Study of DNA Damage-Induced MSI1 Serine-347 Phosphorylation in Regulation of Radiosensitivity in Glioblastoma Multiforme

PURPOSE/OBJECTIVE(S)

Despite the growing therapeutic techniques, Glioblastoma Multiforme (GBM) patients have limited survival due to the location and malignancies of tumor burdens. Radiotherapy is one of the common treatments with maximal surgery and chemotherapy. However, the often radioresistance occurred in GBM results in recurrence and marginal disease control. Therefore, the medical need remains unmet to treat GBM efficiently. Musashi-1 (MSI1) is one of the RNA-binding proteins known for its high oncogenicity in many cancers, including GBM. MSI1 is highly expressed in tumors and abundant in tumorigenic cancer cells. However, the relationship between MSI1 and GBM radioresistance is still largely unknown.

MATERIALS/METHODS

Three human GBM cell lines, U87-MG, 05MG, and S1R1, were used in vitro, and an orthotopic nude mouse GBM model was employed in vivo. Phos-Tag blotting and phospho-MSI1 (Ser 347) antibody helped to detect the phosphorylation level of MSI1. Ultra-low attachment dishes and 3D cell culture were performed for the tumor initiation study. Flow cytometry, immunohistochemistry staining, and confocal microscope with immunofluorescent staining provide respective biomarker expressions.

RESULTS

We initiated our study by inducing DNA damage on GBM cell lines using ionizing radiation and an alkylating agent. With Phos-Tag and NetPhos3.1 prediction, we hypothesized that a novel phosphorylation site on MSI1 serine-347 (S347) may sense DNA damage events. To unveil the molecular mechanism, we found DNA-dependent protein kinase catalytic subunits (DNA-PKcs), one of the DNA damage repair components, physically interacted with MSI1 in the role of a kinase. We suggest that activated DNA-PKcs may phosphorylate MSI1-S347, leading to enhanced oncogenicity and subsequent malignancies. Wild-type MSI1-overexpressing GBM cells (MSI1-WT) showed better colony and sphere-forming ability, whereas loss-of-function mutation S347A deprived the oncogenic behaviors. Besides, S347A limited the cancer initiation in the orthotopic animal model compared with MSI1-WT, suggesting that phosphorylation of MSI1-S347 promotes GBM tumorigenicity both in vitro and in vivo. In addition, we noticed that CD133 (Prominin-1), a well-characterized cancer stem-like cell marker, accompanied MSI1-WT introduction but was not seen in S347A cells. Intriguingly, we identified a few members of the let-7 microRNA family, including let-7b, 7e, and 7i, who were rescued by the S347A mutation and correspondingly expressed with CD133 levels and tumorigenic abilities.

CONCLUSION

This study explains a vital relationship between GBM radioresistance and a novel oncogenic post-translational modification on MSI1 S347. IR-induced DNA damage triggers DNA-PKcs activation that subsequently phosphorylates MSI1-S347, enhancing GBM tumorigenicity via let-7 pathway. Further studies on the potential regulators, either inhibiting DNA-PKcs or antagonizing agents, may provide GBM patients with an optimistic outcome.

[Efficacy and safety of anti-PD-1 monoclonal antibody in advanced hepatocellular carcinoma after TACE combined with TKI therapy]

Objective: To evaluate the efficacy and safety of anti-programmed cell death 1 (PD-1) receptor monoclonal antibody (MoAb) in patients with advanced hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemoembolization (TACE) combined with tyrosine kinase inhibitor (TKI). Methods: From February 2019 to February 2020, 56 HCC patients who relapsed after TACE-TKI treatment in Department of Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University were enrolled. All patients received anti-PD-1 MoAb (sintilimab injection) and followed up every 6 weeks. According to mRECIST, the curative effect was evaluated as complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). Objective response rate (ORR) and disease control rate (DCR), progression-free survival (PFS) and treatment-related adverse events (TRAEs) were recorded. Univariate analysis by Chi-square test and binary logistic regression model was used to determine the influencing factors of DCR. The Kaplan-Meier method and Cox proportional hazard regression model were used to analyze the survival data. Results: A total of 48 patients were enrolled in this study including 42 males and 6 females, with a median age of 55 years (29-71 years). ECOG scores comprised of 0 in 24 cases, 1-2 in 24 cases. Thirty-six patients were in Child-Pugh grade A of liver function and 12 cases were grade B. The median follow-up time was 4.5 months. There were 2 patients achieved CR, 12 patients with PR and 16 with SD. ORR was 29.2%, DCR was 62.5%. The independent influencing factors of DCR was ECOG score and AFP level (P=0.031, P=0.012). Median PFS was 4.1 months (95%CI 2.7-5.4 months), and ECOG score was the independent influencing factor of PFS (P=0.042). Treatment-related adverse events were reported in 70.8% (34/48) patients. Incidence of grade Ⅲ-Ⅳ TRAEs was 22.9% (11/48). Conclusion: In patients with HCC who relapse from TACE and TKI treatment, anti-PD-1 monoclonal antibody is efficacious safe especially in those with ECOG 0 score.

Global White Matter Hypoperfusion on CT Predicts Larger Infarcts and Hemorrhagic Transformation after Acute Ischemia

INTRODUCTION

Presence of white matter hyperintensity (WMH) on MRI is a marker of cerebral small vessel disease and is associated with increased small vessel stroke and increased risk of hemorrhagic transformation (HT) after thrombolysis.

AIM

We sought to determine whether white matter hypoperfusion (WMHP) on perfusion CT (CTP) was related to WMH, and if WMHP predisposed to acute lacunar stroke subtype and HT after thrombolysis.

METHODS

Acute ischemic stroke patients within 12 h of symptom onset at 2 centers were prospectively recruited between 2011 and 2013 for the International Stroke Perfusion Imaging Registry. Participants routinely underwent baseline CT imaging, including CTP, and follow-up imaging with MRI at 24 h.

RESULTS

Of 229 ischemic stroke patients, 108 were Caucasians and 121 Chinese. In the contralateral white matter, patients with acute lacunar stroke had lower cerebral blood flow (CBF) and cerebral blood volume (CBV), compared to those with other stroke subtypes (P = 0.041). There were 46 patients with HT, and WMHP was associated with increased risk of HT (R(2) = 0.417, P = 0.002). Compared to previously reported predictors of HT, WMHP performed better than infarct core volume (R(2) = 0.341, P = 0.034), very low CBV volume (R(2) = 0.249, P = 0.026), and severely delayed perfusion (Tmax>14 second R(2) = 0.372, P = 0.011). Patients with WMHP also had larger acute infarcts and increased infarct growth compared to those without WMHP (mean 28 mL vs. 13 mL P < 0.001).

CONCLUSION

White matter hypoperfusion remote to the acutely ischemic region on CTP is a marker of small vessel disease and was associated with increased HT, larger acute infarct cores, and greater infarct growth.

An initial assessment of the feasibility and effectiveness of implementing diabetes shared care system in Taiwan--some experiences from I-Lan County

Diabetes is the fifth leading cause of death in Taiwan and the burden of suffering is still increasing. Building a comprehensive and efficient health care system is crucial to improve the outcome of the diabetics. We implemented the first diabetes shared care system of Taiwan in I-Lan County since August 1996 under the support of Department of Health, the Executive Yuan. This county-wide system was named 'Lan-Yang Diabetes Shared Care System' by the regional steering committee. Regional guidelines for diabetes management were developed after extensive discussion. A multidisciplinary diabetes care team was organized through a training and certification process. Registered patients held diabetes passports to keep clinical record. Physicians of the system use shared referral protocols and sheets. By the end of June 1999, 99 medical professionals had completed their training for diabetes shared care and been certified. The shared care system awarded 26 clinics to hang the lamp signs with the system logo to make them distinguishable. Such clinics have now been available throughout 12 townships in I-Lan County. The number of registered patients carrying diabetes passport increased to 3484 and there was a community-based patient group in every township of I-Lan County. The amount of continuing diabetes clinical training delivered by the specialists to the primary care physicians and non-physician professionals increased to 1681 person-hours per year. The proportion of registered patients undertaking fundus examination within 1 year increased to 30.9%, checking urine micro-albumin to 28.0% and checking HbA(1c) 72.8%, respectively. Mean HbA(1c) value decreased from 8.7% in the first year to 7.9% in the third year. Our study showed that under the co-ordination by regional health bureau with integration of different levels of medical facilities, governmental sectors and non-governmental community resources, the diabetes shared care model is feasible in Taiwan. Through its implementation, quality of regional diabetes care has achieved preliminary improvement.

Electrophysiological basis for antiarrhythmic efficacy, positive inotropy and low proarrhythmic potential of (-)-caryachine

1. (-)-Caryachine, isolated from the plant (Cryptocarya chinensis), increased the contractility of atrial and right ventricular strips and significantly suppressed the reperfusion arrhythmias in adult rabbit heart (ED50 = 1.27 microM). 2. Data obtained by the whole-cell voltage clamp technique has shown that (-)-caryachine causes a negative shift of the steady-state Na channel inactivation and a slower rate of recovery from inactivation. The maximal Na current amplitude decreased to 67 +/- 7%, 29 +/- 8% and 12 +/- 5% after 0.5, 1.5 and 4.5 microM (-)-caryachine, respectively. 3. This agent also had effects on the time- and voltage-dependent K currents. (-)-Caryachine markedly suppressed the 4-AP-sensitive transient outward current (I10). However, it produced very little voltage-dependent shift in inactivation. After 0.5, 1.5 and 4.5 microM of the compound, the respective value of I10 elicited at +60 mV was 80 +/- 7%, 45 +/- 8% and 15 +/- 3%. At higher concentrations, the inward rectifier K current (IK1) was also inhibited but to a much smaller extent. Its slope conductance after 0.5, 1.5 and 4.5 microM (-)-caryachine was reduced to 71 +/- 9%, 51 +/- 12% and 42 +/- 11%, respectively. The outward hump of inward rectification was not changed. 4. In contrast, the L-type Ca current was not significantly changed by (-)-caryachine. 5. Electrophysiological studies in perfused whole heart preparations revealed that (-)-caryachine increased the intra-atrial conduction interval and also prolonged the atrial refractory period. No proarrhythmic effects were induced during the infusion of this compound (up to 13.5 microM). 6. We conclude that (-)-caryachine predominantly blocks the Na and I10 currents. These changes alter the electrophysiological properties of the heart and terminate the induced ventricular arrhythmias. The relatively selective I10 inhibition, safety margin of Ik1 suppression and lack of effect on Ica-L will provide an opportunity to develop an effective antiarrhythmic agent with positive inotropy as well as low proarrhythmic potential.

Effect of pentoxifylline on intraperitoneal adhesions after intestinal resection in rats

Pentoxifylline, an analogue of the methylxanthine theobromine, inhibits glycosaminoglycan and collagen synthesis by dermal fibroblasts in vitro and also inhibits the proliferation of dermal fibroblasts. It may have the same effect on fibroblasts derived from postoperative adhesion bands, thus preventing postoperative adhesion formation. An animal model was developed to evaluate the effect of pentoxifylline. Twenty-four male Wistar rats were divided into four groups, and all underwent laparotomy with a 15 cm intestinal resection and reanastomosis. The intestinal serosa was scratched to induce adhesion formation. No medication was given in group 1 rats, group 2 rats received 6 mL normal saline by intraoperative peritoneal irrigation, group 3 rats received 6 mL pentoxifylline solution (1 mg/mL) by intraperitoneal irrigation and group 4 rats received both 6 mL intraoperative pentoxifylline solution (1 mg/mL) irrigation and 50 mg/kg pentoxifylline by intramuscular injection, twice a day for 14 days. All rats were sacrificed 2 weeks later. The numbers of fibrous bands at and away from the anastomotic site were recorded and scored. The score for each rat was calculated as the sum of the scores for each band. The strength and the extent of the fibrous bands were also measured and compared. The scores of adhesion bands at the anastomotic site were significantly reduced in group 3 and group 4 rats when compared with group 1 rats. However, there were no significant differences among the 4 groups in the extent and strength of adhesions at sites other than the anastomosis site.

Nuclear transplantation in teleosts. Hybrid fish from the nucleus of crucian and the cytoplasm of carp

Hybrid fish are obtained from the combination of nucleus and cytoplasm from two genera of fresh-water teleosts using the technique of nuclear transplantation (i.e. the combination of the nucleus of crucian (Carassius auratus) and the cytoplasm of carp (Cyprinus carpio]. Morphological characteristics of these hybrid fish that have been examined so far indicate that some features such as barbs, pharyngeal teeth, the number of scales along the lateral line, and the number of vertebrae are similar to those of crucian. Some of the hybrid fish grow to normal adult fish.