Correlation of bioactive components of platelet rich plasma derived from human female adult peripheral blood and umbilical cord blood with age

Platelet-rich plasma (PRP) has gained significant attention in the field of regenerative medicine due to its potential therapeutic applications. However, few studies have reported the components, especially anti-ageing-related components, of PRP derived from umbilical cord blood (UCB). It is essential to understand the influence of age on the composition and efficacy of PRP to optimize its clinical use. The present study compared the concentrations of bioactive components in PRP from healthy female adults and UCB-derived PRP. PRP was obtained from blood samples from females in four age groups (12 per group): neonates (UCB donors) and adults aged 18-25, 26-45, and 46-65 years, respectively. The concentrations of epidermal growth factor, basic fibroblast growth factor-2 (FGF-2), insulin-like growth factor-1, platelet-derived growth factor-AA (PDGF-AA), PDGF-AB/BB, vascular endothelial growth factor A, RANTES, TIMP-1, TIMP-2, GDF11, and clusterin and activity of superoxide dismutase, catalase, and glutathione peroxidase (GPx) in the PRP samples were determined and compared among groups. Pairwise comparisons between the groups showed statistically significant differences in the concentrations of some bioactive components of PRP, such as FGF-2, PDGF-AB/BB, and clusterin, and GPx activity. UCB-derived PRP contains various active ingredients such as VEGF-A, CAT activity, and TIMP-2. Contrary to expectations, UCB-derived PRP did not show higher concentrations of the anti-ageing protein GDF11. Because UCB is a rich source of bioactive components with low immunogenicity, its use in PRP preparation is an important research direction for future studies.

[Diffusion tensor field estimation based on 3D U-Net and diffusion tensor imaging model constraint]

OBJECTIVE

To propose a diffusion tensor field estimation network based on 3D U-Net and diffusion tensor imaging (DTI) model constraint (3D DTI-Unet) to accurately estimate DTI quantification parameters from a small number of diffusion-weighted (DW) images with a low signal-to-noise ratio.

METHODS

The input of 3D DTI-Unet was noisy diffusion magnetic resonance imaging (dMRI) data containing one non-DW image and 6 DW images with different diffusion coding directions. The noise-reduced non-DW image and accurate diffusion tensor field were predicted through 3D U-Net. The dMRI data were reconstructed using the DTI model and compared with the true value of dMRI data to optimize the network and ensure the consistency of the dMRI data with the physical model of the diffusion tensor field. We compared 3D DTI-Unet with two DW image denoising algorithms (MP-PCA and GL-HOSVD) to verify the effect of the proposed method.

RESULTS

The proposed method was better than MP-PCA and GL-HOSVD in terms of quantitative results and visual evaluation of DW images, diffusion tensor field and DTI quantification parameters.

CONCLUSION

The proposed method can obtain accurate DTI quantification parameters from one non-DW image and 6 DW images to reduce image acquisition time and improve the reliability of quantitative diagnosis.

Orthotopic Models of Pancreatic Cancer to Study PDT

A hallmark of pancreatic ductal adenocarcinoma (PDAC) is its poor prognosis that stems from a marked resistance to therapy, an invasive nature, and a high metastatic potential. Photodynamic therapy (PDT) is a promising modality for effectively managing PDAC both preclinically and clinically. While clinical trials of PDT for PDAC are still in their early stages, a plethora of elegant preclinical studies are supporting the translation and clinical adoption of PDT-based treatment regimens, many of which leverage orthotopic preclinical models of PDAC. Given the aggressiveness of the disease that is largely dependent on the localization of PDAC tumors, it is imperative that preclinical models used to evaluate PDT-based treatment regimens recapitulate elements of the natural pathogenesis in order to design treatment regimens tailored to PDAC with the highest potential for clinical success. In light of the importance of clinically relevant models of PDAC, this chapter details and discusses the methodologies developed over the last three decades to leverage orthotopic PDAC models in order to evaluate PDT-based treatment regimens. The shortcomings of these are also discussed, in addition to the future directions that the field is headed to establish the most relevant orthotopic models of PDAC.

Abstract P044: Real-time visualization of tumor cell phenotype and microenvironmental heterogeneity enabled by a hyperspectral fluorescence microendoscope

Tumor microenvironmental heterogeneity is a major driver of treatment resistance and variability in clinical response to therapy. This heterogeneity arises from variations in cellular phenotypes populating the tumor microenvironment (TME), their spatio-temporal localization and expression of surface markers, often associated with specific biological function – stemness, metabolism, proliferation, immune activation and others. Such features are usually studied through ex vivo immunofluorescence and cytometry to identify cellular phenotypes in TME; however, they cannot be applied in vivo for real time TME analysis. Moreover, current in vivo imaging techniques fail to provide real-time high-resolution visualization of the TME. Routinely employed biopsy tissue sampling through fine needle aspirates is limited by its invasive nature and inability to provide a global and dynamic overview of the TME, thus limiting our ability to study spatiotemporal TME dynamics and identify possible features leading to potentially resistant tumor phenotypes. In this study, we demonstrate the use of a hyperspectral fluorescence microendoscope (HFME) to monitor cellular phenotypes in TME with real-time visualization and high video imaging capability (~17 fps). Current fluorescence video microscopy is limited to simultaneous imaging of no more than 2 molecular markers with potential to be expanded to ~4 markers using dichroic mirrors and point detectors; the HFME demonstrated in this study can currently resolve 6 different molecular markers, simultaneously, using a multichannel linear array detector with potential to expand to 10 or more markers. Using a cocktail of near infra-red fluorophore-antibody conjugates targeted against key molecular (surface) markers of different cells in the TME, we are able to capture real-time TME dynamics at cellular resolution in two pre-clinical models; 1) a xenograft orthotopic mouse model of peritoneal carcinomatosis (disseminated metastases within the abdominal cavity) and imaging epidermal growth factor receptor (EGFR), CD44, CA125 (MUC16), transferrin receptor, Thomsen-Friedenreich carbohydrate antigen (T antigen), and CD45, 2) A syngeneic immunocompetent KPC cell line implanted mouse model of pancreatic ductal adenocarcinoma and imaging CD3, CD4, CD8a and CD45. Imaging on these tumor models was performed pre- and post-sub-therapeutic verteporfin (benzoporphyrin derivative monoacid A) photodynamic therapy (PDT, a cytotoxic light-based therapy). PDT treatment resulted in reduction of cancer cell burden, immune cell infiltration and alterations in their relative spatial localization. The results were confirmed by histopathological validation and ex vivo immunofluorescence staining of tumor tissue sections. Collectively, these results demonstrate the capability of HFME to image cancer cell phenotypes and the tumor microenvironment, in real time in live mice. With the ability to monitor cancer growth and treatment effects at a cellular level, HFME can potentially assist in customizing therapies in a patient-specific manner.

Citation Format: Mohammad A. Saad, Bryan Q. Spring, Akilan Palanisami, Eric M. Kercher, Ryan T. Lang, Jason Sutin, Zhiming Mai, Tayyaba Hasan. Real-time visualization of tumor cell phenotype and microenvironmental heterogeneity enabled by a hyperspectral fluorescence microendoscope [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2021 Oct 5-6. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(1 Suppl):Abstract nr P044.

Abstract P031: Enrichment of photodynamically-primed anti-tumor immune infiltrates in pancreatic cancer: Enabling enhanced immunotherapy

Pancreatic ductal adenocarcinoma (PDAC) has a dismal 5-year survival rate of 10%. It poorly responds to conventional cancer treatments. Immune checkpoint blockade (ICB) has revolutionized cancer therapeutics. However, in PDAC, even the modest success of ICB is limited to ~1-3% of patients as the majority of patients' tumors are considered as immunologically ‘'cold'' due to their highly immunosuppressive tumor microenvironment (TME). Photodynamic therapy (PDT) is an FDA approved anti-cancer therapy that utilizes light, a photoresponsive non-toxic chemical called a photosensitizer, and oxygen to generate reactive molecular species that confer direct cytotoxicity or vascular shutdown. PDT alters the TME transiently in a process termed photodynamic priming (PDP), making it more receptive to subsequent therapies, including chemo- and immunotherapy. Previous studies have demonstrated that PDP is capable of affecting both the innate and adaptive immune systems. These immune-stimulatory effects occur through its ability to induce immunogenic cell death via the release of damage-associated molecules (DAMPs) and tumor-associated antigens. In this study, we investigated PDP-induced immunogenicity in PDAC. In an immunocompetent mouse model of PDAC, we evaluated tumor-infiltrating lymphocyte (TIL) enrichment in tumors and ongoing immune responses in mouse spleens/blood from 1h to 120h post-PDP treatment comparing the responses in untreated controls. We observed gradual increases in T and B cell infiltration from 1h to 120h post-PDP where the T cell subset analysis showed an enrichment of CD8+ T cells in PDP-treated tumors. These CD8+ T cells showed temporal increases in PD1, CTLA4 and TIM3 immune checkpoints suggesting PDP-induced immune priming in the TME. This was further evidenced by the upregulation of DAMPs, including high mobility group box protein-1 and calreticulin in PDP treated tumors. Analyzing spleens of mice, we detected a significant increase in CD11C+MHC11hi dendritic cells from 1h to 24h post-PDP. Also, activation of an adaptive immune response in splenic B cell follicles was noted by the presence of proliferating germinal centers by 120h post-PDP. In addition, evaluating the blood of PDP treated mice, we detected expansion of CD8+ effector memory T and natural killer cell populations, signifying PDP-induced systemic immune responses compared to untreated mice. We further investigated how immune cells infiltrate PDP-treated tumors. A reduced formation of blood (CD31+) and lymphatic (Lyve-1+) vessels post-PDP at 120h was observed. However, decreases in PDL1, collagen and fibroblast activation proteins were observed in PDP-treated tumors at 120h, suggesting mitigation of immunosuppressive mechanisms and enhanced tumor permeability, allowing TIL migration. Our data shows converting immunologically silent PDAC tumors into inflamed ‘'hot'' tumors by triggering not only a local immune infiltration but also enhanced systemic immune responses, ultimately enhances the immunogenicity of pancreatic tumors.

Citation Format: Pushpamali De Silva, Mohammad Ahsan Saad, Zhiming Mai, Shazia Bano, Assiris P. Camargo, Tayyaba Hasan. Enrichment of photodynamically-primed anti-tumor immune infiltrates in pancreatic cancer: Enabling enhanced immunotherapy [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2021 Oct 5-6. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(1 Suppl):Abstract nr P031.

Dramatic Reduction of Distant Pancreatic Metastases Using Local Light Activation of Verteporfin with Nab-Paclitaxel

Despite substantial drug development efforts, pancreatic adenocarcinoma (PDAC) remains a difficult disease to treat, and surgical resection is the only potentially curative option. Unfortunately, 80% of patients are ineligible for surgery due to the presence of invasive disease and/or distant metastases at the time of diagnosis. Treatment strategies geared towards reclassifying these patients as surgical candidates by reducing metastatic burden represents the most promising approach to improve long-term survival. We describe a photodynamic therapy (PDT) based approach that, in combination with the first-line chemotherapeutic nab-paclitaxel, effectively addresses distant metastases in three separate orthotopic PDAC models in immunodeficient mice. In addition to effectively controlling local tumor growth, PDT plus nab-paclitaxel primes the tumor to elicit systemic effects and reduce or abrogate metastases. This combination dramatically inhibits (up to 100%) the eventual development of metastases in models of early stage PDAC, and completely eliminates metastasis in 55% of animals with already established distant disease in late-stage models. Our findings suggest that this light activation process initiates local biological and/or physiological changes within the tumor microenvironment that can be leveraged to treat both localized and distant disease, and potentially reclassify patients with previously inoperable disease as surgical candidates.

Abstract LB-052: Photochemistry mediated tumor priming potentiates cytoreduction of distant metastases to enable potential surgical cure in a late stage model of pancreas cancer

Pancreatic cancer is a devastating disease for which the 5 year survival rate remains < 10% despite years of concerted research efforts. Potentially curative surgical resection cannot even be offered to most patients due to the presence of distant metastases at the time of diagnosis. Here, we present a neoadjuvant strategy comprised of photochemistry mediated tumor modulation combined with systemic therapy to significantly cytoreduce, and in 50% of cases completely eliminate, distant metastases to create a window of potential resectability. In a late stage model of pancreas cancer in which distant metastases are present at the time of treatment, combined photodynamic therapy (PDT) and gemcitabine/abraxane led to a 10,000 fold decrease in the number of distant metastases compared to untreated controls. In comparison, gemcitabine + abraxane, the current standard of care for pancreas cancer, only led to a 100 fold cytoreduction. 50% of animals treated with PDT + gem/abraxane harbored no detectable metastases 51 days after treatment compared to 0% of gem/abraxane treated animals, suggesting that PDT plus cytoreduction could enable potentially curative surgery in a sizeable percentage of animals. The strategy presented here is rapidly translatable and holds significant promise to dramatically increase the percentage of patients that are currently eligible for curative therapy for this devastating disease.

Citation Format: Sriram Anbil, Zhiming Mai, Michael Pigula, Tayyaba Hasan. Photochemistry mediated tumor priming potentiates cytoreduction of distant metastases to enable potential surgical cure in a late stage model of pancreas cancer [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 LB-052.

Impacting Pancreatic Cancer Therapy in Heterotypic in Vitro Organoids and in Vivo Tumors with Specificity-Tuned, NIR-Activable Photoimmunonanoconjugates: Towards Conquering Desmoplasia?

Despite untiring efforts to develop therapies for pancreatic ductal adenocarcinoma (PDAC), survival statistics remain dismal, necessitating distinct approaches. Photodynamic priming (PDP), which improves drug delivery and combination regimens, as well as tumor photodestruction are key attributes of photodynamic therapy (PDT), making it a distinctive clinical option for PDAC. Localized, high-payload nanomedicine-assisted delivery of photosensitizers (PSs), with molecular specificity and controlled photoactivation, thus becomes critical in order to reduce collateral toxicity during more expansive photodynamic activation procedures with curative intent. As such, targeted photoactivable lipid-based nanomedicines are an ideal candidate but have failed to provide greater than two-fold cancer cell selectivity, if at all, due to their extensive multivariant physical, optical, and chemical complexity. Here, we report (1) a systematic multivariant tuning approach to engineer (Cet, anti-EGFR mAb) photoimmunonanoconjugates (PINs), and (2) stroma-rich heterotypic PDAC in vitro and in vivo models incorporating patient-derived pancreatic cancer-associated fibroblasts (PCAFs) that recapitulate the desmoplasia observed in the clinic. These offer a comprehensive, disease-specific framework for the development of Cet-PINs. Specificity-tuning of the PINs, in terms of PS lipid anchoring, electrostatic modulation, Cet orientation, and Cet surface densities, achieved ∼16-fold binding specificities and rapid penetration of the heterotypic organoids within 1 h, thereby providing a ∼16-fold enhancement in molecular targeted NIR photodestruction. As a demonstration of their inherent amenability for multifunctionality, encapsulation of high payloads of gemcitabine hydrochloride, 5-fluorouracil, and oxaliplatin within the Cet-PINs further improved their antitumor efficacy in the heterotypic organoids. In heterotypic desmoplastic tumors, the Cet-PINs efficiently penetrated up to 470 μm away from blood vessels, and photodynamic activation resulted in substantial tumor necrosis, which was not elicited in T47D tumors (low EGFR) or when using untargeted constructs in both tumor types. Photodynamic activation of the Cet-PINs in the heterotypic desmoplastic tumors resulted in collagen photomodulation, with a 1.5-fold reduction in collagen density, suggesting that PDP may also hold potential for conquering desmoplasia. The in vivo safety profile of photodynamic activation of the Cet-PINs was also substantially improved, as compared to the untargeted constructs. While treatment using the Cet-PINs did not cause any detriment to the mice's health or to healthy proximal tissue, photodynamic activation of untargeted constructs induced severe acute cachexia and weight loss in all treated mice, with substantial peripheral skin necrosis, muscle necrosis, and bowel perforation. This study is the first report demonstrating the true value of molecular targeting for NIR-activable PINs. These constructs integrate high payload delivery, efficient photodestruction, molecular precision, and collagen photomodulation in desmoplastic PDAC tumors in a single treatment using a single construct. Such combined PIN platforms and heterocellular models open up an array of further multiplexed combination therapies to synergistically control desmoplastic tumor progression and extend PDAC patient survival.

Modulation of redox metabolism negates cancer-associated fibroblasts-induced treatment resistance in a heterotypic 3D culture platform of pancreatic cancer

The complex interplay between cancer cells and their microenvironment remains a major challenge in the design and optimization of treatment strategies for pancreatic ductal adenocarcinoma (PDAC). Recent investigations have demonstrated that mechanistically distinct combination therapies hold promise for treatment of PDAC, but effective clinical translation requires more accurate models that account for the abundant tumor-stroma and its influence on cancer growth, metabolism and treatment insensitivity. In this study, a modular 3D culture model that comprised PDAC cells and patient-derived cancer-associated fibroblasts (CAFs) was developed to assess the effects of PDAC-CAF interactions on treatment efficacies. Using newly-developed high-throughput imaging and image analysis tools, it was found that CAFs imparted a notable and statistically significant resistance to oxaliplatin chemotherapy and benzoporphyrin derivative-mediated photodynamic therapy, which associated with increased levels of basal oxidative metabolism. Increased treatment resistance and redox states were similarly observed in an orthotopic xenograft model of PDAC in which cancer cells and CAFs were co-implanted in mice. Combination therapies of oxaliplatin and PDT with the mitochondrial complex I inhibitor metformin overcame CAF-induced treatment resistance. The findings underscore that heterotypic microtumor culture models recapitulate metabolic alterations stemming from tumor-stroma interactions. The presented infrastructure can be adapted with disease-specific cell types and is compatible with patient-derived tissues to enable personalized screening and optimization of new metabolism-targeted treatment regimens for pancreatic cancer.

Tracking Photodynamic- and Chemotherapy-Induced Redox-State Perturbations in 3D Culture Models of Pancreatic Cancer: A Tool for Identifying Therapy-Induced Metabolic Changes

The metabolic plasticity of cancer cells is considered a highly advantageous phenotype that is crucial for disease progression and acquisition of treatment resistance. A better understanding of cancer metabolism and its adaptability after treatments is vital to develop more effective therapies. To screen novel therapies and combination regimens, three-dimensional (3D) culture models of cancers are attractive platforms as they recapitulate key features of cancer. By applying non-perturbative intensity-based redox imaging combined with high-throughput image analysis, we demonstrated metabolic heterogeneity in various 3D culture models of pancreatic cancer. Photodynamic therapy and oxaliplatin chemotherapy, two cancer treatments with relevance to pancreatic cancer, induced perturbations in redox state in 3D microtumor cultures of pancreatic cancer. In an orthotopic mouse model of pancreatic cancer, a similar disruption in redox homeostasis was observed on ex vivo slices following photodynamic therapy in vivo. Taken together, redox imaging on cancer tissues combined with high-throughput analysis can elucidate dynamic spatiotemporal changes in metabolism following treatment, which will benefit the design of new metabolism-targeted therapeutic approaches.

Association between phosphodiesterase type 5 inhibitors use and risk of melanoma: a meta-analysis

This meta-analysis aimed to clarify the actual association between the phosphodiesterase type 5 inhibitors (PDE5-Is) use and the risk of melanoma in erectile dysfunction (ED) patients. A systematic literature search was conducted in online databases in October, 2016 to identify studies focusing on the association between PDE5-Is use and the risk of melanoma. Summarized multivariate adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to assess the strength of associations. A total of six clinical trials containing more than one million participants were included. ED patients  using PDE5-Is shared a significant high risk of melanoma (RR=1.12, 95% CI=1.03-1.21, p=0.006). Positive associations were observed in all kinds of prescriptions: single prescription (RR=1.20, 95% CI=1.06-1.35, p=0.003), medium number of prescription (RR=1.15, 95% CI=1.01-1.30, p=0.03), and high number of prescription (RR=1.18, 95% CI=1.05-1.34, P=0.006). Additionally, PDE5-Is were also found to be significantly associated with increased risk of basal cell carcinoma (RR=1.14, 95% CI=1.09-1.19, p<0.00001). Our study indicates that PDE5-Is use could significantly increase the risk of melanoma and basal cell carcinoma. However, the risk of melanoma did not rise significantly with the increased number of prescriptions. Consequently, owing to the lack of information about other potential synergistic factors, it is difficult for us to make a solid conclusion that application of PDE5-Is is the direct cause of increased risk of melanoma. Their relationship needs to be validated by further evidences.

Size-dependent Tumor Response to Photodynamic Therapy and Irinotecan Monotherapies Revealed by Longitudinal Ultrasound Monitoring in an Orthotopic Pancreatic Cancer Model

Longitudinal monitoring of tumor size in vivo can provide important biological information about disease progression and treatment efficacy that is not captured by other modes of quantification. Ultrasound enables high-throughput evaluation of orthotopic mouse models via fast acquisition of three-dimensional tumor images and calculation of volume with a reasonable degree of accuracy. Herein, we compare orthotopic pancreatic tumor volume measurements determined by ultrasound with volume measured by calipers and tumor weight, and found strong correlations between the three modalities over a large range of tumor sizes, suggesting ultrasound can accurately quantify tumor volumes in this model. Furthermore, we demonstrate the unique ability of longitudinal treatment monitoring to reveal a tumor size-dependent response to Benzoporphyrin Derivative photodynamic therapy (BPD-PDT) and irinotecan. Small tumors (5-35 mm³ ) were found to respond well to a single round of PDT, while large tumors (35-65 mm³ ) showed no response to the same treatment. These results highlight the role that tumor size can play in preclinical interpretation of treatment response and more generally suggest that careful evaluation of subtle biological features such as this must be carefully considered in order to grant a more comprehensive understanding of disease biology in vivo.

A photoactivable multi-inhibitor nanoliposome for tumour control and simultaneous inhibition of treatment escape pathways

Nanoscale drug delivery vehicles can facilitate multimodal therapies of cancer by promoting tumour-selective drug release. However, few are effective because cancer cells develop ways to resist and evade treatment. Here, we introduce a photoactivable multi-inhibitor nanoliposome (PMIL) that imparts light-induced cytotoxicity in synchrony with a photoinitiated and sustained release of inhibitors that suppress tumour regrowth and treatment escape signalling pathways. The PMIL consists of a nanoliposome doped with a photoactivable chromophore (benzoporphyrin derivative, BPD) in the lipid bilayer, and a nanoparticle containing cabozantinib (XL184)--a multikinase inhibitor--encapsulated inside. Near-infrared tumour irradiation, following intravenous PMIL administration, triggers photodynamic damage of tumour cells and microvessels, and simultaneously initiates release of XL184 inside the tumour. A single PMIL treatment achieves prolonged tumour reduction in two mouse models and suppresses metastatic escape in an orthotopic pancreatic tumour model. The PMIL offers new prospects for cancer therapy by enabling spatiotemporal control of drug release while reducing systemic drug exposure and associated toxicities.

Photodynamic Therapy Synergizes with Irinotecan to Overcome Compensatory Mechanisms and Improve Treatment Outcomes in Pancreatic Cancer

The ability of tumor cells to adapt to therapeutic regimens by activating alternative survival and growth pathways remains a major challenge in cancer therapy. Therefore, the most effective treatments will involve interactive strategies that target multiple nonoverlapping pathways while eliciting synergistic outcomes and minimizing systemic toxicities. Nanoliposomal irinotecan is approved by the FDA for gemcitabine-refractory metastatic pancreatic cancer. However, the full potential of irinotecan treatment is hindered by several cancer cell survival mechanisms, including ATP-binding cassette G2 (ABCG2) transporter-mediated irinotecan efflux from cells. Here, we demonstrate that benzoporphyrin derivative-based photodynamic therapy (PDT), a photochemical cytotoxic modality that activates the apoptotic pathway, reduced ABCG2 expression to increase intracellular irinotecan levels in pancreatic cancer. Moreover, we show that PDT inhibited survivin expression. Although PDT potentiated irinotecan treatment, we also demonstrate that irinotecan reduced the tumoral expression of monocarboxylate transporter 4, which was upregulated by PDT. Notably, using orthotopic xenograft models, we demonstrate that combination of single low-dose PDT and a subclinical dose of nanoliposomal irinotecan synergistically inhibited tumor growth by 70% for 3 weeks compared with 25% reduction after either monotherapies. Our findings offer new opportunities for the clinical translation of PDT and irinotecan combination therapy for effective pancreatic cancer treatment.

Photodynamic Therapy Synergizes with Irinotecan to Overcome Compensatory Mechanisms and Improve Treatment Outcomes in Pancreatic Cancer

The ability of tumor cells to adapt to therapeutic regimens by activating alternative survival and growth pathways remains a major challenge in cancer therapy. Therefore, the most effective treatments will involve interactive strategies that target multiple nonoverlapping pathways while eliciting synergistic outcomes and minimizing systemic toxicities. Nanoliposomal irinotecan is approved by the FDA for gemcitabine-refractory metastatic pancreatic cancer. However, the full potential of irinotecan treatment is hindered by several cancer cell survival mechanisms, including ATP-binding cassette G2 (ABCG2) transporter-mediated irinotecan efflux from cells. Here, we demonstrate that benzoporphyrin derivative-based photodynamic therapy (PDT), a photochemical cytotoxic modality that activates the apoptotic pathway, reduced ABCG2 expression to increase intracellular irinotecan levels in pancreatic cancer. Moreover, we show that PDT inhibited survivin expression. Although PDT potentiated irinotecan treatment, we also demonstrate that irinotecan reduced the tumoral expression of monocarboxylate transporter 4, which was upregulated by PDT. Notably, using orthotopic xenograft models, we demonstrate that combination of single low-dose PDT and a subclinical dose of nanoliposomal irinotecan synergistically inhibited tumor growth by 70% for 3 weeks compared with 25% reduction after either monotherapies. Our findings offer new opportunities for the clinical translation of PDT and irinotecan combination therapy for effective pancreatic cancer treatment.

Diffusion kurtosis imaging probes cortical alterations and white matter pathology following cuprizone induced demyelination and spontaneous remyelination

Although MRI is the gold standard for the diagnosis and monitoring of multiple sclerosis (MS), current conventional MRI techniques often fail to detect cortical alterations and provide little information about gliosis, axonal damage and myelin status of lesioned areas. Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) provide sensitive and complementary measures of the neural tissue microstructure. Additionally, specific white matter tract integrity (WMTI) metrics modelling the diffusion in white matter were recently derived. In the current study we used the well-characterized cuprizone mouse model of central nervous system demyelination to assess the temporal evolution of diffusion tensor (DT), diffusion kurtosis tensor (DK) and WMTI-derived metrics following acute inflammatory demyelination and spontaneous remyelination. While DT-derived metrics were unable to detect cuprizone induced cortical alterations, the mean kurtosis (MK) and radial kurtosis (RK) were found decreased under cuprizone administration, as compared to age-matched controls, in both the motor and somatosensory cortices. The MK remained decreased in the motor cortices at the end of the recovery period, reflecting long lasting impairment of myelination. In white matter, DT, DK and WMTI-derived metrics enabled the detection of cuprizone induced changes differentially according to the stage and the severity of the lesion. More specifically, the MK, the RK and the axonal water fraction (AWF) were the most sensitive for the detection of cuprizone induced changes in the genu of the corpus callosum, a region less affected by cuprizone administration. Additionally, microgliosis was associated with an increase of MK and RK during the acute inflammatory demyelination phase. In regions undergoing severe demyelination, namely the body and splenium of the corpus callosum, DT-derived metrics, notably the mean diffusion (MD) and radial diffusion (RD), were among the best discriminators between cuprizone and control groups, hence highlighting their ability to detect both acute and long lasting changes. Interestingly, WMTI-derived metrics showed the aptitude to distinguish between the different stages of the disease. Both the intra-axonal diffusivity (Da) and the AWF were found to be decreased in the cuprizone treated group, Da specifically decreased during the acute inflammatory demyelinating phase whereas the AWF decrease was associated to the spontaneous remyelination and the recovery period. Altogether our results demonstrate that DKI is sensitive to alterations of cortical areas and provides, along with WMTI metrics, information that is complementary to DT-derived metrics for the characterization of demyelination in both white and grey matter and subsequent inflammatory processes associated with a demyelinating event.

In vivo evaluation of battery-operated light-emitting diode-based photodynamic therapy efficacy using tumor volume and biomarker expression as endpoints

In view of the increase in cancer-related mortality rates in low- to middle-income countries (LMIC), there is an urgent need to develop economical therapies that can be utilized at minimal infrastructure institutions. Photodynamic therapy (PDT), a photochemistry-based treatment modality, offers such a possibility provided that low-cost light sources and photosensitizers are available. In this proof-of-principle study, we focus on adapting the PDT light source to a low-resource setting and compare an inexpensive, portable, battery-powered light-emitting diode (LED) light source with a standard, high-cost laser source. The comparison studies were performed in vivo in a xenograft murine model of human squamous cell carcinoma subjected to 5-aminolevulinic acid-induced protoporphyrin IX PDT. We observed virtually identical control of the tumor burden by both the LED source and the standard laser source. Further insights into the biological response were evaluated by biomarker analysis of necrosis, microvessel density, and hypoxia [carbonic anhydrase IX (CAIX) expression] among groups of control, LED-PDT, and laser-PDT treated mice. There is no significant difference in the percent necrotic volume and CAIX expression in tumors that were treated with the two different light sources. These encouraging preliminary results merit further investigations in orthotopic animal models of cancers prevalent in LMICs.

Abstract B148: Ultrasound image guided combination therapies involving photodynamic therapy and irinotecan

Introduction: The field of cancer therapeutics is moving towards attacking the pathology with mechanistically distinct or synergistic combination therapies. In addition to possessing distinct cytotoxicity mechanisms, factors such as dose and sequence of combination therapy needs to be determined for effective therapeutic outcome. Non-invasive imaging techniques play a major role in personalizing these therapies by providing quantitative information on tumor volume, perfusion, oxygenation status, drug concentration etc. In particular we utilized ultrasound imaging to gauge the efficacy of photodynamic therapy (PDT) and irinotecan combination therapy in orthotopic pancreatic tumors of different volume. The rationale behind choosing PDT and irinotecan combination is that Irinotecan intracellular concentrations are increased, as PDT is known to cause destruction of ABC transporters that are responsible for the efflux of the drug and its metabolites outside of the cells. Photoacoustic imaging (a technique that provides contrast based on optical absorption properties of the tissue) was utilized to monitor changes in blood volume and oxygen saturation post photodynamic therapy.

Materials and Methods: Orthotopic or subcutaneous pancreatic tumor models were established using MIA PaCA-2 cell line in Swiss Nu/Nu mice (4-6 weeks old). Cells (1 × 106in 50 μL of Matrigel-containing media) were injected into the pancreas or subcutaneously using a 301/2-gauge needle. Orthotopic tumors were imaged to gauge the combination treatment efficacy while the subcutaneous tumors provided change in tumor blood volume post PDT. Ultrasound imaging was used to non-invasively monitor tumor volume in mice and treatment was initiated when the tumors reached ∼35 mm3or ∼70 mm3. Irinotecan and photosensitizer, Benzoporphyrin derivative (BPD) were encapsulated in liposomes and injected via tail vein at concentrations 0.25 mg/kg and 20 mg/kg respectively, 60 minutes prior to PDT light irradiation. Interstitial PDT (690 nm laser, 100mW/cm2, 75 J/cm2) was performed on the exteriorized pancreas of the anesthetized mice with orthotopic tumors. Subcutaneous tumors also received the same PDT dose. Ultrasound and photoacoustic imaging was performed using commercially available Vevo LAZR system.

Results and Conclusions: The longitudinal non-invasive ultrasound monitoring of orthotopic tumor volume in response to combination therapy was carried out with appropriate controls. We observed that PDT significantly enhances the tumoricidal efficacy of irinotecan and significantly inhibited tumor growth up to at least 3 weeks post-treatment (p &lt; 0.05). A second combination treatment given at this point did not yield a reduction in tumor volume. In addition we also observed the treatment was ineffective in larger tumors. Photoacoustic imaging of subcutaneous tumors showed decrease in oxygen saturation and blood volume post PDT. The findings of this study recognize the importance of longitudinally monitoring tumor volume, vasculature and blood oxygen status for success of combination treatments.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B148.

Citation Format: Srivalleesha Mallidi, Huang-Chiao Huang, Zhiming Mai, Ruth Goldschmidt, Joyce Liu, Patrick Chiang, Dmitriy Timerman, Imran Rizvi, Bryan Spring, Akilan Palanisami, Tayyaba Hasan. Ultrasound image guided combination therapies involving photodynamic therapy and irinotecan. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B148.

Abstract 3853: Targeting intracellular VEGF using nanotechnology for subcellular delivery of bevacizumab improves efficacy of combination therapy against pancreatic cancer

Objective: To study the efficacy of neutralizing the intracellular VEGF using nanotechnology-based delivery of bevacizumab (Avastin) in combination with a light-based cytotoxic therapy in an in vivo orthotopic pancreatic cancer (PanCa) model.

Rationale: Avastin, a monoclonal antibody against vascular endothelial growth factor (VEGF), have been approved for many cancers. Recent findings suggest the existence of an intracellular VEGF pool which cannot be neutralized by conventional delivery of Avastin. Inhibiting the intracellular VEGF pool may lead to a better treatment response than the conventional strategy. The intracellular VEGF pool can be neutralized through the intracellular delivery of Avastin by using nanotechnology. PanCa is highly resistant to cytotoxic therapies and few patients are candidates for surgical intervention. Photodynamic therapy (PDT), a photochemistry based modality, has demonstrated promising results in treating PanCa. PDT often bypasses the resistance mechanism of chemotherapy and radiotherapy. PDT is known to sensitize cancers to anti-VEGF therapy. Simultaneous delivery of multiple agents in a single nano-construct could improve the treatment response of combination therapies.

Methods: We investigated the effect of neutralizing intracellular VEGF using nanotechnology for co-delivery of Avastin and a PDT agent in AsPC-1 in vitro and an orthotopic in vivo pancreatic cancer mouse models. For this we explored the use of a new construct called “nanocells” in which the PS was non-covalently trapped inside polymer nanoparticles and these, along with Avastin, were then encapsulated inside liposomes.

Results: In vitro, nanocells containing Avastin (NCA) delivered Avastin intracellularly and this significantly enhanced the cytotoxicity in AsPC-1 cells. NCA based PDT also significantly improved the acute treatment response in mice that were orthotopically implanted with human pancreatic tumors. Avastin delivered extracellularly with PDT did not show much improvement. NCA-based treatment also significantly reduced the occurrence and extent of metastasis to distal organs like liver, lungs and the lymph nodes.

Conclusions: We propose a new paradigm for Avastin-based therapy by combining intracellular delivery of Avastin with PDT using nanotechnology for the treatment of PanCa. This suggests the involvement of an intracellular VEGF signaling pathway that plays an important role in cancer cell survival, proliferation and migration following PDT. Encapsulation of Avastin may drastically reduce the serious side effects associated with the drug which have recently come to light while significantly improving its efficacy. This could have a major clinical impact on diseases that are currently being treated with Avastin.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3853.

Abstract 5484: Simultaneous targeting of EGFR and MET pathways using nanotechnology improves the treatment outcomes of photodynamic therapy for pancreatic cancer

Pancreatic Cancer (PanCa) is difficult to treat due to its inherent resistance to most therapies. First line chemotherapy only has a 5% response rate that yields a dismal prognosis of 6-month median survival and &lt;4% 5-year survival. Combination therapies only showed modest benefits and there are still vital unmet needs for alternative treatment that improve overall patient survival.

Photodynamic Therapy (PDT), a light-regulated cytotoxic therapy, showed promise as a new treatment modality for PanCa which improved median survival from 6 to 9.5 months in a pilot clinical trial. This result triggered our preclinical development of PDT combination regimen targeting proliferative pathways to further enhance treatment outcome.

Using nanotechnology, we designed and synthesized nano-constructs co-encapsulating multiple therapeutic agents that can simultaneously target EGFR and MET-regulated proliferative pathways in combination with cytotoxic PDT treatment. We tested these nano-constructs in orthotopic pancreatic cancer models for treatment efficacy and our major findings include:

1) The nanoscale multidrug delivery system allows simultaneous targeting of EGFR and MET-regulated proliferative pathways and offered the best reduction of local tumor burden and metastatic burden to lymph nodes, lung and liver. With only one time of treatment, the local tumor burden is reduced to 10% of that of non-treated, and significant reductions of organ metastasis were also achieved.

2) The nanoscale multidrug delivery system delivers PDT agent and MET inhibitor PHA-665752 with higher payload and reduces their systemic toxicity. The EGFR inhibitor Cetuximab is delivered intracellularly into cancer cells, which targets both intracellular and cell surface EGFR. Intracellular delivery of Cetuximab increased treatment efficacy compared to naked Cetuximab.

We are continuing optimizing the scheduling of individual treatments to further improve treatment outcomes.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5484.

Abstract A127: Combination therapy targeting EGFR/MET crosstalk using nanotechnology improves photodynamic therapy treatment of pancreatic cancer

Pancreatic cancer (PanCa) is very difficult to treat due to its inherent resistance to most therapies. First line chemotherapy only has a 5% response rate, yielding a median survival of 6 months and a 5-year survival rate of &lt; 5%. Combinations of chemotherapy with numerous targeted therapies only showed modest benefits. In a pilot clinical trial, Photodynamic Therapy (PDT) showed considerable promise as an emerging alternative treatment modality for PanCa in humans by improving median survival from 6 to 9 months, which led to our subsequent investigation of a rationally designed molecularly targeted combination therapy to enhance PDT treatment of PanCa in an orthotopic murine model.

Targeted biological therapies in PanCa include an EGF Receptor (EGFR) antibody, C225 which has shown no survival benefits in humans either alone or in combination with other modalities. One of the mechanisms involved in the development of resistance to EGFR targeted therapy is the crosstalk between EGFR and MET signaling pathways. MET is also a growth factor receptor that is frequently deregulated in pancreatic cancer. In some cancers, the EGFR and MET signaling pathways synergistically drive proliferative and metastatic growth. To achieve effective tumor control it is vital that both EGFR and MET pathways are targeted simultaneously. In this preclinical study, we have developed an innovative nanoscale multidrug delivery system that targets the EGFR/MET crosstalk in combination with PDT. To target EGFR we are using C225 antibody while the MET activation is suppressed using a small molecule inhibitor PHA-665752.

Major findings of this work include: 1) Our nanoscale multidrug delivery system enabled higher payloads of the PDT agent and PHA-665752 to be delivered with reduced systemic toxicity. In our nano-construct, the C225 is now delivered intracellularly into cancer cells thus allowing the targeting of both intracellular and membrane EGFR, as opposed to carrier-free C225 delivery which only down-regulates the cell surface EGFR level. 2) Intracellular targeting of EGFR by encapsulated C225 sensitized the cancer cells to PDT treatment. This combination showed greater efficacy in reducing the EGFR levels and improved PDT treatment effect by showing a greater reduction of the local tumor burden, compared to using carrier-free C225 extracellularly. 3) Blocking the EGFR/MET crosstalk with both C225 and PHA-665752 further enhanced PDT treatment by reducing the local tumor burden. We are further investigating if this combination treatment regimen reduces tumor metastasis to distal organs and the optimal scheduling of individual biological treatments.

Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A127.

Abstract A2: Targeting intracellular VEGF using nanotechnology for subcellular delivery of bevacizumab improves efficacy of combination therapy against pancreatic cancer

Objective: To study the efficacy of neutralizing the intracellular VEGF using nanotechnology-based delivery of bevacizumab (Avastin) in combination with a light-based cytotoxic therapy in an in vivo orthotopic pancreatic cancer model.

Rationale: VEGF is a key mediator of angiogenesis and agents like Avastin, a monoclonal antibody against vascular endothelial growth factor (VEGF), have been approved for many cancers. Avastin is cell impermeant and blocks secreted VEGF. Avastin either as monotherapy or in combination with other agents has shown modest improvements in overall survival. Recent findings suggest the existence of an intracellular VEGF pool which cannot be neutralized by conventional delivery of Avastin. Inhibiting the intracellular VEGF pool may lead to a better treatment response than the conventional strategy of neutralizing only the extracellularly secreted VEGF with free Avastin. The intracellular VEGF pool can be neutralized through the intracellular delivery of Avastin by using nanotechnology. Pancreatic cancer (PanCa) is highly resistant to cytotoxic therapies and few patients are candidates for surgical intervention. Photodynamic therapy (PDT), photochemistry based modality, has demonstrated promising results in treating PanCa. PDT relies on the activation of a non-toxic chemical called photosensitizer (PS) with an appropriate wavelength of light and often bypasses the resistance mechanism of chemotherapy and radiotherapy. PDT is known to sensitize cancers to anti-VEGF therapy. Combination of PDT with anti-angiogenic therapy has been found to enhance treatment outcome. Simultaneous delivery of multiple agents in a single nano-construct could further improve the treatment response of such mechanism-based combinations.

Methods: We investigated the effect of neutralizing intracellular VEGF using nanotechnology for co-delivery of Avastin and a PDT agent in AsPC-1 in vitro and an orthotopic in vivo pancreatic cancer mouse models. For this we explored the use of a new construct called “nanocells” in which the PS was non-covalently trapped inside polymer nanoparticles and these, along with Avastin, were then encapsulated inside liposomes.

Results: In vitro, nanocells containing Avastin (NCA) delivered Avastin intracellularly and this significantly enhanced the cytotoxicity in AsPC-1 cells. NCA based PDT also significantly improved the acute treatment response in mice that were orthotopically implanted with human pancreatic tumors. Avastin delivered extracellularly with PDT did not show much improvement. NCA-based treatment also significantly reduced the occurrence and extent of metastasis to distal organs like liver, lungs and the lymph nodes.

Conclusions: We propose a new paradigm for Avastin-based therapy by combining intracellular delivery of Avastin with PDT using nanotechnology for the treatment of PanCa. This suggests the involvement of an intracellular VEGF signaling pathway that plays an important role in cancer cell survival, proliferation and migration following PDT. Encapsulation of Avastin may drastically reduce the serious side effects associated with the drug which have recently come to light while significantly improving its efficacy. This could have a major clinical impact on diseases that are currently being treated with Avastin.

Citation Information: Mol Cancer Ther 2009;8(12 Suppl):A2.

In vivo high-resolution fluorescence microendoscopy for ovarian cancer detection and treatment monitoring

Background:

In patients with advanced ovarian cancer (OvCa), microscopic residual tumour nodules that remain after surgical debulking frequently escape detection by current treatment assessment methods and lead to disease recurrence. The aim of this study was to evaluate the use of high-resolution fibre-optic fluorescence imaging of the clinically approved photodynamic therapy (PDT) agent benzoporphyin-derivative monoacid ring A (BPD-MA) for detection of microscopic OvCa and for monitoring treatment response.

Methods:

Our fluorescence microendoscope consists of a flexible imaging fibre coupled to a custom epi-fluorescence system optimised for imaging BPD-MA, which, after a single administration, serves as both an imaging agent and a light-activated therapeutic agent. After characterisation in an in vitro OvCa 3D model, we used the flexible imaging fibre to minimally invasively image the peritoneal cavity of a disseminated OvCa murine model using BPD-MA administered intraperitoneally (i.p.). To evaluate longitudinal changes in response to treatment, we compared sets of images obtained before and after PDT with those from untreated mice imaged at the same time points.

Results:

By comparison with histopathology, we report an 86% sensitivity for tumour detection in vivo using the microendoscope. Using a custom routine to batch process-image data in the monitoring study, treated mice exhibited an average decrease of 58.8% in tumour volumes compared with an increase of 59.3% in untreated controls (P<0.05).

Conclusions:

Our findings indicate the potential of this approach as a reporter of treatment outcome that could aid in the rational design of strategies to mitigate recurrent OvCa.

Strategies for enhanced photodynamic therapy effects

Photodynamic therapy (PDT) is a treatment modality for the selective destruction of cancerous and nonneoplastic pathologies that involves the simultaneous presence of light, oxygen and a light-activatable chemical called a photosensitizer (PS) to achieve a cytotoxic effect. The photophysics and mechanisms of cell killing by PDT have been extensively studied in recent years, and PDT has received regulatory approval for the treatment of a number of diseases worldwide. As the application of this treatment modality expands with regard to both anatomical sites and disease stages, it will be important to develop strategies for enhancing PDT outcomes. This article focuses on two broad approaches for PDT enhancement: (1) mechanism-based combination treatments in which PDT and a second modality can be designed to either increase the susceptibility of tumor cells to PDT or nullify the treatment outcome-mitigating molecular responses triggered by PDT of tumors, and (2) the more recent approaches of PS targeting, either by specific cellular function-sensitive linkages or via conjugation to macromolecules.

Genistein sensitizes inhibitory effect of tamoxifen on the growth of estrogen receptor-positive and HER2-overexpressing human breast cancer cells

Although tamoxifen (TAM) is used for the front-line treatment and prevention of estrogen receptor-positive (ER+) breast tumors, nearly 40% of estrogen-dependent breast tumors do not respond to TAM treatment. Moreover, the positive response is usually of short duration, and most tumors eventually develop TAM-resistance. Overexpression of HER2 gene is associated with TAM-resistance of breast tumor, and suppression of HER2 expression enhances the TAM activity. Soy isoflavone genistein has been shown to have anti-cancer activities and suppress expression of HER2 and ERalpha. The objective of this study was to test the hypothesis that genistein may sensitize the response of ER+ and HER2-overexpressing breast cancer cells to TAM treatment. The combination treatment of TAM and genistein inhibited the growth of ER+/HER2-overexpressing BT-474 human breast cancer cells in a synergistic manner in vitro. Determination of cellular markers indicated that this synergistic inhibitory effect might be contributed in part from combined effects on cell-cycle arrest at G(1) phase and on induction of apoptosis. Further determination of the molecular markers showed that TAM and genistein combination synergistically induced BT-474 cell apoptosis in part by synergistic downregulation of the expression of survivin, one of the apoptotic effectors, and downregulation of EGFR, HER2, and ERalpha expression. Our research may provide a novel approach for the prevention and/or treatment of TAM insensitive/resistant human breast cancer, and warrants further in vivo studies to verify the efficacy of genistein and TAM combination on the growth of ER+/HER2-overexpressing breast tumors and to elucidate the in vivo mechanisms of synergistic actions.

Soy phytochemicals synergistically enhance the preventive effect of tamoxifen on the growth of estrogen-dependent human breast carcinoma in mice

The objective of this work was to determine the interactive effects between soy bioactive components and tamoxifen (TAM) on prevention of estrogen-dependent breast cancer (BRCA). We initially investigated the effects of soy isoflavone genistein and TAM on the growth and cell cycle progression of estrogen-dependent MCF-7 human BRCA cells, and on the expression of ERalpha, pS2 and EGFR genes in vitro. Genistein or TAM alone inhibited the growth of MCF-7 cells in part via G(1) phase arrest, but their combinations showed suggestive antagonistic effects. We further evaluated the effects of bioactive soy components and TAM on the growth inhibition of MCF-7 tumors in a clinically relevant breast tumor model. TAM and bioactive soy components, genistein and soy phytochemical concentrate (SPC), delayed the growth of MCF-7 tumors. The combination of TAM with genistein or SPC, especially at the lower dose of TAM, had synergistic effects on delaying the growth of MCF-7 tumors. Biomarker determination suggests that the combination of TAM and soy components may synergistically delay the growth of MCF-7 tumors via their combined effects on induction of tumor cell apoptosis and inhibition of tumor cell proliferation. In addition, genistein and TAM combination synergistically delayed the growth of breast tumor via decreased estrogen level and activity, and down-regulation of EGFR expression. The results from our studies suggest that further investigations may be warranted to determine if the combination of TAM and bioactive soy components may be used for prevention and/or treatment of estrogen-dependent BRCA.

Methotrexate used in combination with aminolaevulinic acid for photodynamic killing of prostate cancer cells

Photodynamic therapy (PDT) using 5-aminolaevulinic acid (ALA) to drive production of an intracellular photosensitiser, protoporphyrin IX (PpIX), is a promising cancer treatment. However, ALA-PDT is still suboptimal for thick or refractory tumours. Searching for new approaches, we tested a known inducer of cellular differentiation, methotrexate (MTX), in combination with ALA-PDT in LNCaP cells. Methotrexate alone promoted growth arrest, differentiation, and apoptosis. Methotrexate pretreatment (1 mg l⁻¹, 72 h) followed by ALA (0.3 mM, 4 h) resulted in a three-fold increase in intracellular PpIX, by biochemical and confocal analyses. After exposure to 512 nm light, killing was significantly enhanced in MTX-preconditioned cells. The reverse order of treatments, ALA-PDT followed by MTX, yielded no enhancement. Methotrexate caused a similar relative increase in PpIX, whether cells were incubated with ALA, methyl-ALA, or hexyl-ALA, arguing against a major effect upon ALA transport. Searching for an effect among porphyrin synthetic enzymes, we found that coproporphyrinogen oxidase (CPO) was increased three-fold by MTX at the mRNA and protein levels. Transfection of LNCaP cells with a CPO-expressing vector stimulated the accumulation of PpIX. Our data suggest that MTX, when used to modulate intracellular production of endogenous PpIX, may provide a new combination PDT approach for certain cancers.

Kinetics of T cell cytokine gene expression in gerbils after a primary subcutaneous Brugia pahangi infection

The majority of patients infected with lymphatic filariae are microfilaremic but tend to manifest little obvious pathology because of the infections. Data collected from the Mongolian gerbil-Brugia spp. model for human lymphatic filariasis suggest this experimental animal model system most closely represents this patient group and will be useful in studying immunological parameters associated with chronic infections. This article reports the quantitation of interleukin (IL)-4, IL-5, IL-10, IL-13, and interferon (IFN)-gamma messenger RNA (mRNA) in gerbils after a primary subcutaneous infection with Brugia pahangi. Chronically infected gerbils showed elevated IL-4 in all tissues, compared with earlier time points, linking this Th2 cytokine to the downregulation of responsiveness, which develops in gerbils and humans. Both IL-5 and IL-13 mRNA expression were transient in all tissues. The peak in IL-5 at 14-28 days postinfection reflects the peak of peripheral eosinophilia observed in B. pahangi-infected gerbils. Little IFN-gamma mRNA was reported from chronically infected gerbils. The data collected thus far suggest that the expression profile of many of the measured cytokines in B. pahangi-infected gerbils reflects what is seen in an important subset of humans infected with lymphatic filariae, the microfilaremic, asymptomatic patient.

Combined inhibition of estrogen-dependent human breast carcinoma by soy and tea bioactive components in mice

Breast cancer is significantly less prevalent among Asian women, whose diets contain high intake of soy products and tea. The objective of our present study was to identify the combined effects of dietary soy phytochemicals and tea components on breast tumor progression in a clinically relevant in vivo model of MCF-7 androgen-dependent human breast tumor in female SCID mice. MCF-7 tumor growth, tumor cell proliferation and apoptosis, microvessel density, and expressions of tumor estrogen receptors were compared in mice treated with genistin-rich soy isoflavones (GSI), soy phytochemical concentrate (SPC), black tea (BT), green tea (GT), SPC/BT combination and SPC/GT combination. GSI and SPC led to dose-dependent inhibition of MCF-7 tumor growth via inhibition of cancer cell proliferation in vivo. GT showed more potent anti-breast tumor activity than BT. GT infusion at 1.5 g tealeaf/100 mL water produced significant (p < 0.05) reductions of 56% in final tumor weight. GT plus SPC at 0.1% of the diet further reduced final tumor weight by 72% (p < 0.005). Analysis of serum and tumor biomarkers showed that the combined effects of SPC and GT inhibited tumor angiogenesis, and reduced estrogen receptor (ER)-alpha and serum levels of insulin-like growth factor (IGF)-I. Our study suggests that dietary SPC plus GT may be used as a potential effective dietary regimen for inhibiting progression of estrogen-dependent breast cancer.

Chitinase secretion by encysting Entamoeba invadens and transfected Entamoeba histolytica trophozoites: localization of secretory vesicles, endoplasmic reticulum, and Golgi apparatus

Entamoeba histolytica, the protozoan parasite that phagocytoses bacteria and host cells, has a vesicle/vacuole-filled cytosol like that of macrophages. In contrast, the infectious cyst form has four nuclei and a chitin wall. Here, anti-chitinase antibodies identified hundreds of small secretory vesicles in encysting E. invadens parasites and in E. histolytica trophozoites overexpressing chitinase under an actin gene promoter. Abundant small secretory vesicles were also identified with antibodies to the surface antigen Ariel and with a fluorescent substrate of cysteine proteinases. Removal of an N-terminal signal sequence directed chitinase to the cytosol. Addition of a C-terminal KDEL peptide, identified on amebic BiP, retained chitinase in a putative endoplasmic reticulum, which was composed of a few vesicles of mixed sizes. A putative Golgi apparatus, which was Brefeldin A sensitive and composed of a few large, perinuclear vesicles, was identified with antibodies to ADP-ribosylating factor and to epsilon-COP. We conclude that the amebic secretory pathway is similar to those of other eukaryotic cells, even if its appearance is somewhat different.

Hsp60 is targeted to a cryptic mitochondrion-derived organelle ("crypton") in the microaerophilic protozoan parasite Entamoeba histolytica

Entamoeba histolytica is a microaerophilic protozoan parasite in which neither mitochondria nor mitochondrion-derived organelles have been previously observed. Recently, a segment of an E. histolytica gene was identified that encoded a protein similar to the mitochondrial 60-kDa heat shock protein (Hsp60 or chaperonin 60), which refolds nuclear-encoded proteins after passage through organellar membranes. The possible function and localization of the amebic Hsp60 were explored here. Like Hsp60 of mitochondria, amebic Hsp60 RNA and protein were both strongly induced by incubating parasites at 42 degreesC. 5' and 3' rapid amplifications of cDNA ends were used to obtain the entire E. histolytica hsp60 coding region, which predicted a 536-amino-acid Hsp60. The E. histolytica hsp60 gene protected from heat shock Escherichia coli groEL mutants, demonstrating the chaperonin function of the amebic Hsp60. The E. histolytica Hsp60, which lacked characteristic carboxy-terminal Gly-Met repeats, had a 21-amino-acid amino-terminal, organelle-targeting presequence that was cleaved in vivo. This presequence was necessary to target Hsp60 to one (and occasionally two or three) short, cylindrical organelle(s). In contrast, amebic alcohol dehydrogenase 1 and ferredoxin, which are bacteria-like enzymes, were diffusely distributed throughout the cytosol. We suggest that the Hsp60-associated, mitochondrion-derived organelle identified here be named "crypton," as its structure was previously hidden and its function is still cryptic.

Hypoxanthine phosphoribosyltransferase cDNA in gerbils (Meriones unguiculatus)

Hypoxanthine phosphoribosyltransferase (HPRT) is a purine salvage enzyme that catalyzes conversion of hypoxanthine and guanine to their respective mononucleotides. Because of its ubiquitous nature, HPRT is known as a "housekeeping" gene and has been frequently used as an internal control in reverse transcriptase-polymerase chain reaction (RT-PCR) quantification of cytokine mRNA. Cloning and sequencing of the gerbil HPRT cDNA sequence is an important step in the development of RT-PCR procedures in this model. Two forms of gerbil HPRT cDNA were isolated and molecularly characterized.

A new gene family (ariel) encodes asparagine-rich Entamoeba histolytica antigens, which resemble the amebic vaccine candidate serine-rich E. histolytica protein

A family of genes, called ariel, are named for and encode asparagine-rich Entamoeba histolytica antigens containing 2 to 16 octapeptide repeats. Ariel proteins, which are constitutively expressed by trophozoites, belong to a large antigen family that includes the serine-rich E. histolytica protein (SREHP), an amebic vaccine candidate.

Evidence for the bacterial origin of genes encoding fermentation enzymes of the amitochondriate protozoan parasite Entamoeba histolytica

Entamoeba histolytica is an amitochondriate protozoan parasite with numerous bacterium-like fermentation enzymes including the pyruvate:ferredoxin oxidoreductase (POR), ferredoxin (FD), and alcohol dehydrogenase E (ADHE). The goal of this study was to determine whether the genes encoding these cytosolic E. histolytica fermentation enzymes might derive from a bacterium by horizontal transfer, as has previously been suggested for E. histolytica genes encoding heat shock protein 60, nicotinamide nucleotide transhydrogenase, and superoxide dismutase. In this study, the E. histolytica por gene and the adhE gene of a second amitochondriate protozoan parasite, Giardia lamblia, were sequenced, and their phylogenetic positions were estimated in relation to POR, ADHE, and FD cloned from eukaryotic and eubacterial organisms. The E. histolytica por gene encodes a 1,620-amino-acid peptide that contained conserved iron-sulfur- and thiamine pyrophosphate-binding sites. The predicted E. histolytica POR showed fewer positional identities to the POR of G. lamblia (34%) than to the POR of the enterobacterium Klebsiella pneumoniae (49%), the cyanobacterium Anabaena sp. (44%), and the protozoan Trichomonas vaginalis (46%), which targets its POR to anaerobic organelles called hydrogenosomes. Maximum-likelihood, neighbor-joining, and parsimony analyses also suggested as less likely E. histolytica POR sharing more recent common ancestry with G. lamblia POR than with POR of bacteria and the T. vaginalis hydrogenosome. The G. lamblia adhE encodes an 888-amino-acid fusion peptide with an aldehyde dehydrogenase at its amino half and an iron-dependent (class 3) ADH at its carboxy half. The predicted G. lamblia ADHE showed extensive positional identities to ADHE of Escherichia coli (49%), Clostridium acetobutylicum (44%), and E. histolytica (43%) and lesser identities to the class 3 ADH of eubacteria and yeast (19 to 36%). Phylogenetic analyses inferred a closer relationship of the E. histolytica ADHE to bacterial ADHE than to the G. lamblia ADHE. The 6-kDa FD of E. histolytica and G. lamblia were most similar to those of the archaebacterium Methanosarcina barkeri and the delta-purple bacterium Desulfovibrio desulfuricans, respectively, while the 12-kDa FD of the T. vaginalis hydrogenosome was most similar to the 12-kDa FD of gamma-purple bacterium Pseudomonas putida. E. histolytica genes (and probably G. lamblia genes) encoding fermentation enzymes therefore likely derive from bacteria by horizontal transfer, although it is not clear from which bacteria these amebic genes derive. These are the first nonorganellar fermentation enzymes of eukaryotes implicated to have derived from bacteria.

Cross-species PCR cloning of gerbil (Meriones unguiculatus) interleukin-2 cDNA and its expression in COS-7 cells

A cDNA clone of the gerbil interleukin-2 (IL-2) gene was isolated by cross-species PCR cloning, and demonstrated to produce a functional gerbil IL-2 protein when inserted in the eucaryotic expression vector pSV-SPORT1 and transfected into COS-7 monkey cells. The open reading frame codes for a polypeptide of 155 amino acid residues with a molecular weight (MW) of 17,601 which includes a putative signal peptide. The mature gerbil IL-2 is deduced to contain 135 amino acid residues and has a calculated MW of 15,496. Culture supernatant of COS-7 cells transfected with pSV-SPORT1-GIL-2, but not pSV-SPORT1 stimulates the proliferation of the IL-2 dependent murine CTLL-2 cells. Molecular characteristics of gerbil IL-2 have been compared with IL-2 of mouse, rat, human, bovine, ovine and porcine origin. The mature form of gerbil IL-2 is similar in molecular weight to all species except the mouse. A N-glycosylation site present in bovine, ovine and porcine IL-2 respectively, is absent in gerbil. Three Cys residues are conserved in all compared mature IL-2 molecules. In these comparisons, gerbil IL-2 has highest identity with rat IL-2 for both nucleotide and amino acid sequence.