Spike firing attenuation of serotonin neurons in learned helplessness rats is reversed by ketamine

Animals suffering from uncontrollable stress sometimes show low effort to escape stress (learned helplessness). Changes in serotonin (5-hydroxytryptamine) signalling are thought to underlie this behaviour. Although the release of 5-hydroxytryptamine is triggered by the action potential firing of dorsal raphe nuclei 5-hydroxytryptamine neurons, the electrophysiological changes induced by uncontrollable stress are largely unclear. Herein, we examined electrophysiological differences among 5-hydroxytryptamine neurons in naïve rats, learned helplessness rats and rats resistant to inescapable stress (non-learned helplessness). Five-week-old male Sprague Dawley rats were exposed to inescapable foot shocks. After an avoidance test session, rats were classified as learned helplessness or non-learned helplessness. Activity-dependent 5-hydroxytryptamine release induced by the administration of high-potassium solution was slower in free-moving learned helplessness rats. Subthreshold electrophysiological properties of 5-hydroxytryptamine neurons were identical among the three rat groups, but the depolarization-induced spike firing was significantly attenuated in learned helplessness rats. To clarify the underlying mechanisms, potassium (K+) channels regulating the spike firing were initially examined using naïve rats. K+ channels sensitive to 500 μM tetraethylammonium caused rapid repolarization of the action potential and the small conductance calcium-activated K+ channels produced afterhyperpolarization. Additionally, dendrotoxin-I, a blocker of Kv1.1 (encoded by Kcna1), Kv1.2 (encoded by Kcna2) and Kv1.6 (encoded by Kcna6) voltage-dependent K+ channels, weakly enhanced the spike firing frequency during depolarizing current injections without changes in individual spike waveforms in naïve rats. We found that dendrotoxin-I significantly enhanced the spike firing of 5-hydroxytryptamine neurons in learned helplessness rats. Consequently, the difference in spike firing among the three rat groups was abolished in the presence of dendrotoxin-I. These results suggest that the upregulation of dendrotoxin-I-sensitive Kv1 channels underlies the firing attenuation of 5-hydroxytryptamine neurons in learned helplessness rats. We also found that the antidepressant ketamine facilitated the spike firing of 5-hydroxytryptamine neurons and abolished the firing difference between learned helplessness and non-learned helplessness by suppressing dendrotoxin-I-sensitive Kv1 channels. The dendrotoxin-I-sensitive Kv1 channel may be a potential target for developing drugs to control activity of 5-hydroxytryptamine neurons.

Evaluation of apocynin in vitro on high glucose-induced oxidative stress on tenocytes

Aims

The purpose of this study was to evaluate the in vitro effects of apocynin, an inhibitor of nicotinamide adenine dinucleotide phosphate oxidase (NOX) and a downregulator of intracellular reactive oxygen species (ROS), on high glucose-induced oxidative stress on tenocytes.

Methods

Tenocytes from normal Sprague-Dawley rats were cultured in both control and high-glucose conditions. Apocynin was added at cell seeding, dividing the tenocytes into four groups: the control group; regular glucose with apocynin (RG apo+); high glucose with apocynin (HG apo+); and high glucose without apocynin (HG apo–). Reactive oxygen species production, cell proliferation, apoptosis and messenger RNA (mRNA) expression of NOX1 and 4, and interleukin-6 (IL-6) were determined in vitro.

Results

Expression of NOX1, NOX4, and IL-6 mRNA in the HG groups was significantly higher compared with that in the RG groups, and NOX1, NOX4, and IL-6 mRNA expression in the HG apo+ group was significantly lower compared with that in the HG apo– group. Cell proliferation in the RG apo+ group was significantly higher than in the control group and was also significantly higher in the HG apo+ group than in the HG apo– group. Both the ROS accumulation and the amounts of apoptotic cells in the HG groups were greater than those in the RG groups and were significantly less in the HG apo+ group than in the HG apo– group.

Conclusion

Apocynin reduced ROS production and cell death via NOX inhibition in high-glucose conditions. Apocynin is therefore a potential prodrug in the treatment of diabetic tendinopathy.

Cite this article:Bone Joint Res 2020;9(1):23–28.

Abstract P6-02-09: Diagnostic performance of dedicated breast PET for the prediction of pathological response after neoadjuvant chemotherapy

Background: Neoadjuvant chemotherapy (NAC) is a standard treatment for operable breast cancer. However, imaging methods for evaluating treatment response have not been established. Previous studies reported that ring-type dedicated breast positron emission tomography (DbPET) detected residual tumors following NAC more accurately than whole-body PET/CT. This study assessed DbPET parameters for predicting pathological complete response (pCR) in patients with breast cancer.

Patients and Methods: Among patients with breast cancer who underwent surgery after NAC, 61 were examined using ring-type DbPET before and after NAC. The maximum standardized uptake values (SUVmax) and tumor-to-normal-tissue ratio (TNR) were calculated before and after NAC (pre-SUVmax, pre-TNR, post-SUVmax and post-TNR, respectively). Moreover, the reduction rates (ΔSUVmax and ΔTNR) were determined. pCR was defined as complete remission of breast cancer.

Results: The median patient age was 52 years. Forty patients (65.6%) were estrogen receptor (ER)-positive, whereas 25 patients (41.0%) were HER2-positive. Fifteen patients (24.6%) achieved pCR after NAC. The calculated values for the parameters of DbPET are summarized in Table 1. The most promising parameters for predicting pCR were ΔSUVmax (area under the curve [AUC]: 0.506) and post-TNR (AUC: 0.640). Although neither of these two parameters reflected the pathological response to NAC in patients with ER-positive disease, post-TNR showed the highest AUC (i.e., AUC: 0.750) for pCR in patients with ER-negative disease. The sensitivity and specificity of post-TNR in the ER-positive group were 85.7% and 39.4%, respectively. In the ER-negative group, these values were 100% and 58.3%, respectively [Table 2]

Table 1.Diagnostic performance of dedicated breast positron-emission tomography for the prediction of pathological complete response after neoadjuvant chemotherapyParameterspCR Median (IQR)Non-pCR Median (IQR)PAUC (95% CI)Pre-SUVmax14.8 (9.2–17.7)14.4 (10.7–19.8)0.6040.454 (0.285–0.624)Post-SUVmax1.8(1.5–2.1)2.0 (1.6–3.4)0.2370.603 (0.460–0.746)ΔSUVmax (%)87.32 (81.5–91.8)88.6(82.8–91.8)0.9540.506 (0.329–0.682)Pre-TNR8.0 (5.3–9.2)7.3(5.9–10.2)0.7570.472 (0.297–0.647)Post-TNR1.7(1.0–1.1)1.2 (1.0–2.4)0.0980.640 (0.506–0.774)ΔTNR (%)87.3 (78.3–89.1)79.8 (62.7–86.7)0.1130.638 (0.472–0.803)pCR, pathological complete response; IQR, interquartile range; AUC, area under the curve; CI, confidence interval, SUV, standardized uptake value; TNR, tumor-to-normal-tissue ratio.Table 2.Diagnostic accuracy of post-TNR according to estrogen receptor status Sensitivity (%)Specificity (%)Accuracy (%)PPV (%)NPV (%)ER-positive85.739.447.523.192.9ER-negative10058.375.061.5100TNR, tumor-to-normal-tissue ratio; ER, estrogen receptor; PPV, positive predictive value; NPV, negative predictive value

Conclusion: In DbPET, ΔSUVmax and post-TNR were shown to be promising parameters for predicting pathological response to NAC. Post-TNR provided the highest sensitivity for predicting pCR in patients with ER-negative breast cancer.

Citation Format: Suzuki E, Sasada S, Sueoka S, Masumoto N, Goda N, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Diagnostic performance of dedicated breast PET for the prediction of pathological response after neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-02-09.

Combined brain-derived neurotrophic factor with extinction training alleviate impaired fear extinction in an animal model of post-traumatic stress disorder

Impaired fear memory extinction (Ext) is one of the hallmark symptoms of post-traumatic stress disorder (PTSD). However, since the precise mechanism of impaired Ext remains unknown, effective interventions have not yet been established. Recently, hippocampal-prefrontal brain-derived neurotrophic factor (BDNF) activity was shown to be crucial for Ext in naïve rats. We therefore examined whether decreased hippocampal-prefrontal BDNF activity is also involved in the Ext of rats subjected to a single prolonged stress (SPS) as a model of PTSD. BDNF levels were measured by enzyme-linked immunosorbent assay (ELISA), and phosphorylation of TrkB was measured by immunohistochemistry in the hippocampus and medial prefrontal cortex (mPFC) of SPS rats. We also examined whether BDNF infusion into the ventral mPFC or hippocampus alleviated the impaired Ext of SPS rats in the contextual fear conditioning paradigm. SPS significantly decreased the levels of BDNF in both the hippocampus and mPFC and TrkB phosphorylation in the ventral mPFC. Infusion of BDNF 24 hours after conditioning in the infralimbic cortex (ILC), but not the prelimbic cortex (PLC) nor hippocampus, alleviated the impairment of Ext. Since amelioration of impaired Ext by BDNF infusion did not occur without extinction training, it seems the two interventions must occur consecutively to alleviate impaired Ext. Additionally, BDNF infusion markedly increased TrkB phosphorylation in the ILC of SPS rats. These findings suggest that decreased BDNF signal transduction might be involved in the impaired Ext of SPS rats, and that activation of the BDNF-TrkB signal might be a novel therapeutic strategy for the impaired Ext by stress.

The effects of high glucose condition on rat tenocytes in vitro and rat Achilles tendon in vivo

Objectives

The aim of this study was to investigate the effect of hyperglycaemia on oxidative stress markers and inflammatory and matrix gene expression within tendons of normal and diabetic rats and to give insights into the processes involved in tendinopathy.

Methods

Using tenocytes from normal Sprague-Dawley rats, cultured both in control and high glucose conditions, reactive oxygen species (ROS) production, cell proliferation, messenger RNA (mRNA) expression of NADPH oxidase (NOX) 1 and 4, interleukin-6 (IL-6), matrix metalloproteinase (MMP)-2, tissue inhibitors of matrix metalloproteinase (TIMP)-1 and -2 and type I and III collagens were determined after 48 and 72 hours in vitro. In an in vivo study, using diabetic rats and controls, NOX1 and 4 expressions in Achilles tendon were also determined.

Results

In tenocyte cultures grown under high glucose conditions, gene expressions of NOX1, MMP-2, TIMP-1 and -2 after 48 and 72 hours, NOX4 after 48 hours and IL-6, type III collagen and TIMP-2 after 72 hours were significantly higher than those in control cultures grown under control glucose conditions. Type I collagen expression was significantly lower after 72 hours. ROS accumulation was significantly higher after 48 hours, and cell proliferation after 48 and 72 hours was significantly lower in high glucose than in control glucose conditions. In the diabetic rat model, NOX1 expression within the Achilles tendon was also significantly increased.

Conclusion

This study suggests that high glucose conditions upregulate the expression of mRNA for NOX1 and IL-6 and the production of ROS. Moreover, high glucose conditions induce an abnormal tendon matrix expression pattern of type I collagen and a decrease in the proliferation of rat tenocytes.

Cite this article: Y. Ueda, A. Inui, Y. Mifune, R. Sakata, T. Muto, Y. Harada, F. Takase, T. Kataoka, T. Kokubu, R. Kuroda. The effects of high glucose condition on rat tenocytes in vitro and rat Achilles tendon in vivo. Bone Joint Res 2018;7:362–372. DOI: 10.1302/2046-3758.75.BJR-2017-0126.R2

Abstract P5-02-03: Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography

Background: Dedicated breast positron emission tomography (DbPET)provides detailed high resolution images of the breast and enables quantitative assessment using standard uptake values (SUVs). We aimed to determine whether DbPET can predict the pathological malignancy grade and neoplastic progress of breast cancer compared with whole body (WB) PET.

Methods: We investigated 196 consecutive patients with invasive breast cancerwho underwent concurrent Db- and WB-PET from January 2016 to March 2017. All Db- and WB-PET were quantified based on SUVs. We also investigated pathological features of breast cancer who had a ring-like uptake (RU) without central FDG accumulation on DbPET.

Results:

The associations between the SUVs for DB- and WB-PET and the pathological factors in breast cancerCharacteristicSUV WBPETDbPET Mean ± SDpMean ± SDpall3.6 ± 3.4 9.4±7.9 Tumor size    ≤2.0 cm2.2±1.6<0.0016.5±5.2<0.001>2.0 cm5.5±4.1 13.3±9.2 LN    Negative3.1±3.3<0.0018.4±7.8<0.001Positive4.9±3.2 11.8±7.7 NG    1 or 22.4±2.1<0.0016.6±5.9<0.00135.1±4.0 12.7±8.7 Ki67    < 201.8±1.1<0.0015.2±3.3<0.001≥ 204.4±3.7 11.4±8.6 ER    positive3.4±3.30.028.8±7.60.006negative5.2±3.6 13.5±8.6 HER-2    positive4.6±3.10.0911.8±7.60.04negative3.4±3.4 9.0±7.9 Sub type vs Lumnal A vs Lumnal ALuminal A1.8±1.1 5.2±3.3 Luminal B4.0±3.8<0.00110.1±8.5<0.001HER24.6±3.1<0.00111.8±7.6<0.001Triple negative5.3±3.8<0.00113.8±9.2<0.001

summarizes the association between SUVs for Db- and WB-PET and pathological factors inbreast cancer.SUVs on PET were significantly higher for the tumor size of >2.0 cm than for tumor size ≤2.0 cm (p<0.001), for LN-positive than for LN-negative (p<0.001), for NG3 than for NG1-NG2 (p<0.001), for higher Ki67 expression than for lower Ki67 expression (p<0.001), and for ER-negative than for ER-positive (WBPET, p=0.02; DbPET, p=0.006). SUVs were significantly lower for Luminal A than for Luminal B, HER2, and triple-negative cancer (p<0.001 for all three).SUVs for DbPET was significantly higher for HER2-positive than for HER2-negative (p=0.02).

The association between SUVs for breast cancer with and without RU on DbPETCharacteristicRU(-), nRU(+), npall17323 Tumor size   ≤2.0 cm1095<0.001>2.0 cm6418 LN   Negative1299<0.001Positive4414 NG   1 or 210070.0237316 Ki67   < 206130.03≥ 2011220 ER   positive152190.49negative214 HER-2   positive2620.38negative14721 Sub type  vs Lumnal ALuminal A493 Luminal B84150.02HER22620.81Triple negative1430.04

summarizes the association between SUVs for breast cancer with and without RU on DbPET. SUVs for breast cancer with RU on DbPET were significantly higher for the tumor size of >2.0 cm than for tumor size ≤2.0 cm, for LN -positive than for LN-negative (p<0.001), for NG3 than for NG1-2 (p=0.02), and for higher Ki67 expression than for lowerKi67 expression (p=0.03). SUVs were significantly lower for Luminal A than for Luminal B (p=0.02) and triple-negative cancer (p=0.04).

Conclusions: SUVs for DbPET were equal or superiorto WBPET in predicting the pathological malignancy grade and neoplastic progress in tumors. Furthermore, the presence of RU on DbPET can provide excellent predictive value for high-grade malignancy and might help to determine appropriate therapeutic strategies.

Citation Format: Masumoto N, Kadoya T, Nishina M, Kimura Y, Suzuki E, Sueoka S, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kataoka T, Okada M. Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-02-03.

Abstract P6-03-08: Detection ability of dedicated breast positron emission tomography for small-sized breast cancer

Background: Whole body (WB) 18F-fluorodeoxyglucose positron emission tomography (PET) has a relatively poor spatial resolution (>1 cm), which limits the capability to detect small lesions. Therefore, small-sized breast cancers (≤1 cm) may not be visible on WBPET. To overcome these limitations, dedicated breast PET (DbPET) has been developed to improve spatial resolution. DbPET enables detailed high-resolution images within the breast. We aimed to determine whether DbPET can detect small-sized breast cancer compared to WBPET.

Methods: We investigated 203 consecutive patients (217 tumors) (T1–3, N0–3a, M0) with breast cancer who underwent concurrent DbPET and WBPET between January 2016 and March 2017. All DbPET and WBPET images were semi-quantified based on standard uptake values. The diagnostic performance of each scanner was assessed in DbPET and WBPET. Tumors were classified based on pathological classification as follows: Tis, ductal carcinoma in situ (DCIS); T1a, ≤0.5 cm; T1b, 0.5–1 cm; and T1c, 1–2 cm; T2, 2–5 cm; T3, >5 cm. The sensitivities of DbPET and WBPET were compared in each size group.

Results: Table 1 shows the detection rate of breast cancer in WBPET and DbPET

The detection rate of breast cancer in WB- and Db-PET DbPETWBPETpTumor sizeDetection (-) n(%)Detection (+) n(%)Detection (-) n(%)Detection (+) n(%) Tis6(14.6)35(85.4)18(43.9)23(56.1)0.0030T1a2(8)23(92)7(28)18(72)0.0594T1b2(6.5)29(93.5)10(32.3)21(67.7)0.0077T1c5(8.2)56(91.8)11(18)50(82)0.1038T20(0)57(100)1(1.8)56(98.2)0.2375T30(0)2(100)0(0)2(100)-total15(6.9)202(93.1)47(21.7)170(78.3)<0.0001

. The overall detection rate in DBPET [93.1% (202/217)] was significantly higher than that of WBPET [78.3% (170/217)] (P < 0.001). For smaller tumors, DbPET was more sensitive than WBPET: Tis (85.4% vs. 56.1%), T1a (92% vs. 72%), T1b (93.5% vs. 67.7%), T1c (91.8% vs. 82%), T2 (100% vs. 98.2%), and T3 (100% vs. 100%). The sensitivity of DbPET was significantly higher than that of WBPET in Tis (P = 0.003) and T1b (P = 0.008) and tended to be higher than that of WBPET in T1a (P = 0.059). Conversely, no significant differences were observed in T1c (P = 0.103) and T2 (P = 0.238).

Conclusion: The imaging sensitivity of DbPET was higher than that of WBPET. DbPET showed significant sensitivity in DCIS and tumors ≤1 cm, which is a weak point for WBPET. DbPET may serve as a new diagnostic modality to detect small-sized breast cancer.

Citation Format: Sueoka S, Masumoto N, Nishina M, Kimura Y, Suzuki E, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Detection ability of dedicated breast positron emission tomography for small-sized breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-03-08.

Analysis of Progressive Ophthalmic Lesion in a Patient with Subacute Sclerosing Panencephalitis

Purpose

To evaluate the progressive lesions affecting the visual system in a patient with subacute sclerosing panencephalitis (SSPE).

Methods

The authors observed a 15-year-old boy with SSPE. Since the diagnosis was made before the appearance of ocular manifestations, the authors recorded the progressive ocular lesions using various ophthalmic examinations.

Results

The patient showed no ophthalmic abnormalities until he developed a left homonymous hemianopia with sudden bilateral disturbed visual acuity. Severe progressive macular lesions including a pigment epithelial window defect by fluorescein angiography, a marked decrease in foveal thickness by optical coherence tomography, and an extensive disorder mainly specific to cone cells in the central retina by electroretinography were demonstrated. Novel findings such as a transient relative afferent pupillary defect and an anterior uveitis were also observed.

Conclusions

Analyses over a long period of time showed progressive ophthalmic findings in a patient with SSPE.

Abstract P4-02-06: Evaluation of contrast-enhanced ultrasonography for early prediction of response to neoadjuvant chemotherapy in triple negative breast cancer

Objectives

We aimed to determine whether contrast-enhanced ultrasonography (CEUS) can predict the early effects of neoadjuvant chemotherapy on triple negative breast cancer.

Methods

The clinical responses of 20 consecutive patients with breast cancer (T1–2, N0–1, M0) to neoadjuvant chemotherapy between October 2012 and Feb 2016 were assessed using ultrasonography and contrast-enhanced ultrasonography before starting the therapy and after the treatment of 2 courses. Ascending slope (AS) of perfusion parameters for contrast-enhanced ultrasonography were created from time–intensity curves based on enhancement intensity and temporal changes to objectively evaluate contrast-enhanced ultrasonography findings.We investigated whether rate of change of ascending slope (ΔAS) and tumor size (Δ US) could predict pCR.

Results

Eight (40.0%) of the 20 patients achieved pathological complete response. ΔAS were significantly higher (-25.5 ± 35.5 vs. 14.7 ± 33.2; P < 0.02) in patients who achieved pCR than in those who did not. On the other hand, ΔUS of pCR and non-pCR did not significantly differ among tumors (-40.8 ± 22.4 vs. -21.4 ± 20.6; P = 0.06). The AUC values for ΔAS and ΔUS were 0.792 (95% CI, 0.579 -1.000, P = 0.03) and 0.729 (95% CI, 0.501 - 0.957;p = 0.09), respectively. We set ΔAS and Δ US cut-offs for predicting pCR at-20.08 and - 33.75 based on the ROC curves. Clinical and pathological characteristics of the 20 patients are summarized in Univariate (odds ratio, 2.71; p= 0.02) and multivariate (odds ratio, 2.88; p= 0.03) analysis showed that ΔAS was the sole independent predictor of pCR.

Clinical and pathological characteristics of patients with breast cancer.CharacteristicpCR (n)Non pCR (n)pClinical T status   T1110.71T2711 Clinical N status   Negative570.85Positive35 Nuclear Grade   1 or 2340.85358 ΔUS (%)   < -33.75390.09≥ -33.7553 ΔAS (%)   < -20.082100.009≥ -20.0862 

Univariate and multivariate logistic analysis of significant predictive factors for pCR in triple negative subtype Univariate analysisMultivariate analysis OR, 95% CI, pOR, 95% CI, pΔUS  > -33.751.61, 0.72-34.7, 0.101.85, 0.51-79.1, 0.15≤-33.75  ΔAS  > -20.082.71, 1.65-136.1, 0.022.88, 1.44-218.7, 0.03≤ -20.08  

Conclusion

ΔAS assessed with CEUS can help the physician to early predict the probability of achieving pCR or not.

Citation Format: Masumoto N, Kadoya T, Murakami C, Gouda N, Sasada S, Emi A, Haruta R, Kataoka T, Okada M. Evaluation of contrast-enhanced ultrasonography for early prediction of response to neoadjuvant chemotherapy in triple negative breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-02-06.

Hybrid preparation of terbium(iii)-doped mesoporous silica particles with calcium phosphates

Terbium-doped mesoporous silica/calcium phosphate interfacial hybrid particles were prepared to demonstrate characteristic luminescence behavior.

A comparison of 3-D computed tomography versus 2-D radiography measurements of ulnar variance and ulnolunate distance during forearm rotation

Positive ulnar variance is associated with ulnar impaction syndrome and ulnar variance is reported to increase with pronation. However, radiographic measurement can be affected markedly by the incident angle of the X-ray beam. We performed three-dimensional (3-D) computed tomography measurements of ulnar variance and ulnolunate distance during forearm rotation and compared these with plain radiographic measurements in 15 healthy wrists. From supination to pronation, ulnar variance increased in all cases on the radiographs; mean ulnar variance increased significantly and mean ulnolunate distance decreased significantly. However on 3-D imaging, ulna variance decreased in 12 cases on moving into pronation and increased in three cases; neither the mean ulnar variance nor mean ulnolunate distance changed significantly. Our results suggest that the forearm position in which ulnar variance increased varies among individuals. This may explain why some patients with ulnar impaction syndrome complain of wrist pain exacerbated by forearm supination. It also suggests that standard radiographic assessments of ulnar variance are unreliable.

The potential of SLC6A4 gene methylation analysis for the diagnosis and treatment of major depression

We examined the utility of DNA methylation profiles at the CpG island of SLC6A4 (DMS) as a diagnostic biomarker for major depression (MD). In addition, the relationship between DMS and the serotonin transporter gene-linked polymorphic region (5-HTTLPR) allele, the severity of symptoms, number of early adversities, and therapeutic responses to antidepressants were examined. Genomic DNA was extracted from peripheral blood of Japanese healthy controls and patients with MD before and after treatment. DMS was analyzed using a MassARRAY Compact System. The severity of depression was evaluated using the Hamilton Rating Scale for Depression, and early adversity was evaluated using the Early Trauma Inventory. We were unable to distinguish between and healthy controls, or between unmedicated patients and medicated patients using DMS. The 5-HTTLPR allele had no significant effect on DMS. The methylation rates for several CpGs differed significantly after treatment. Notably, the methylation rate of CpG 3 in patients with better therapeutic responses was significantly higher than that in patients with poorer responses. Although further studies examining the function of specific CpG units of SLC6A4 are required, these results suggest that the pre-treatment methylation rate of SLC6A4 is associated with therapeutic responses to antidepressants in unmedicated patients with MD.

Abstract P2-03-07: Prediction of the pathological response to neoadjuvant chemotherapy in patients with breast cancer using sonazoid-enhanced ultrasonography

Background:

Altered blood flow in malignant tumors is evidenced by contrast-enhanced ultrasonography (CEUS) because of its image perfusion capabilities.

This study aimed to investigate the value of CEUS in the evaluation of the response of breast cancer lesions to neoadjuvant chemotherapy (NAC). We evaluated whether the prediction of a pathological complete response (pCR) using CEUS was more precise than that using other standard evaluation methods such as magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT).

Methods:

Ten patients (mean age, 50.2 years) who underwent NAC for invasive breast cancer between September 2012 and April 2013 were eligible for this cohort study. Clinical tumor response was evaluated using contrast-enhanced MRI, PET/CT, and CEUS following NAC. A pCR was defined as the absence of invasive cancer in the breast and lymph nodes according to the Japanese Breast Cancer Society criteria.

A clinically complete response (cCR) was defined as the absence of residual disease on MRI and PET/CT. The HI VISION ASCENDUS (Hitachi Aloka Medical Corp.) was used for ultrasonography. Tumors were observed 50 s after Sonazoid injection at a dose of 0.01 ml/kg. A time-intensity curve of tumor signal intensity was drawn. The brightness of the tumor was digitized and the curve was created on the basis of brightness changes over time. The intensity of brightness of the breast cancer lesions was calculated as the increased rate of brightness (IRB) using the following formula: maximal intensity/intensity before contrast.

Results:

Four (40%) of the 10 patients were diagnosed with pCR by NAC. Among 4 (40%) patients diagnosed with cCR by MRI, 1 (25%) achieved pCR. All patients were diagnosed with pCR by PET/CT. The IRB values of the 10 patients who received CEUS before surgery were 1.0, 1.1, 1.2, 1.2, 1.3, 1.6, 1.8, 1.9, 2.5, and 4.2. The IRB values of the 4 patients diagnosed with pCR were 1.0, 1.1, 1.2, and 1.2. IRB values were significantly lower in patients who achieved pCR than in those who did not (pCR vs. no pCR, 1.1 ± 0.9 vs. 2.2 ± 1.0, P < 0.05). Furthermore, among the patients who achieved pCR, the IRB values of 2 patients with no residual ductal carcinoma in situ (DCIS) were 1.0 and 1.1, whereas those of 2 patients with residual DCIS were both 1.2.

In the 4 patients who achieved cCR as diagnosed by MRI and PET/CT, 3 with pathological residual disease had detectable IRB by CEUS.

table 1caseageStageSub typeMRIPET-CTpathological responseIncrease rate of brightness (IRB)167T2N1 IIBLuminal HER2PRCRCR1237T2N0 IIAHER2 positivePRCRCR1.1346T3N1 IIIAHER2 positiveCRCRCR1.2446T2N3c IIICLuminal HER2PRCRCR1.2564T2N0 IIAHER-2 positiveCRCRPR1.3658T2N1 IIBLuminal BCRCRPR1.6738T2N0 IIALuminal BPRCRPR1.8857T1cN0 ILuminal HER-2PRCRPR1.9939T2N1 IIBLuminalBSDCRSD2.51050T2N1 IIBTriple negativePRCRSD4.2

Conclusions:

The prediction of pCR after NAC in patients with breast cancer is more precise with Sonazoid-enhanced ultrasonography than with standard methods such as MRI and PET/CT. Furthermore, CEUS may be useful for predicting residual DCIS on the basis of brightness intensity.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-03-07.