Large-Scale Prospective Genome-Wide Association Study of Oxaliplatin in Stage II/III Colon Cancer and Neuropathy

IMPORTANCE

The severity of oxaliplatin (L-OHP)-induced peripheral sensory neuropathy (PSN) exhibits substantial interpatient variability, and some patients suffer from long-term, persisting PSN.

OBJECTIVE

To identify single-nucleotide polymorphisms (SNPs) predicting L-OHP-induced PSN using a genome-wide association study (GWAS) approach.

DESIGN, SETTING, PARTICIPANTS

A large prospective GWAS including 1,379 patients with stage II/III colon cancer who received L-OHP-based adjuvant chemotherapy (mFOLFOX6/CAPOX) under the phase II (JOIN/JFMC41) or the phase III (ACHIVE/JFMC47) trial.

MAIN OUTCOMES AND MEASURES

First, GWAS comparison of worst grade PSN (grade 0/1 vs. 2/3) was performed. Next, to minimize the impact of ambiguity in PSN grading, extreme PSN phenotypes were selected and analyzed by GWAS. SNPs that could predict time to recovery from PSN were also evaluated. In addition, SNPs associated with L-OHP-induced allergic reactions (AR) and time to disease recurrence were explored.

RESULTS

No SNPs exceeded the genome-wide significance (p < 5.0 × 10^-8) in either GWAS comparison of worst grade PSN, extreme PSN phenotypes, or time to recovery from PSN. Association study focusing on AR or time to disease recurrence also failed to reveal any significant SNPs.

CONCLUSION AND RELEVANCE

Our results highlight the challenges of utilizing SNPs for predicting susceptibility to L-OHP-induced PSN in daily clinical practice.

Multifaceted properties of Andreev bound states: interplay of symmetry and topology

Andreev bound states (ABSs) ubiquitously emerge as a consequence of non-trivial topological structures of the order parameter of superfluids and superconductors and significantly contribute to thermodynamics and low-energy quantum transport phenomena. We here share the current status of our knowledge on their multifaceted properties such as Majorana fermions and odd-frequency pairing. A unified concept behind ABSs originates from a soliton state in the one-dimensional Dirac equation with mass domain wall and interplay of ABSs with symmetry and topology enrich their physical characteristics. We make an overview of ABSs with a special focus on superfluid 3He. The quantum liquid confined to restricted geometries serves as a rich repository of noteworthy quantum phenomena, such as the mass acquisition of Majorana fermions driven by spontaneous symmetry breaking, topological quantum criticality, Weyl superfluidity and the anomalous magnetic response. The marriage of the superfluid 3He and nano-fabrication techniques will take one to a new horizon of topological quantum phenomena associated with ABSs.This article is part of the theme issue 'Andreev bound states'.

Zidovudine, an anti-viral drug, resensitizes gemcitabine-resistant pancreatic cancer cells to gemcitabine by inhibition of the Akt-GSK3β-Snail pathway

Pancreatic cancer is one of the most difficult malignancies to treat owing to the rapid acquisition of resistance to chemotherapy. Gemcitabine, a first-line treatment for pancreatic cancer, prolongs patient survival by several months, and combination treatment with gemcitabine and other anti-cancer drugs in the clinic do not show any significant effects on overall survival. Thus, identification of a drug that resensitizes gemcitabine-resistant pancreatic cancer to gemcitabine and a better understanding of the molecular mechanisms of gemcitabine resistance are critical to develop new therapeutic options for pancreatic cancer. Here, we report that zidovudine resensitizes gemcitabine-resistant pancreatic cancer to gemcitabine as shown by screening a compound library, including clinical medicine, using gemcitabine-resistant cells. In analyzing the molecular mechanisms of zidovudine effects, we found that the epithelial-to-mesenchymal transition (EMT)-like phenotype and downregulation of human equilibrative nucleoside transporter 1 (hENT1) are essential for the acquisition of gemcitabine resistance, and zidovudine restored these changes. The chemical biology investigations also revealed that activation of the Akt-GSK3β-Snail1 pathway in resistant cells is a key signaling event for gemcitabine resistance, and zidovudine resensitized resistant cells to gemcitabine by inhibiting this activated pathway. Moreover, our in vivo study demonstrated that co-administration of zidovudine and gemcitabine strongly suppressed the formation of tumors by gemcitabine-resistant pancreatic cancer and prevented gemcitabine-sensitive pancreatic tumors from acquiring gemcitabine-resistant properties, inducing an EMT-like phenotype and downregulating hENT1 expression. These results suggested that co-treatment with zidovudine and gemcitabine may become a novel therapeutic strategy for pancreatic cancer by inhibiting chemoresistance-specific signaling.

eNOS plays an important role in the regulation of colonic inflammation: a novel therapeutic target and a predictive marker for the prognosis of ulcerative colitis

BACKGROUND

We reported that deficiency of the eNOS protein exacerbates colitis induced by dextran sodium sulfate (DSS-induced colitis). However, the role of eNOS in colitis remains controversial. Therefore, we studied how over-expression of eNOS affected this inflammatory condition, using vascular endothelial cells and mice as in vitro and in vivo models, respectively. Furthermore, we investigated the influence of a polymorphism in the eNOS gene on the clinical features of ulcerative colitis (UC).

METHODS

We examined the effect of eNOS overexpression on the expression of adhesion molecules in the endothelium and assessed the degree of DSS-induced colitis in eNOS transgenic (eNOS-Tg) mice. We also investigated the relationship between a polymorphism in the eNOS gene and clinical features of patients with UC.

RESULTS

The expression of adhesion molecules, under inflammatory conditions, was attenuated in eNOS gene-transfected vascular endothelial cells, as measured by western blot analysis. Symptoms of DSS-induced colitis were likewise attenuated in eNOS-Tg mice, which exhibited lower weight loss, mortality, histological damage (by inflammation score and crypt damage score), and colonic myeloperoxidase activity, tumor necrosis factor-α expression, and MAdCAM-1 expression than in wild-type mice. Furthermore, there was a significant relationship between intractable cases of UC and a polymorphism in the eNOS gene promoter (c.-786 T > C) that decreases eNOS expression.

CONCLUSION

The eNOS gene plays an important role in the regulation of colonic inflammation. The level of eNOS expression may be a predictive marker for prognosis of UC, and eNOS expression may be a novel therapeutic target.

Early skin toxicity predicts better outcomes, and early tumor shrinkage predicts better response after cetuximab treatment in advanced colorectal cancer

Cetuximab-containing treatments for metastatic colorectal cancer have been shown to have higher overall response rates and longer progression-free and overall survival than other systemic therapies. Cetuximab-related manifestations, including severe skin toxicity and early tumor shrinkage, have been shown to be predictors of response to cetuximab. We hypothesized that early skin toxicity is a predictor of response and better outcomes in patients with advanced colorectal carcinoma. We retrospectively evaluated 62 patients with colorectal adenocarcinoma who had unresectable tumors and were treated with cetuximab in our institution. Skin toxicity grade was evaluated on each treatment day. Tumor size was evaluated using computed tomography prior to treatment and 4-8 weeks after the start of treatment with cetuximab.Patients with early tumor shrinkage after starting treatment with cetuximab had a significantly higher overall response rate (P = 0.0001). Patients with early skin toxicity showed significantly longer overall survival (P = 0.0305), and patients with higher skin toxicity grades had longer progression-free survival (P = 0.0168).We have shown that early tumor shrinkage, early onset of skin toxicity, and high skin toxicity grade are predictors of treatment efficacy and/or outcome in patients with advanced colorectal carcinoma treated with cetuximab.

Acid inhibits TRPV4-mediated Ca²⁺ influx in mouse esophageal epithelial cells

BACKGROUND

The transient receptor potential vanilloid 4 (TRPV4), a thermo-sensitive stretch-activated cation channel, is expressed in the skin stratified squamous epithelium, contributing to the acquisition of barrier function. Similarly, functional TRPV4 may be located in the stratified squamous epithelial lining of the esophagus, being involved in the pathogenesis of gastroesophageal reflux disease (GERD). Here we investigated the expression of TRPV4 in the mouse esophageal epithelium.

METHODS

TRPV4 expression at the mRNA and protein levels was examined by reverse transcription-polymerase chain reaction (RT-PCR), in situ hybridization, and immunohistochemistry. A calcium imaging technique and ATP assay were used to evaluate the functionality of TRPV4 in freshly isolated esophageal epithelial cells.

KEY RESULTS

Transcripts and proteins encoding TRPV4 were colocalized in the basal and intermediate layers of the esophageal epithelium. Both 4α-phorbol 12,13- didecanoate (4α-PDD), a selective agonist for TRPV4, and hypo-osmolar solution (160 mOsm) elevated the intracellular calcium concentration ([Ca(2+) ](i) ) in a subset of the isolated cells (70%). These [Ca(2+) ](i) increases were potently inhibited by ruthenium red (RuR), a TRPV4 channel antagonist, and were suppressed by extracellular protons (pH 5.0). Finally, application of 4α-PDD evoked ATP release in primary esophageal epithelial cells.

CONCLUSIONS & INFERENCES

Acid-sensitive TRPV4 channels were mainly expressed in the esophageal epithelial cells of the basal and intermediate layers. Direct exposure of TRPV4-expressing cells to gastric acid, as would occur in cases of GERD, could influence their cellular functions, possibly aggravating the disease state.

Outcome of initially unresectable advanced and metastatic colorectal cancer patients treated with first-line mFOLFOX6 followed by surgical tumor removal of metastases: Preliminary results of a phase II trial

e15122

Objective: The aim of this study was to evaluate the efficacy and tolerability of treatment with mFOLFOX6 followed by surgical tumor removal in patients (pts) with initially unresectable liver metastases and/or extrahepatic disease from colorectal cancer (CRC). Methods: This study was a multicenter, open-label clinical trial. Eligibility criteria defined pts with advanced and metastatic CRC deemed not optimally resectable. mFOLFOX6 (oxaliplatin 85 mg/m2, l-leucovorin 200 mg/m2, and fluorouracil [400 mg/m2 bolus followed by 2,400mg /m2 as a continuous 46-hour infusion]) was administered every 2 weeks for a maximum of 10 cycles. Resectability was the primary end point. Results: 26 pts (15M/11F; PS 0/1 19/7; median age: 60 years, rage 37–73) received 181cycles (median 7, range, 3–10) of mFOLFOX6. Main unresectable lesions were liver metastases in 10 pts and extrahepatic disease in 16 pts. Eleven pts (42%) had at least one grade 3 or greater adverse events. Sixteen pts (61%) achieved an objective response to mFOLFOX6 and 8 pts (31%) had a best overall response of stable disease. In 16 of these 24 pts who achieved the disease control, surgical tumor removal was performed (resectability 61%). The main reasons for initial unresectability in these 16 pts were the presence of liver metastases (6 pts), para-aortic lymph-node metastases (4 pts), carcinomatous peritonitis (4 pts), direct invasion to neighboring organ (2 pts). Four complications (25%) which were anastomotic leak, wound infection, chylous ascites, and cholangitis, were observed. At a median follow-up of 13 months (range 5 -21), 5 pts had relapsed after surgical tumor removal. The median time to progression (TTP) of the pts who underwent operation is not reached to date and those who did not undergo surgical removal is 8.6 months (log-rank p<0.05). Conclusions: Our data suggest that mFOLFOX6 has a significant antitumor activity in pts with not only liver metastases but also extrahepatic disease from CRC, allowing for successful resection of disease in a portion of pts initially not judged to be optimally resectable.

No significant financial relationships to disclose.

Role of the Majorana fermion and the edge mode in chiral superfluidity near a p-wave Feshbach resonance

The visualization of chiral p-wave superfluidity in Fermi gases near p-wave Feshbach resonances is theoretically examined. It is proposed that the superfluidity becomes detectable in the entire BCS-BEC regimes through (i) vortex visualization by the density depletion inside the vortex core and (ii) intrinsic angular momentum in vortex-free states. It is revealed that both (i) and (ii) are closely connected with the Majorana zero energy mode of the vortex core and the edge mode, which survive until the strong coupling BCS regime is approached from the weak coupling limit and vanish in the Bose-Einstein condensation regime.

Majorana bound state in rotating superfluid 3He-A between parallel plates

A concrete and experimentally feasible example for testing the putative Majorana zero-energy state bound in a vortex is theoretically proposed for a parallel plate geometry of superfluid 3He-A phase. We examine the experimental setup in connection with ongoing rotating cryostat experiments. The theoretical analysis is based on the well-established Ginzburg-Landau functional, supplemented by microscopic calculations of the Bogoliubov-de Gennes equation, both of which allow the precise location of the parameter regions of the Majorana state to be found in realistic situations.

Kelvin waves of quantized vortex lines in trapped Bose-Einstein condensates

We have theoretically investigated Kelvin waves of quantized vortex lines in trapped Bose-Einstein condensates. Counterrotating perturbation induces an elliptical instability to the initially straight vortex line, driven by a parametric resonance between a quadrupole mode and a pair of Kelvin modes of opposite momenta. Subsequently, Kelvin waves rapidly decay to longer wavelengths emitting sound waves in the process. We present a modified Kelvin wave dispersion relation for trapped superfluids and propose a simple method to excite Kelvin waves of specific wave number.

Spinor dipolar bose-einstein condensates: classical spin approach

Bose-Einstein condensates which are dominated by magnetic dipole-dipole interaction are discussed under spinful situations. We treat the spin degrees of freedom as a classical spin vector, approaching from the large spin limit to obtain an effective minimal Hamiltonian. This is a version extended from a nonlinear sigma model. By solving the Gross-Pitaevskii equation, we find several novel spin textures where the mass density and spin density are strongly coupled, depending upon trap geometries due to the long-range and anisotropic natures of the dipole-dipole interaction.

Therapeutic effect of a new immunosuppressive agent, everolimus, on interleukin-10 gene-deficient mice with colitis

A limited number of therapeutic strategies are currently available for patients with inflammatory bowel disease (IBD). In particular, the maintenance therapy after remission in Crohn's disease (CD) is not satisfactory and new approaches are needed. Interleukin-10 gene-deficient (IL-10-/-) mice, a well-characterized experimental model of CD, develop severe chronic colitis due to an aberrant Th1 immune response. Everolimus, an inhibitor of the mammalian target of rapamycin (mTOR), a new immunosuppressive reagent, has been used successfully in animal models for heart, liver, lung and kidney transplantation. In the present study, we examined the efficacy of everolimus in the treatment of chronic colitis in an IL-10-/- mouse model. Everolimus was administered orally for a period of 4 weeks to IL-10-/- mice with clinical signs of colitis. The gross and histological appearances of the colon and the numbers, phenotype and cytokine production of lymphocytes were compared with these characteristics in a control group. The 4-week administration of everolimus resulted in a significant decrease in the severity of colitis, together with a significant reduction in the number of CD4+ T cells in the colonic lamina propria as well as IFN-gamma production in colonic lymphocytes. Everolimus treatment of established colitis in IL-10-/- mice ameliorated the colitis, probably as a result of decreasing the number of CD4+ T cells in the colonic mucosa and an associated reduction in IFN-gamma production.

Various stress proteins protect gastric mucosal cells against non-steroidal anti-inflammatory drugs

Gastric mucosal cell death induced by non-steroidal anti-inflammatory drugs (NSAIDs) is suggested to be involved in NSAID-induced gastric lesions. Therefore, cellular factors that suppress this cell death are important for protection of the gastric mucosa from NSAIDs. When cells are exposed to various stressors, including NSAIDs, they induce a number of proteins, so-called stress proteins, in order to protect themselves against such stressors. Stress proteins contain cytosolic molecular chaperons (such as heat shock proteins), endoplasmic reticulum molecular chaperons (such as glucose-regulated proteins) and heme oxygenase-1. We recently showed that (i) these stress proteins are up-regulated by NSAIDs both in vitro and in vivo; (ii) these up-regulation make gastric mucosal cells resistant to NSAIDs in vitro; (iii) these up-regulation protects the gastric mucosa from NSAID-induced gastric lesions in vivo. In this review, I summarize these results and propose that non-toxic inducers of these stress proteins are therapeutically beneficial as anti-ulcer drugs.

Vortex-core structure in neutral fermion superfluids with population imbalance

Quantized vortex-core structure is theoretically investigated in fermion superfluids with population imbalance for two atom species of neutral atom clouds near a Feshbach resonance. In contrast with the vortex core in balance case where the quantum depletion makes a vortex visible through the density profile measurement, the vortex core is filled in and becomes less visible because the quantized discrete bound states are occupied exclusively by the majority species. Yet it is shown that the core can be visible through the minority density profile experiment using phase contrast imaging, revealing an interesting opportunity to examine low-lying fermionic core bound states unexplored so far.

Generic phase diagram of Fermion superfluids with population imbalance

It is shown by microscopic calculations for trapped imbalanced Fermi superfluids that the gap function always has sign changes, i.e., the Fulde-Ferrell-Larkin-Ovchinnikov (FFLO)-like state, up to a critical imbalance P(c), beyond which normal state becomes stable, at temperature T=0. A temperature-versus-pressure phase diagram is constructed, where the BCS state without sign change is stable only at T not equal to 0. We reproduce the observed bimodality in the density profile to identify its origin and evaluate P(c) as functions of T and the coupling strength. These dependencies match with the recent experiments.

Celecoxib upregulates endoplasmic reticulum chaperones that inhibit celecoxib-induced apoptosis in human gastric cells

Nonsteroidal anti-inflammatory drugs (NSAIDs) induce apoptosis in cancer cells and this effect is involved in their antitumor activity. We recently demonstrated that NSAIDs upregulate GRP78, an endoplasmic reticulum (ER) chaperone, in gastric mucosal cells in primary culture. In the present study, induction of ER chaperones by NSAIDs and the effect of those chaperones on NSAID-induced apoptosis were examined in human gastric carcinoma cells. Celecoxib, an NSAID, upregulated ER chaperones (GRP78 and its cochaperones ERdj3 and ERdj4) but also C/EBP homologous transcription factor (CHOP), a transcription factor involved in apoptosis. Celecoxib also upregulated GRP78 in xenograft tumors, accompanying with the suppression of tumor growth in nude mice. Celecoxib caused phosphorylation of eukaryotic translation initiation factor 2 kinase (PERK) and eukaryotic initiation factor-2alpha (eIF2alpha) and production of activating transcription factor (ATF)4 mRNA. Suppression of ATF4 expression by small interfering RNA (siRNA) partially inhibited the celecoxib-dependent upregulation of GRP78. Celecoxib increased the intracellular Ca2+ concentration, while 1,2-bis(2-aminophenoxy)ethane-N,N,N'N'-tetraacetic acid, an intracellular Ca2+ chelator, inhibited the upregulation of GRP78 and ATF4. These results suggest that the Ca2+-dependent activation of the PERK-eIF2alpha-ATF4 pathway is involved in the upregulation of ER chaperones by celecoxib. Overexpression of GRP78 partially suppressed the apoptosis and induction of CHOP in the presence of celecoxib and this suppression was stimulated by coexpression of either ERdj3 or ERdj4. On the other hand, suppression of GRP78 expression by siRNA drastically stimulated cellular apoptosis and production of CHOP in the presence of celecoxib. These results show that upregulation of ER chaperones by celecoxib protects cancer cells from celecoxib-induced apoptosis, thus may decrease the potential antitumor activity of celecoxib.

Noxious cold stimulation induces mitogen-activated protein kinase activation in transient receptor potential (TRP) channels TRPA1- and TRPM8-containing small sensory neurons

Two cold-sensitive transient receptor potential (TRP) channels, TRPA1 and TRPM8, have been identified and considered interesting because of their possible roles in thermosensation, nociception and other functions. Recently, we have reported that the phosphorylation of extracellular signal-regulated protein kinase and p38 mitogen-activated protein kinase occurred in primary afferent neurons in response to noxious heat stimulation of the peripheral tissue, i.e. activity-dependent activation of extracellular signal-regulated protein kinase and p38 in dorsal root ganglion neurons. In the present study, we investigated the phosphorylation of extracellular signal-regulated protein kinase, p38, and c-Jun N-terminal kinase in the rat dorsal root ganglion by cold stimulation using immunohistochemistry. Cold stimuli (28-4 degrees C) were applied by immersion of the hind paw into a water bath (six times of 10 s stimulation and 10 s interval, total 2 min). Noxious cold stimulation induced phosphorylated-extracellular signal-regulated protein kinase and phosphorylated-p38, but not phosphorylated-c-Jun N-terminal kinase, in small to medium diameter sensory neurons with a peak at 2 min after stimulation. We found that a cold stimulation at 4 degrees C showed a marked increase in the number of activated neurons. Furthermore, double staining for phosphorylated-extracellular signal-regulated protein kinase and phosphorylated-p38 showed no colocalization in the dorsal root ganglion neurons. We then performed double-labeling experiments for TRPA1 and TRPM8 mRNA and phosphorylation of mitogen-activated protein kinase. The majority of phosphorylated-extracellular signal-regulated protein kinase-positive neurons also expressed TRPM8 mRNA, whereas phosphorylated-p38 heavily colocalized with TRPA1 mRNA after noxious cold stimulation. Our data suggest that the noxious, but not innocuous, cold stimulation in vivo induced differential activation of extracellular signal-regulated protein kinase and p38 pathways in each subpopulation containing TRPA1 or TRPM8 in dorsal root ganglion.