NS). Compared with controls, 46% of HA patients had decreased frequency of LH pulses, 7% decreased amplitude, 18% decreases in both frequency and amplitude, 18% absent pulses, and 11% normal-appearing pulses. Pulse pattern at baseline did not predict recovery.

CONCLUSIONS

The aetiology of HA at the time of presentation predicts subsequent recovery of menstrual function. In stress, weight loss, or eating disorder-related HA, rates of recovery exceeded 80% when precipitating factors were reversed. Idiopathic HA may represent a different disorder as recovery rates were <30%.

Point-of-purchase messages framed in terms of cost, convenience, taste, and energy improve healthful snack selection in a college foodservice setting

OBJECTIVE

To examine the effects of a point-of-purchase (POP) intervention emphasizing various properties of healthful food items on college students' snack purchases.

DESIGN

In Study 1, vegetable baskets (containing cut pieces of vegetables), fruit baskets (containing cut pieces of fruit), pretzels, and yogurt were promoted in separate POP interventions. Food sales were monitored over 2-week baseline, 4-week intervention, and 2-week follow-up periods. In Study 2, yogurt was promoted across a 2-week baseline, 12-week intervention, and 2-week follow-up periods and an intercept survey was conducted.

SUBJECTS/SETTING

Approximately 2,280 university students were potentially exposed to the intervention, and 72 students responded to the intercept survey.

INTERVENTION

POP messages were placed on an 11 x 17-in poster located at the cafeteria entrance, and two 4 x 2.5-in signs placed next to the targeted food item. Messages emphasized the Budget-friendly, Energizing, Sensory/taste, Time efficient/convenient (BEST) stimulus properties of food.

MAIN OUTCOME MEASURES

Daily sales of the targeted food items.

STATISTICAL ANALYSES PERFORMED

Analyses of variance with Tukey post hoc tests were used to compare food sales during the baseline, intervention, and follow-up periods.

RESULTS

In Study 1, yogurt and pretzel sales increased during the intervention and post-intervention periods (P<.05). Interventions had no effect on fruit basket and vegetable basket sales (P>.05), but whole fruit sales increased during the fruit basket intervention and follow-up (P<.05). In Study 2, yogurt sales were significantly greater during the intervention and follow-up periods than at baseline (P<.01).

APPLICATIONS/CONCLUSIONS

Using the BEST properties in POP interventions may be beneficial in promoting the consumption of healthful foods among university students, particularly when the targeted foods are priced comparably to less healthful foods.

Specific factors predict the response to pulsatile gonadotropin-releasing hormone therapy in polycystic ovarian syndrome

Ovulation induction is particularly challenging in patients with polycystic ovarian syndrome (PCOS) and may be complicated by multifollicular development. Pulsatile GnRH stimulates monofollicular development in women with anovulatory infertility; however, ovulation rates are considerably lower in the subgroup of patients with PCOS. The aim of this retrospective study was to determine specific hormonal, metabolic, and ovarian morphological characteristics that predict an ovulatory response to pulsatile GnRH therapy in patients with PCOS. Subjects with PCOS were defined by chronic amenorrhea or oligomenorrhea and clinical and/or biochemical hyperandrogenism in the absence of an adrenal or pituitary disorder. At baseline, gonadotropin dynamics were assessed by 10-min blood sampling, insulin resistance by fasting insulin levels, ovarian morphology by transvaginal ultrasound, and androgen production by total testosterone levels. Intravenous pulsatile GnRH was then administered. During GnRH stimulation, daily blood samples were analyzed for gonadotropins, estradiol (E(2)), progesterone, inhibin B, and androgen levels, and serial ultrasounds were performed. Forty-one women with PCOS underwent a total of 144 ovulation induction cycles with pulsatile GnRH. Fifty-six percent of patients ovulated with 40% of ovulatory patients achieving pregnancy. Among the baseline characteristics, ovulatory cycles were associated with lower body mass index (P < 0.05), lower fasting insulin (P = 0.02), lower 17-hydroxyprogesterone and testosterone responses to hCG (P < 0.03) and higher FSH (P < 0.05). In the first week of pulsatile GnRH treatment, E(2) and the size of the largest follicle were higher (P < 0.03), whereas androstenedione was lower (P < 0.01) in ovulatory compared with anovulatory patients. Estradiol levels of 230 pg/mL (844 pmol/L) or more and androstenedione levels of 2.5 ng/mL (8.7 nmol/L) or less on day 4 and follicle diameter of 11 mm or more by day 7 of pulsatile GnRH treatment had positive predictive values for ovulation of 86.4%, 88.4%, and 99.6%, respectively. Ovulatory patients who conceived had lower free testosterone levels at baseline (P < 0.04). In conclusion, pulsatile GnRH is an effective and safe method of ovulation induction in a subset of patients with PCOS. Patient characteristics associated with successful ovulation in response to pulsatile GnRH include lower body mass index and fasting insulin levels, lower androgen response to hCG, and higher baseline FSH. In ovulatory patients, high free testosterone is negatively associated with pregnancy. A trial of pulsatile GnRH therapy may be useful in all PCOS patients, as E(2) and androstenedione levels on day 4 or follicle diameter on day 7 of therapy are highly predictive of the ovulatory response in this group of patients.

Role of self-presentation in the health practices of a sample of Irish adolescents

The association between self-presentational motives and health behaviors were studied in a sample of 183 Irish adolescents. Among girls, dieters and nonexercisers scored higher on measures of trait self-presentational concern than nondieters and exercisers. Self-presentational concerns were positively correlated with boys' and girls' endorsement of self-presentational motives for certain health practices.

Prevalence, phenotypic spectrum, and modes of inheritance of gonadotropin-releasing hormone receptor mutations in idiopathic hypogonadotropic hypogonadism

Mutations in the GnRH receptor (GNRHR) have been described as a cause of reproductive failure in a subset of patients with idiopathic hypogonadotropic hypogonadism (IHH). Given the apparent rarity of these mutations, we set out to determine the frequency and distribution of GNRHR mutations in a heterogeneous population of patients with IHH who were well characterized with respect to diagnosis, phenotype, and mode of inheritance and to define their distribution within the receptor protein. One hundred and eight probands with IHH were screened for mutations in the coding sequence of GNRHR. Forty-eight of the 108 patients had a normal sense of smell, whereas the remaining 60 had anosmia or hyposmia (Kallmann syndrome). Exon segments in the GNRHR were screened for mutations using temperature gradient gel electrophoresis, and all mutations were confirmed by direct sequencing. Five unrelated probands (3 men and 2 women), all normosmic, were documented to have changes in the coding sequence of the GNRHR. Two of these probands were from a subgroup of 5 kindreds consistent with a recessive mode of inheritance, establishing a GNRHR mutation frequency of 2 of 5 (40%) in patients with normosmic, autosomal recessive IHH. The remaining 3 probands with GNRHR mutations were from a subgroup of 18 patients without evidence of familial involvement, indicating a prevalence of 3 of 18 (16.7%) in patients with sporadic IHH and a normal sense of smell. Among the five individuals bearing GNRHR mutations, a broad spectrum of phenotypes was noted, including testicular sizes in the male that varied from prepubertal to the normal adult male range. Three probands had compound heterozygous mutations, and two had homozygous mutations. Of the eight DNA sequence changes identified, four were novel: Thr(32)Ile, Cys(200)Tyr, Leu(266)Arg, and Cys(279)TYR: COS-7 cells transiently transfected with complementary DNAs encoding the human GNRHR containing each of these four novel mutations failed to respond to GnRH agonist stimulation. We conclude that 1) the spectrum of phenotypes in patients with GNRHR mutations is much broader than originally anticipated; 2) the frequency of GNRHR mutations may be more common than previously appreciated in familial cases of normosmic IHH and infrequent in sporadic cases; and 3) functional mutations of the GNRHR are distributed widely throughout the protein.

Serum and follicular fluid hormone levels during in vitro fertilization after short- or long-course treatment with a gonadotropin-releasing hormone agonist

OBJECTIVE

To examine the impact of flare (short) vs. down-regulation (long) GnRH agonist (GnRH-a) on serum and follicular fluid (FF) LH and androgen concentrations in women undergoing IVF treatment cycles.

DESIGN

Prospective observational study.

SETTING

IVF clinic.

PATIENT(S)

One hundred sixteen ovulatory subjects undergoing IVF.

INTERVENTION(S)

Fifty-eight ovulatory patients undergoing a down-regulation regimen matched with 58 undergoing the flare regimen as part of an IVF cycle.

MAIN OUTCOME MEASURE(S)

Serum concentrations of LH, FSH, Progesterone (P4), Androstenedione (A), T, and E(2) on the day of hCG administration were compared between the two groups. In addition, the FF P4, 17OHP4, A, T, and E(2) levels were compared in the two groups.

RESULT(S)

Serum LH was significantly higher with the flare regimen (15.2 +/- 1.14 IU/L, P<.05) when compared with results with the down-regulation protocol (9.5 +/- 0.77 IU/L). In addition, FF A was significantly higher in the flare protocol (57.3 +/- 13.3 ng/mL, P<.05) compared with in the down-regulation protocol (27 +/- 2.44 ng/mL). Serum and FF P4, 17OH P4, T, and E(2) were not statistically significantly different between the two groups.

CONCLUSION(S)

Serum LH and FF A are significantly higher in the flare regimen in comparison with the down-regulation regimen. Circulating LH appears to play a role in determining FF A concentration.

Perceived importance and satisfaction with physical function in patients with knee osteoarthritis

This investigation examined the determinants of satisfaction with physical function for participants in an Observational Arthritis Study in Seniors (OASIS). The sample consisted of 480 men (51%) and women (49%) over the age of 65 years who had difficulty performing activities of daily living due to knee pain. As part of baseline testing for OASIS, participants completed a measure that assessed satisfaction with function for six physical activities. After controlling for relevant covariates, scores on the satisfaction index were regressed on seven conceptually relevant predictor variables. The results revealed that satisfaction with physical function is a distinct construct from level of function, irrespective of whether the latter variable is measured objectively or subjectively. When entered into a hierarchical regression model, 6-minute walk test data accounted for 11% of the variance in satisfaction scores, whereas perceived difficulty accounted for an additional 22%. Moreover, a significant interaction term between importance and perceived difficulty revealed that patients who rated the activities as important and who had high levels of perceived difficulty had the lowest satisfaction scores. Discussion focuses on the determinants of satisfaction with physical function with emphasis on the interaction between perceived difficulty and importance.

Regulation of ribosomal S6 kinase 2 by effectors of the phosphoinositide 3-kinase pathway

Ribosomal S6 kinase (S6K1), through phosphorylation of the 40 S ribosomal protein S6 and regulation of 5'-terminal oligopyrimidine tract mRNAs, is an important regulator of cellular translational capacity. S6K1 has also been implicated in regulation of cell size. We have recently identified S6K2, a homolog of S6K1, which phosphorylates S6 in vitro and is regulated by the phosphatidylinositide 3-kinase (PI3-K) and mammalian target of rapamycin pathways in vivo. Here, we characterize S6K2 regulation by PI3-K signaling intermediates and compare its regulation to that of S6K1. We report that S6K2 is activated similarly to S6K1 by the PI3-K effectors phosphoinositide-dependent kinase 1, Cdc42, Rac, and protein kinase Czeta but that S6K2 is more sensitive to basal activation by myristoylated protein kinase Czeta than is S6K1. The C-terminal sequence of S6K2 is divergent from that of S6K1. We find that the S6K2 C terminus plays a greater role in S6K2 regulation than does the S6K1 C terminus by functioning as a potent inhibitor of activation by various agonists. Removal of the S6K2 C terminus results in an enzyme that is hypersensitive to agonist-dependent activation. These data suggest that S6K1 and S6K2 are similarly activated by PI3-K effectors but that sequences unique to S6K2 contribute to stronger inhibition of its kinase activity. Understanding the regulation of the two S6K homologs may provide insight into the physiological roles of these kinases.

Ribosomal S6 kinase 2 inhibition by a potent C-terminal repressor domain is relieved by mitogen-activated protein-extracellular signal-regulated kinase kinase-regulated phosphorylation

Ribosomal S6 kinase 2 (S6K2) is a recently identified serine/threonine protein kinase that phosphorylates the 40 S ribosomal protein S6 in vitro. S6K2 is highly homologous to S6K1 in the core kinase and linker regulatory domains but differs from S6K1 in the N- and C-terminal regions and is differently localized primarily to the nucleus because of a C-terminal nuclear localization signal unique to S6K2. We have recently demonstrated that S6K2 is regulated similarly to S6K1 by the mammalian target of rapamycin pathway and by multiple PI3-K pathway effectors in vivo. However, deletion of the C-terminal domain of S6K2 enhances kinase activity, whereas analogous deletion of S6K1 is inhibitory. Here, we characterize the S6K2 C-terminal motifs that confer this differential regulation. We demonstrate that the inhibitory effects of the S6K2 C-terminal domain are only partly attributable to the nuclear localization signal but that three C-terminal proline-directed potential mitogen-activated protein kinase phosphorylation sites are critical mediators of this inhibitory effect. Site-specific mutation of these sites to alanine completely desensitizes S6K2 to activating inputs, whereas mutation to aspartic acid to mimic phosphorylation results in an activated enzyme which is hypersensitive to activating inputs. Pretreatment of cells with the mitogen-activated protein-extracellular signal-regulated kinase kinase (MEK) inhibitor U0126 inhibited S6K2 activation to a greater extent than S6K1. Furthermore, S6K2 mutants with C-terminal deletion or acidic phosphorylation site mutations displayed greatly reduced U0126 sensitivity. Thus, MEK-dependent inputs to C-terminal phosphorylation sites appear to be essential for relief of S6K2 inhibition but less critical for activation of S6K1. These data suggest a mechanism by which weak PI3-K agonists can regulate S6 phosphorylation and selective translation in the presence of mitogen-activated protein kinase signaling.

Who will adhere? Key issues in the study and prediction of adherence in randomized controlled trials

Adherence determinants and key adherence research issues are discussed for three types of randomized controlled trials: pharmacological, dietary, and physical activity. This article highlights theoretical and methodological limitations that have hampered the ability to identify patients at risk for poor treatment compliance. Control Clin Trials 2000;21:195S-199S

Decrease in gonadotropin-releasing hormone (GnRH) pulse frequency with aging in postmenopausal women

Increasing evidence suggests that aging is associated with dynamic changes in the hypothalamic and pituitary components of the reproductive axis that are independent of changes in gonadal hormone secretion. This study was designed to determine the effect of age on GnRH pulse frequency in women in the absence of gonadal feedback using gonadotropin free alpha-subunit (FAS) and LH as neuroendocrine markers of endogenous GnRH secretion. All studies were performed in healthy, euthyroid postmenopausal women (PMW) during daytime hours. The impact of sampling interval and duration on assessment of pulse frequency in PMW was first examined in 10 women with a mean age of 61.6 +/- 8 yr (mean +/- SD), in whom blood was sampled every 5 min for 12 h. Each 5-min series was then reduced to simulate a 10-min series and then a 15-min series for pulse analysis, and the effect of 8 h compared with 12 h of sampling was determined. To define the changes in the frequency and amplitude of pulsatile hormone secretion with aging, 11 younger (45-55 yr) and 11 older (70-80 yr) PMW were then studied over 8 h at a 5-min sampling interval. In the initial series, the mean interpulse intervals (IPIs) for FAS were 53.8 +/- 3.6, 69.2 +/- 3.9, and 87.6 +/- 7.3 min at sampling intervals of 5, 10, and 15 min, respectively (P < 0.0005). The LH IPI also increased progressively with sampling intervals of 5, 10, and 15 min (54.4 +/- 2.5, 70.4 +/- 2.3, and 91.1 +/- 4.4 min; P < 0.0001). At the 5-min sampling interval, the calculated number of pulses/24 h was not different between a 12-h series compared with an 8-h series for either FAS or LH. In the second series of studies, the older PMW had lower gonadotropin levels (LH, 86.5 +/- 8.8 vs. 51.3 +/- 7.7 IU/L, P < 0.01; FSH, 171.6 +/- 16.9 vs. 108.2 +/- 10.5 IU/L, P < 0.005; FAS, 1021.5 +/- 147.4 vs. 425.6 +/- 89.6 ng/L, P < 0.005, in younger and older PMW, respectively) despite no differences in estrone or estradiol levels. The older PMW also demonstrated a slower FAS pulse frequency compared with their younger counterparts, as reflected in an increased FAS IPI (52.6 +/- 3.1 and 70.6 +/- 5.9 min; P < 0.002). The difference in IPIs between younger and older PMW was not statistically significant for LH (65.4 +/- 5.6 and 71.8 +/- 6.6 min for younger and older PMW, respectively). FAS pulse amplitude was decreased in older PMW compared with younger PMW (431.7 +/- 66.2 vs. 224.6 +/- 81.9 ng/L; P < 0.01), whereas the decrease in LH pulse amplitude with age was of borderline statistical significance (23.2 +/- 3.1 vs. 15.9 +/- 2.1 IU/L; P = 0.09).

IN CONCLUSION

1) the use of a 5-min sampling interval and measurement of FAS as the primary marker of GnRH pulse generator activity indicate that GnRH pulse frequency in younger PMW is faster than previously reported, but not increased over that seen in the late follicular phase and midcycle surge in women with intact ovarian function; and 2) the marked decrease in FAS pulse frequency with age provides evidence of age-related changes in the hypothalamic component of the reproductive axis that are independent of changes in gonadal function.