1
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Meuser E, Chang K, Walters A, Hurley JJ, West HD, Perry I, Mort M, Reyes-Uribe L, Truscott R, Jones N, Lawrence R, Jenkins G, Giles P, Dolwani S, Al-Sarireh B, Hawkes N, Short E, Williams GT, Taggart MW, Luetchford K, Lynch PM, Terlouw D, Nielsen M, Walton SJ, Latchford A, Clark SK, Sampson JR, Vilar E, Thomas LE. PIGA mutations and glycosylphosphatidylinositol anchor dysregulation in polyposis-associated duodenal tumorigenesis. Mol Cancer Res 2024:742062. [PMID: 38546397 DOI: 10.1158/1541-7786.mcr-23-0810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/30/2024] [Accepted: 03/26/2024] [Indexed: 05/23/2024]
Abstract
The pathogenesis of duodenal tumours in the inherited tumour syndromes Familial Adenomatous Polyposis (FAP) and MUTYH-associated Polyposis (MAP) is poorly understood. This study aimed to identify genes that are significantly mutated in these tumours and to explore the effects of these mutations. Whole exome and whole transcriptome sequencing identified recurrent somatic coding variants of PIGA in 19/70 (27%) FAP and MAP duodenal adenomas, and further confirmed the established driver roles for APC and KRAS. PIGA catalyses the first step in glycosylphosphatidylinositol (GPI) anchor biosynthesis. Flow cytometry of PIGA-mutant adenoma-derived and CRISPR-edited duodenal organoids confirmed loss of GPI anchors in duodenal epithelial cells and transcriptional profiling of duodenal adenomas revealed transcriptional signatures associated with loss of PIGA. Implications: PIGA somatic mutation in duodenal tumours from patients with FAP and MAP and loss of membrane GPI-anchors may present new opportunities for understanding and intervention in duodenal tumorigenesis.
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Affiliation(s)
| | - Kyle Chang
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | | | - Iain Perry
- Swansea University, Swansea, United Kingdom
| | | | - Laura Reyes-Uribe
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | | | | | - Peter Giles
- Cardiff University, Cardiff, Wales, United Kingdom
| | | | | | - Neil Hawkes
- Cwm Taf University Health Board, United Kingdom
| | - Emma Short
- Swansea Bay University Health Board, United Kingdom
| | | | - Melissa W Taggart
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kim Luetchford
- Molecular Devices (United Kingdom), Cardiff, United Kingdom
| | - Patrick M Lynch
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | | | | | | | | | - Eduardo Vilar
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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2
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Daly CS, Shaw P, Ordonez LD, Williams GT, Quist J, Grigoriadis A, Van Es JH, Clevers H, Clarke AR, Reed KR. Correction: Functional redundancy between Apc and Apc2 regulates tissue homeostasis and prevents tumorigenesis in murine mammary epithelium. Oncogene 2024; 43:918. [PMID: 38263250 PMCID: PMC11098734 DOI: 10.1038/s41388-024-02941-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Affiliation(s)
- C S Daly
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - P Shaw
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - L D Ordonez
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - G T Williams
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - J Quist
- Breast Cancer Now Unit, King's College London, Guy's Hospital London, London, UK
- Cancer Bioinformatics, King's College London, Guy's Hospital London, London, UK
| | - A Grigoriadis
- Breast Cancer Now Unit, King's College London, Guy's Hospital London, London, UK
- Cancer Bioinformatics, King's College London, Guy's Hospital London, London, UK
| | - J H Van Es
- Hubrecht Laboratory, Netherlands Institute for Developmental Biology, Utrecht, The Netherlands
| | - H Clevers
- Hubrecht Laboratory, Netherlands Institute for Developmental Biology, Utrecht, The Netherlands
| | - A R Clarke
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - K R Reed
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK.
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3
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Tonge DP, Darling D, Farzaneh F, Williams GT. Whole-genome-scale identification of novel non-protein-coding RNAs controlling cell proliferation and survival through a functional forward genetics strategy. Sci Rep 2022; 12:182. [PMID: 34997014 PMCID: PMC8741825 DOI: 10.1038/s41598-021-03983-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/13/2021] [Indexed: 12/29/2022] Open
Abstract
Identification of cell fate-controlling lncRNAs is essential to our understanding of molecular cell biology. Here we present a human genome-scale forward-genetics approach for the identification of lncRNAs based on gene function. This approach can identify genes that play a causal role, and immediately distinguish them from those that are differentially expressed but do not affect cell function. Our genome-scale library plus next-generation-sequencing and bioinformatic approach, radically upscales the breadth and rate of functional ncRNA discovery. Human gDNA was digested to produce a lentiviral expression library containing inserts in both sense and anti-sense orientation. The library was used to transduce human Jurkat T-leukaemic cells. Cell populations were selected using continuous culture ± anti-FAS IgM, and sequencing used to identify sequences controlling cell proliferation. This strategy resulted in the identification of thousands of new sequences based solely on their function including many ncRNAs previously identified as being able to modulate cell survival or to act as key cancer regulators such as AC084816.1*, AC097103.2, AC087473.1, CASC15*, DLEU1*, ENTPD1-AS1*, HULC*, MIRLET7BHG*, PCAT-1, SChLAP1, and TP53TG1. Independent validation confirmed 4 out of 5 sequences that were identified by this strategy, conferred a striking resistance to anti-FAS IgM-induced apoptosis.
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Affiliation(s)
- D P Tonge
- Faculty of Natural Sciences, School of Life Sciences, Keele University, Keele, ST5 5BG, UK.
| | - D Darling
- Molecular Medicine Group, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Kings College London, London, UK
| | - F Farzaneh
- Molecular Medicine Group, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Kings College London, London, UK
| | - G T Williams
- Faculty of Natural Sciences, School of Life Sciences, Keele University, Keele, ST5 5BG, UK
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4
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Hurt C, Ramaraj R, Farr A, Morgan M, Williams N, Philips CJ, Williams GT, Gardner G, Porter C, Sampson J, Hillier S, Heard H, Dolwani S. Feasibility and economic assessment of chromocolonoscopy for detection of proximal serrated neoplasia within a population-based colorectal cancer screening programme (CONSCOP): an open-label, randomised controlled non-inferiority trial. Lancet Gastroenterol Hepatol 2019; 4:364-375. [PMID: 30885505 DOI: 10.1016/s2468-1253(19)30035-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Most post-colonoscopy interval colorectal cancers are proximal; serrated polyps are often precursors to these cancers and are considered difficult to detect. We assessed the safety, feasibility, and economic effect of chromocolonoscopy on detection of proximal serrated neoplasia. METHODS We did an open-label, multicentre, randomised, controlled non-inferiority trial including patients from Bowel Screening Wales centres. Participants who tested positive for faecal occult blood and who were eligible for and considered fit to have colonoscopy (patients with known cases of polyposis syndromes, Lynch syndrome, and chronic inflammatory disease were excluded) were randomly assigned (1:1; with the use of minimisation, stratified by centre with an 80:20 random element) to either standard white light colonoscopy (standard group) or chromocolonoscopy (indigo carmine dye [0·2%]; chromocolonoscopy group) using a secure, internet-based, computerised, randomisation system that used centralised, dynamic allocation. Participants were followed up for 1 year and data from index colonoscopies and associated clearance procedures were analysed. All proximal polyps were reviewed by an expert pathologist panel. The main outcome on which power was based was time taken to perform the colonoscopy procedure, defined as from the time when the scope was inserted to withdrawal from the anus, assessed in the per-protocol population. The non-inferiority margin was 15 min. This trial is complete and is registered with ClinicalTrials.gov, number NCT01972451. FINDINGS Between Nov 20, 2014, and June 16, 2016, 741 (72%) of 1031 patients screened were eligible and consented: 360 were randomly assigned to white light colonoscopy and 381 to chromocolonoscopy. In the chromocolonoscopy group, the procedure took a mean of 36·8 min (SD 15·0), compared with a mean of 30·6 min (13·7) in the standard group (mean difference 6·3 min [95% CI 4·2-8·4] longer with chromocolonoscopy than in the standard group). The mean difference was within the prespecified non-inferiority margin. Detection rates for proximal serrated lesions were significantly higher in the chromocolonoscopy group than in the control group (45 [12%] of 381 patients vs 23 [6%] of 360 patients; odds ratio 1·96 [95% CI 1·16-3·32]; p=0·012). Serious adverse events (four cases of postpolypectomy bleeding [two in each group], and one case of anxiety and hyperventilation [in the chromocolonoscopy group]), colonoscopy quality measures, comfort scores, and sedation were similar between groups. INTERPRETATION Chromocolonoscopy is feasible within a population-based colorectal cancer screening programme, is safe, and has significantly increased detection of proximal serrated neoplasia and other polyp types compared with standard colonoscopy. Larger randomised trials of chromocolonoscopy, powered for improved detection of significant serrated polyps and for longer-term follow-up to investigate the effect on reduction of interval cancers within screening populations, are warranted. FUNDING Health and Care Research Wales (RfPPB-1021).
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Affiliation(s)
- Chris Hurt
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Rajeswari Ramaraj
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Angela Farr
- College of Human and Health Sciences, Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - Meleri Morgan
- Department of Pathology, Cardiff and Vale University Health Board, Cardiff, UK
| | - Namor Williams
- Department of Pathology, Abertawe Bro Morgannwg University Health Board, Port Talbot, UK
| | - Ceri J Philips
- College of Human and Health Sciences, Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - Geraint T Williams
- Department of Pathology, Cardiff University School of Medicine, Cardiff, UK
| | | | | | - Julian Sampson
- Division of Cancer and Genetics, Department of Medical Genetics, Cardiff University School of Medicine, Cardiff, UK
| | | | - Hayley Heard
- Bowel Screening Wales, Public Health Wales, Llantrisant, UK
| | - Sunil Dolwani
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK.
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5
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Greenow KR, Zverev M, May S, Kendrick H, Williams GT, Phesse T, Parry L. Lect2 deficiency is characterised by altered cytokine levels and promotion of intestinal tumourigenesis. Oncotarget 2018; 9:36430-36443. [PMID: 30559928 PMCID: PMC6284865 DOI: 10.18632/oncotarget.26335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 10/28/2018] [Indexed: 01/21/2023] Open
Abstract
Leukocyte cell-derived chemotaxin 2 (Lect2) is a chemokine-like chemotactic factor that has been identified as a downstream target of the Wnt signalling pathway. Whilst the primary function of Lect2 is thought to be in modulating the inflammatory process, it has recently been implicated as a potential inhibitor of the Wnt pathway. Deregulation of the Wnt pathway, often due to loss of the negative regulator APC, is found in ~80% of colorectal cancer (CRC). Here we have used the ApcMin/+Lect2-/- mouse model to characterise the role of Lect2 in Wnt-driven intestinal tumourigenesis. Histopathological, immunohistochemical, PCR and flow cytometry analysis were employed to identify the role of Lect2 in the intestine. The ApcMin/+Lect2-/- mice had a reduced mean survival and a significantly increased number of adenomas in the small intestine with increased severity. Analysis of Lect2 loss indicated it had no effect on the Wnt pathway in the intestine but significant differences were observed in circulating inflammatory markers, CD4+ T cells, and T cell lineage-specification factors. In summary, in the murine intestine loss of Lect2 promotes the initiation and progression of Wnt-driven colorectal cancer. This protection is performed independently of the Wnt signalling pathway and is associated with an altered inflammatory environment during Wnt-driven tumorigenesis.
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Affiliation(s)
- Kirsty R. Greenow
- European Cancer Stem Cell Research Institute, Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - Matthew Zverev
- European Cancer Stem Cell Research Institute, Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - Stephanie May
- European Cancer Stem Cell Research Institute, Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - Howard Kendrick
- European Cancer Stem Cell Research Institute, Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | | | - Toby Phesse
- European Cancer Stem Cell Research Institute, Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - Lee Parry
- European Cancer Stem Cell Research Institute, Cardiff School of Biosciences, Cardiff University, Cardiff, UK
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6
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May S, Owen H, Phesse TJ, Greenow KR, Jones G, Blackwood A, Cook PC, Towers C, Gallimore AM, Williams GT, Stürzl M, Britzen‐Laurent N, Sansom OJ, MacDonald AS, Bird AP, Clarke AR, Parry L. Mbd2 enables tumourigenesis within the intestine while preventing tumour-promoting inflammation. J Pathol 2018; 245:270-282. [PMID: 29603746 PMCID: PMC6032908 DOI: 10.1002/path.5074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 02/22/2018] [Accepted: 03/08/2018] [Indexed: 01/14/2023]
Abstract
Epigenetic regulation plays a key role in the link between inflammation and cancer. Here we examine Mbd2, which mediates epigenetic transcriptional silencing by binding to methylated DNA. In separate studies the Mbd2-/- mouse has been shown (1) to be resistant to intestinal tumourigenesis and (2) to have an enhanced inflammatory/immune response, observations that are inconsistent with the links between inflammation and cancer. To clarify its role in tumourigenesis and inflammation, we used constitutive and conditional models of Mbd2 deletion to explore its epithelial and non-epithelial roles in the intestine. Using a conditional model, we found that suppression of intestinal tumourigenesis is due primarily to the absence of Mbd2 within the epithelia. Next, we demonstrated, using the DSS colitis model, that non-epithelial roles of Mbd2 are key in preventing the transition from acute to tumour-promoting chronic inflammation. Combining models revealed that prior to inflammation the altered Mbd2-/- immune response plays a role in intestinal tumour suppression. However, following inflammation the intestine converts from tumour suppressive to tumour promoting. To summarise, in the intestine the normal function of Mbd2 is exploited by cancer cells to enable tumourigenesis, while in the immune system it plays a key role in preventing tumour-enabling inflammation. Which role is dominant depends on the inflammation status of the intestine. As environmental interactions within the intestine can alter DNA methylation patterns, we propose that Mbd2 plays a key role in determining whether these interactions are anti- or pro-tumourigenic and this makes it a useful new epigenetic model for inflammation-associated carcinogenesis. © 2018 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Stephanie May
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
| | - Heather Owen
- Wellcome Trust Centre for Cell BiologyUniversity of Edinburgh, Michael Swann BuildingEdinburghUK
| | - Toby J Phesse
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
| | - Kirsty R Greenow
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
| | - Gareth‐Rhys Jones
- Manchester Collaborative Centre for Inflammation ResearchManchesterUK
| | - Adam Blackwood
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
| | - Peter C Cook
- Manchester Collaborative Centre for Inflammation ResearchManchesterUK
| | - Christopher Towers
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
| | - Awen M Gallimore
- Cardiff Institute of Infection and Immunity, Henry Wellcome BuildingCardiffUK
| | - Geraint T Williams
- Institute of Cancer and GeneticsCardiff University School of MedicineCardiffUK
| | - Michael Stürzl
- Division of Molecular and Experimental Surgery, Department of SurgeryFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg and Universitätsklinikum ErlangenErlangenGermany
| | - Nathalie Britzen‐Laurent
- Division of Molecular and Experimental Surgery, Department of SurgeryFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg and Universitätsklinikum ErlangenErlangenGermany
| | | | | | - Adrian P Bird
- Wellcome Trust Centre for Cell BiologyUniversity of Edinburgh, Michael Swann BuildingEdinburghUK
| | - Alan R Clarke
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
| | - Lee Parry
- European Cancer Stem Cell Research InstituteCardiff University, School of BiosciencesCardiffUK
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7
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Abstract
Gastrointestinal lymphoma (GIL) is rare but may be cured by surgery and chemotherapy. Because symptoms frequently mimic common abdominal conditions, presentation is often to a surgeon. Fiftyfive patients with GIL were treated between 1975 and 1984: all underwent operations before the correct diagnosis was made, 22 (40%) as emergencies. Misdiagnosis in 23 (42%) led to a delay in correct treatment of ≥ 6 months from the start of symptoms: in 17 (31%) the delay was ≥ one year. Endoscopy and radiology were inaccurate and suggested peptic ulceration, Crohn's disease or irritable bowel syndrome. The site of disease was usually stomach and duodenum (26, 47%) or ileum and jejunum (29, 53%). The extent of surgical resection was associated with survival at ≥3 years - in 16 (29%) who underwent ‘complete resection’ 14 survived, but only one of 28 survived when the operation was limited to diagnostic biopsy (P < 0.0001). Most deaths occurred within one year of operation, commonlyfrom perforation or haematemesis from residual mural disease during chemotherapy. In 5 of 11 patients who had biopsy only, CT scans suggested localized disease, and ‘complete resection’ was achieved at a second laparotomy. Complete resection should be attempted wherever possible before chemotherapy. The place for surgeons with experience is clearly central to the management of this disease.
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Affiliation(s)
- A D Baildam
- Department of Surgery, Christie Hospital, Manchester
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8
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Jezkova J, Williams JS, Pinto F, Sammut SJ, Williams GT, Gollins S, McFarlane RJ, Reis RM, Wakeman JA. Brachyury identifies a class of enteroendocrine cells in normal human intestinal crypts and colorectal cancer. Oncotarget 2017; 7:11478-86. [PMID: 26862851 PMCID: PMC4905487 DOI: 10.18632/oncotarget.7202] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/23/2016] [Indexed: 12/22/2022] Open
Abstract
Normal homeostasis of adult intestinal epithelium and repair following tissue damage is maintained by a balance of stem and differentiated cells, many of which are still only poorly characterised. Enteroendocrine cells of the gut are a small population of differentiated, secretory cells that are critical for integrating nutrient sensing with metabolic responses, dispersed amongst other epithelial cells. Recent evidence suggests that sub-sets of secretory enteroendocrine cells can act as reserve stem cells. Given the link between cells with stem-like properties and cancer, it is important that we identify factors that might provide a bridge between the two. Here, we identify a sub-set of chromogranin A-positive enteroendocrine cells that are positive for the developmental and cancer-associated transcription factor Brachyury in normal human small intestinal and colonic crypts. Whilst chromogranin A-positive enteroendocrine cells are also Brachyury-positive in colorectal tumours, expression of Brachyury becomes more diffuse in these samples, suggesting a more widespread function in cancer. The finding of the developmental transcription factor Brachyury in normal adult human intestinal crypts may extend the functional complexity of enteroendocrine cells and serves as a platform for assessment of the molecular processes of intestinal homeostasis that underpins our understanding of human health, cancer and aging.
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Affiliation(s)
- Jana Jezkova
- North West Cancer Research Institute, School of Medical Sciences, Bangor University, Bangor, UK
| | - Jason S Williams
- North West Cancer Research Institute, School of Medical Sciences, Bangor University, Bangor, UK
| | - Filipe Pinto
- Life and Health Sciences Research Institute (ICVS), School Health Sciences, University Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Stephen J Sammut
- North West Cancer Research Institute, School of Medical Sciences, Bangor University, Bangor, UK
| | - Geraint T Williams
- Institute of Cancer and Genetics, Cardiff University Medical School, Cardiff, UK
| | - Simon Gollins
- North Wales Cancer Treatment Centre, Betsi Cadwaladr University Health Board, Bodelwyddan, UK
| | - Ramsay J McFarlane
- North West Cancer Research Institute, School of Medical Sciences, Bangor University, Bangor, UK.,NISCHR Cancer Genetics Biomedical Research Unit, Cardiff, UK
| | - Rui Manuel Reis
- Life and Health Sciences Research Institute (ICVS), School Health Sciences, University Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil
| | - Jane A Wakeman
- North West Cancer Research Institute, School of Medical Sciences, Bangor University, Bangor, UK
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9
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Thomas LE, Hurley JJ, Meuser E, Jose S, Ashelford KE, Mort M, Idziaszczyk S, Maynard J, Brito HL, Harry M, Walters A, Raja M, Walton SJ, Dolwani S, Williams GT, Morgan M, Moorghen M, Clark SK, Sampson JR. Burden and Profile of Somatic Mutation in Duodenal Adenomas from Patients with Familial Adenomatous- and MUTYH-associated Polyposis. Clin Cancer Res 2017; 23:6721-6732. [PMID: 28790112 DOI: 10.1158/1078-0432.ccr-17-1269] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/21/2017] [Accepted: 07/25/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Duodenal polyposis and cancer are important causes of morbidity and mortality in familial adenomatous polyposis (FAP) and MUTYH-associated polyposis (MAP). This study aimed to comprehensively characterize somatic genetic changes in FAP and MAP duodenal adenomas to better understand duodenal tumorigenesis in these disorders.Experimental Design: Sixty-nine adenomas were biopsied during endoscopy in 16 FAP and 10 MAP patients with duodenal polyposis. Ten FAP and 10 MAP adenomas and matched blood DNA samples were exome sequenced, 42 further adenomas underwent targeted sequencing, and 47 were studied by array comparative genomic hybridization. Findings in FAP and MAP duodenal adenomas were compared with each other and to the reported mutational landscape in FAP and MAP colorectal adenomas.Results: MAP duodenal adenomas had significantly more protein-changing somatic mutations (P = 0.018), truncating mutations (P = 0.006), and copy number variants (P = 0.005) than FAP duodenal adenomas, even though MAP patients had lower Spigelman stage duodenal polyposis. Fifteen genes were significantly recurrently mutated. Targeted sequencing of APC, KRAS, PTCHD2, and PLCL1 identified further mutations in each of these genes in additional duodenal adenomas. In contrast to MAP and FAP colorectal adenomas, neither exome nor targeted sequencing identified WTX mutations (P = 0.0017).Conclusions: The mutational landscapes in FAP and MAP duodenal adenomas overlapped with, but had significant differences to those reported in colorectal adenomas. The significantly higher burden of somatic mutations in MAP than FAP duodenal adenomas despite lower Spigelman stage disease could increase cancer risk in the context of apparently less severe benign disease. Clin Cancer Res; 23(21); 6721-32. ©2017 AACR.
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Affiliation(s)
- Laura E Thomas
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Joanna J Hurley
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom.,Department of Gastroenterology, Prince Charles Hospital, Merthyr Tydfil, United Kingdom
| | - Elena Meuser
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Sian Jose
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Kevin E Ashelford
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Matthew Mort
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Shelley Idziaszczyk
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Julie Maynard
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Helena Leon Brito
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Manon Harry
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Angharad Walters
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Meera Raja
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | | | - Sunil Dolwani
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom.,Division of Population Medicine, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Geraint T Williams
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom
| | - Meleri Morgan
- Department of Pathology, University Hospital for Wales, Cardiff, United Kingdom
| | - Morgan Moorghen
- The Polyposis Registry, St. Marks Hospital, Harrow, United Kingdom.,Department of Pathology, St. Marks Hospital, Harrow, United Kingdom
| | - Susan K Clark
- The Polyposis Registry, St. Marks Hospital, Harrow, United Kingdom.,Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Julian R Sampson
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, United Kingdom.
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10
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Daly CS, Shaw P, Ordonez LD, Williams GT, Quist J, Grigoriadis A, Van Es JH, Clevers H, Clarke AR, Reed KR. Functional redundancy between Apc and Apc2 regulates tissue homeostasis and prevents tumorigenesis in murine mammary epithelium. Oncogene 2017; 36:1793-1803. [PMID: 27694902 PMCID: PMC5219933 DOI: 10.1038/onc.2016.342] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 08/02/2016] [Accepted: 08/05/2016] [Indexed: 02/08/2023]
Abstract
Aberrant Wnt signaling within breast cancer is associated with poor prognosis, but regulation of this pathway in breast tissue remains poorly understood and the consequences of immediate or long-term dysregulation remain elusive. The exact contribution of the Wnt-regulating proteins adenomatous polyposis coli (APC) and APC2 in the pathogenesis of human breast cancer are ill-defined, but our analysis of publically available array data sets indicates that tumors with concomitant low expression of both proteins occurs more frequently in the 'triple negative' phenotype, which is a subtype of breast cancer with particularly poor prognosis. We have used mouse transgenics to delete Apc and/or Apc2 from mouse mammary epithelium to elucidate the significance of these proteins in mammary homeostasis and delineate their influences on Wnt signaling and tumorigenesis. Loss of either protein alone failed to affect Wnt signaling levels or tissue homeostasis. Strikingly, concomitant loss led to local disruption of β-catenin status, disruption in epithelial integrity, cohesion and polarity, increased cell division and a distinctive form of ductal hyperplasia with 'squamoid' ghost cell nodules in young animals. Upon aging, the development of Wnt activated mammary carcinomas with squamous differentiation was accompanied by a significantly reduced survival. This novel Wnt-driven mammary tumor model highlights the importance of functional redundancies existing between the Apc proteins both in normal homeostasis and in tumorigenesis.
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Affiliation(s)
- C S Daly
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - P Shaw
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - L D Ordonez
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - G T Williams
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - J Quist
- Breast Cancer Now Unit, King's College London, Guy's Hospital London, London, UK
- Cancer Bioinformatics, King's College London, Guy's Hospital London, London, UK
| | - A Grigoriadis
- Breast Cancer Now Unit, King's College London, Guy's Hospital London, London, UK
- Cancer Bioinformatics, King's College London, Guy's Hospital London, London, UK
| | - J H Van Es
- Hubrecht Laboratory, Netherlands Institute for Developmental Biology, Utrecht, The Netherlands
| | - H Clevers
- Hubrecht Laboratory, Netherlands Institute for Developmental Biology, Utrecht, The Netherlands
| | - A R Clarke
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
| | - K R Reed
- European Cancer Stem Cell Research Institute, Cardiff University School of Biosciences, Cardiff, Wales, UK
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11
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Griggs RKL, Novelli MR, Sanders DSA, Warren BF, Williams GT, Quirke P, Shepherd NA. Challenging diagnostic issues in adenomatous polyps with epithelial misplacement in bowel cancer screening: 5 years’ experience of the Bowel Cancer Screening Programme Expert Board. Histopathology 2016; 70:466-472. [DOI: 10.1111/his.13092] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/23/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Rebecca K L Griggs
- Gloucestershire Cellular Pathology Laboratory; Cheltenham General Hospital; Cheltenham UK
| | - Marco R Novelli
- Department of Cellular Pathology; University College Hospital; London UK
| | | | - Bryan F Warren
- Late of the Cellular Pathology Department; John Radcliffe Hospital; Oxford UK
| | - Geraint T Williams
- Division of Cancer & Genetics; Cardiff University School of Medicine; Cardiff UK
| | - Philip Quirke
- Leeds Institute of Cancer and Pathology; St James's University Hospital; Leeds UK
| | - Neil A Shepherd
- Gloucestershire Cellular Pathology Laboratory; Cheltenham General Hospital; Cheltenham UK
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12
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Rashid M, Fischer A, Wilson CH, Tiffen J, Rust AG, Stevens P, Idziaszczyk S, Maynard J, Williams GT, Mustonen V, Sampson JR, Adams DJ. Adenoma development in familial adenomatous polyposis and MUTYH-associated polyposis: somatic landscape and driver genes. J Pathol 2015; 238:98-108. [PMID: 26414517 PMCID: PMC4832337 DOI: 10.1002/path.4643] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 07/03/2015] [Accepted: 09/21/2015] [Indexed: 12/12/2022]
Abstract
Familial adenomatous polyposis (FAP) and MUTYH‐associated polyposis (MAP) are inherited disorders associated with multiple colorectal adenomas that lead to a very high risk of colorectal cancer. The somatic mutations that drive adenoma development in these conditions have not been investigated comprehensively. In this study we performed analysis of paired colorectal adenoma and normal tissue DNA from individuals with FAP or MAP, sequencing 14 adenoma whole exomes (eight MAP, six FAP), 55 adenoma targeted exomes (33 MAP, 22 FAP) and germline DNA from each patient, and a further 63 adenomas by capillary sequencing (41 FAP, 22 MAP). With these data we examined the profile of mutated genes, the mutational signatures and the somatic mutation rates, observing significant diversity in the constellations of mutated driver genes in different adenomas, and loss‐of‐function mutations in WTX (9%; p < 9.99e‐06), a gene implicated in regulation of the WNT pathway and p53 acetylation. These data extend our understanding of the early events in colorectal tumourigenesis in the polyposis syndromes. © 2015 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Mamunur Rashid
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Andrej Fischer
- Population Genomics of Adaptation, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Cathy H Wilson
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Jessamy Tiffen
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Alistair G Rust
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Philip Stevens
- The Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Shelley Idziaszczyk
- Institute of Medical Genetics, Cardiff University School of Medicine, UK.,Institute of Cancer and Genetics, Cardiff University School of Medicine, UK
| | - Julie Maynard
- Institute of Medical Genetics, Cardiff University School of Medicine, UK.,Institute of Cancer and Genetics, Cardiff University School of Medicine, UK
| | - Geraint T Williams
- Institute of Medical Genetics, Cardiff University School of Medicine, UK.,Institute of Cancer and Genetics, Cardiff University School of Medicine, UK
| | - Ville Mustonen
- Population Genomics of Adaptation, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Julian R Sampson
- Institute of Medical Genetics, Cardiff University School of Medicine, UK.,Institute of Cancer and Genetics, Cardiff University School of Medicine, UK
| | - David J Adams
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
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13
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Raja M, Zverev M, Seipel K, Williams GT, Clarke AR, Shaw PHS. Assessment of the In Vivo Activity of PI3K and MEK Inhibitors in Genetically Defined Models of Colorectal Cancer. Mol Cancer Ther 2015. [PMID: 26206338 DOI: 10.1158/1535-7163.mct-15-0223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of tailoring medicines for cancer patients according to the molecular profile of their disease holds great promise for the improvement of cancer therapy. Nevertheless, this approach has been limited, in part, due to the lack of predictive and informative preclinical studies. Herein, we describe an assessment of the therapeutic potential of targeting PI3K/mTOR and MAPK signaling in genetically defined mouse models of colorectal cancer mirroring disease subtypes targeted for novel therapy in the FOCUS4 trial. Our studies demonstrate that dual PI3K/mTOR inhibition is highly effective in invasive adenocarcinoma models characterized by combinatorial mutations in Apc and Pten; Apc and Kras; and Apc, Pten and Kras. MEK inhibition was effective in the combinatorial Apc and Kras setting, but had no impact in either Apc Pten mutants or in Apc Pten Kras triple mutants. Furthermore, we describe the importance of scheduling for combination studies and show that although no additional benefit is gained in Apc Pten mice, combination of PI3K/mTOR and MAPK inhibition leads to an additive benefit in survival in Apc Kras mice and a synergistic increase in survival in Apc Pten Kras mice. This is the first study using robust colorectal cancer genetically engineered mouse models to support the validity of PI3K/mTOR and MEK inhibitors as tailored therapies for colorectal cancer and highlight the potential importance of drug scheduling in the clinic.
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Affiliation(s)
- Meera Raja
- European Cancer Stem Cell Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Matt Zverev
- European Cancer Stem Cell Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Katja Seipel
- European Cancer Stem Cell Research Institute, Cardiff University, Cardiff, United Kingdom. University Hospital Bern, Bern, Switzerland
| | | | - Alan R Clarke
- European Cancer Stem Cell Research Institute, Cardiff University, Cardiff, United Kingdom.
| | - Paul H S Shaw
- European Cancer Stem Cell Research Institute, Cardiff University, Cardiff, United Kingdom
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14
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Bento DC, Jones E, Junaid S, Tull J, Williams GT, Godkin A, Ager A, Gallimore A. High endothelial venules are rare in colorectal cancers but accumulate in extra-tumoral areas with disease progression. Oncoimmunology 2015; 4:e974374. [PMID: 25949892 PMCID: PMC4404788 DOI: 10.4161/2162402x.2014.974374] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/03/2014] [Indexed: 01/31/2023] Open
Abstract
Prolonged patient survival after surgical resection, is associated with a higher cytotoxic and memory T cell density within colorectal cancers (CRC). High endothelial venules (HEVs) are specialized blood vessels present in secondary lymphoid organs (SLO) that allow ingress of naïve and central memory T cells from the blood. It has been proposed that HEVs in tumors might serve as a similar route of entry for lymphocytes into the tumor and result in an improved prognosis. The present study aimed to characterize HEVs and their microenvironment in resected tumors from colorectal cancer patients (n = 62). We observed HEVs in association with lymphoid aggregates in 49 out of 62 patients. However, these HEV+ lymphoid aggregates were largely at the invasive margin of the tumor and although there was an association with lymphocytes and HEVs at the invasive margin (p = 0.002) there was only a very weak association with tumor infiltrating lymphocytes. Indeed, lymphoid aggregates were associated with more advanced disease (Dukes’ stage C) and did not indicate a favorable prognosis.
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Affiliation(s)
- Diana Costa Bento
- Infection and Immunity; School of Medicine; Henry Wellcome Building; Cardiff University ; Cardiff, UK
| | - Emma Jones
- Infection and Immunity; School of Medicine; Henry Wellcome Building; Cardiff University ; Cardiff, UK
| | - Syed Junaid
- Infection and Immunity; School of Medicine; Henry Wellcome Building; Cardiff University ; Cardiff, UK
| | - Justyna Tull
- Institute of Medical Genetics; University Hospital of Wales ; Cardiff, UK
| | - Geraint T Williams
- Institute of Cancer and Genetics; Cardiff University School of Medicine ; Cardiff, UK
| | - Andrew Godkin
- Infection and Immunity; School of Medicine; Henry Wellcome Building; Cardiff University ; Cardiff, UK
| | - Ann Ager
- Infection and Immunity; School of Medicine; Henry Wellcome Building; Cardiff University ; Cardiff, UK
| | - Awen Gallimore
- Infection and Immunity; School of Medicine; Henry Wellcome Building; Cardiff University ; Cardiff, UK
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15
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Greenow KR, Clarke AR, Williams GT, Jones R. Wnt-driven intestinal tumourigenesis is suppressed by Chk1 deficiency but enhanced by conditional haploinsufficiency. Oncogene 2014; 33:4089-96. [PMID: 24037525 DOI: 10.1038/onc.2013.371] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 05/17/2013] [Accepted: 06/07/2013] [Indexed: 12/11/2022]
Abstract
Chk1 is essential in maintaining genomic stability due to its role in cell cycle regulation. Several recent studies have indicated that the abrogation of checkpoints in tumourigenesis through the inhibition of Chk1 may be of therapeutic value. To further investigate the role of Chk1 in the mouse small intestine and its potential role as a therapy for colorectal cancer, we simultaneously deleted Chk1 and Apc in the mouse small intestine. We found that homozygous loss of Chk1 is not compatible with Wnt-driven proliferation and resulted in the suppression of Wnt-driven tumourigenesis in the mouse small intestine. In contrast, heterozygous loss of Chk1 in a Wnt-driven background resulted in an increase in DNA damage and apoptosis and accelerated both tumour development and progression.
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Affiliation(s)
- K R Greenow
- Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - A R Clarke
- Cardiff School of Biosciences, Cardiff University, Cardiff, UK
| | - G T Williams
- School of Medicine, Cardiff University, Cardiff, UK
| | - R Jones
- Cardiff School of Biosciences, Cardiff University, Cardiff, UK
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16
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Holik AZ, Young M, Krzystyniak J, Williams GT, Metzger D, Shorning BY, Clarke AR. Brg1 loss attenuates aberrant wnt-signalling and prevents wnt-dependent tumourigenesis in the murine small intestine. PLoS Genet 2014; 10:e1004453. [PMID: 25010414 PMCID: PMC4091792 DOI: 10.1371/journal.pgen.1004453] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/07/2014] [Indexed: 01/19/2023] Open
Abstract
Tumourigenesis within the intestine is potently driven by deregulation of the Wnt pathway, a process epigenetically regulated by the chromatin remodelling factor Brg1. We aimed to investigate this interdependency in an in vivo setting and assess the viability of Brg1 as a potential therapeutic target. Using a range of transgenic approaches, we deleted Brg1 in the context of Wnt-activated murine small intestinal epithelium. Pan-epithelial loss of Brg1 using VillinCreERT2 and AhCreERT transgenes attenuated expression of Wnt target genes, including a subset of stem cell-specific genes and suppressed Wnt-driven tumourigenesis improving animal survival. A similar increase in survival was observed when Wnt activation and Brg1 loss were restricted to the Lgr5 expressing intestinal stem cell population. We propose a mechanism whereby Brg1 function is required for aberrant Wnt signalling and ultimately for the maintenance of the tumour initiating cell compartment, such that loss of Brg1 in an Apc-deficient context suppresses adenoma formation. Our results highlight potential therapeutic value of targeting Brg1 and serve as a proof of concept that targeting the cells of origin of cancer may be of therapeutic relevance.
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Affiliation(s)
- Aliaksei Z. Holik
- Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom
- Stem Cells and Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Madeleine Young
- Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Joanna Krzystyniak
- Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | | | - Daniel Metzger
- IGBMC, CNRS UMR7104/INSERM U964/Université de Strasbourg, Illkirch, France
| | - Boris Y. Shorning
- Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Alan R. Clarke
- Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom
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17
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Maughan TS, Meade AM, Adams RA, Richman SD, Butler R, Fisher D, Wilson RH, Jasani B, Taylor GR, Williams GT, Sampson JR, Seymour MT, Nichols LL, Kenny SL, Nelson A, Sampson CM, Hodgkinson E, Bridgewater JA, Furniss DL, Roy R, Pope MJ, Pope JK, Parmar M, Quirke P, Kaplan R. A feasibility study testing four hypotheses with phase II outcomes in advanced colorectal cancer (MRC FOCUS3): a model for randomised controlled trials in the era of personalised medicine? Br J Cancer 2014; 110:2178-86. [PMID: 24743706 PMCID: PMC4007241 DOI: 10.1038/bjc.2014.182] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/27/2014] [Accepted: 03/13/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Molecular characteristics of cancer vary between individuals. In future, most trials will require assessment of biomarkers to allocate patients into enriched populations in which targeted therapies are more likely to be effective. The MRC FOCUS3 trial is a feasibility study to assess key elements in the planning of such studies. PATIENTS AND METHODS Patients with advanced colorectal cancer were registered from 24 centres between February 2010 and April 2011. With their consent, patients' tumour samples were analysed for KRAS/BRAF oncogene mutation status and topoisomerase 1 (topo-1) immunohistochemistry. Patients were then classified into one of four molecular strata; within each strata patients were randomised to one of two hypothesis-driven experimental therapies or a common control arm (FOLFIRI chemotherapy). A 4-stage suite of patient information sheets (PISs) was developed to avoid patient overload. RESULTS A total of 332 patients were registered, 244 randomised. Among randomised patients, biomarker results were provided within 10 working days (w.d.) in 71%, 15 w.d. in 91% and 20 w.d. in 99%. DNA mutation analysis was 100% concordant between two laboratories. Over 90% of participants reported excellent understanding of all aspects of the trial. In this randomised phase II setting, omission of irinotecan in the low topo-1 group was associated with increased response rate and addition of cetuximab in the KRAS, BRAF wild-type cohort was associated with longer progression-free survival. CONCLUSIONS Patient samples can be collected and analysed within workable time frames and with reproducible mutation results. Complex multi-arm designs are acceptable to patients with good PIS. Randomisation within each cohort provides outcome data that can inform clinical practice.
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Affiliation(s)
- T S Maughan
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | - A M Meade
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - R A Adams
- Cardiff University and Velindre Cancer Centre, Cardiff, UK
| | - S D Richman
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - R Butler
- University Hospital of Wales, Cardiff CF14 4XW, UK
| | - D Fisher
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - R H Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast BT9 7AE, UK
| | - B Jasani
- Institute of Cancer and Genetics, Cardiff University, Cardiff CF14 4XN, UK
| | - G R Taylor
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - G T Williams
- Institute of Cancer and Genetics, Cardiff University, Cardiff CF14 4XN, UK
| | - J R Sampson
- Institute of Cancer and Genetics, Cardiff University, Cardiff CF14 4XN, UK
| | - M T Seymour
- St James's Institute of Oncology, University of Leeds, Leeds LS9 7TF, UK
| | - L L Nichols
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - S L Kenny
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - A Nelson
- Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, UK
| | - C M Sampson
- Wales Cancer Trials Unit, Cardiff University, Cardiff CF14 4YS, UK
| | - E Hodgkinson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK
| | | | - D L Furniss
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK
| | - R Roy
- Department of Oncology, Castle Hill Hospital, East Riding of Yorkshire HU16 5JQ, UK
| | - M J Pope
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - J K Pope
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - M Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
| | - P Quirke
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS9 7TF, UK
| | - R Kaplan
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London WC2B 6NH, UK
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18
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Davies EJ, Marsh Durban V, Meniel V, Williams GT, Clarke AR. PTEN loss and KRAS activation leads to the formation of serrated adenomas and metastatic carcinoma in the mouse intestine. J Pathol 2014; 233:27-38. [PMID: 24293351 DOI: 10.1002/path.4312] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/22/2013] [Accepted: 11/26/2013] [Indexed: 12/15/2022]
Abstract
Mutation or loss of the genes PTEN and KRAS have been implicated in human colorectal cancer (CRC), and have been shown to co-occur despite both playing a role in the PI3' kinase (PI3'K) pathway. We investigated the role of these genes in intestinal tumour progression in vivo, using genetically engineered mouse models, with the aim of generating more representative models of human CRC. Intestinal-specific deletion of Pten and activation of an oncogenic allele of Kras was induced in wild-type (WT) mice and mice with a predisposition to adenoma development (Apc(fl/+) ). The animals were euthanized when they became symptomatic of a high tumour burden. Histopathological examination of the tissues was carried out, and immunohistochemistry used to characterize signalling pathway activation. Mutation of Pten and Kras resulted in a significant life-span reduction of mice predisposed to adenomas. Invasive adenocarcinoma was observed in these animals, with evidence of activation of the PI3'K pathway but no metastasis. However, mutation of Pten and Kras in WT animals not predisposed to adenomas led to perturbed homeostasis of the intestinal epithelium and the development of hyperplastic polyps, dysplastic sessile serrated adenomas and metastasizing adenocarcinomas with serrated features. These studies demonstrate synergism between Pten and Kras mutations in intestinal tumour progression, in an autochthonous and immunocompetent murine model, with potential application to preclinical drug testing. In particular, they show that Pten and Kras mutations alone predispose mice to the spectrum of serrated lesions that reflect the serrated pathway of CRC progression in humans.
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Affiliation(s)
- Emma J Davies
- Cardiff School of Biosciences, Cardiff University, UK
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19
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Turner JK, Williams GT, Morgan M, Wright M, Dolwani S. Interobserver agreement in the reporting of colorectal polyp pathology among bowel cancer screening pathologists in Wales. Histopathology 2013; 62:916-24. [PMID: 23611360 DOI: 10.1111/his.12110] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 02/06/2013] [Indexed: 12/27/2022]
Abstract
AIMS To assess the interobserver agreement in the reporting of colorectal polyps among histopathologists participating in the Welsh Bowel Cancer Screening (BCS) programme. METHODS AND RESULTS Twelve benign polyps representative of BCS cases were identified from pathology files and reported by 28 BCS histopathologists using proforma sheets. The level of agreement between the participants and a gold standard was determined using kappa (κ) statistics. A moderate level of agreement was achieved in the reporting of polyp type [κ = 0.45; 95% confidence interval (CI) 0.34-0.59] and adenomatous lesions were distinguished from non-adenomatous lesions in 96% of cases. Substantial agreement was obtained in distinguishing low- and high-grade dysplasias (κ = 0.67; 95% CI 0.50-0.86), but there was only fair agreement in reporting excision margin status (κ = 0.24; 95% CI 0.07-0.43) with frequent use of the 'uncertain' category. Significant issues included categorizing serrated lesions, recognizing focal high-grade dysplasia and epithelial misplacement, and apparent overdiagnosis of villous change in adenomas. CONCLUSIONS Interobserver variability in some aspects of reporting colorectal polyps by BCS pathologists is suboptimal, with a potential impact upon patient management and the efficient running of the screening service. Approaches to addressing this are discussed.
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Affiliation(s)
- Jeff K Turner
- Department of Gastroenterology, University Hospital Llandough, Cardiff, UK
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20
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Roger L, Jones RE, Heppel NH, Williams GT, Sampson JR, Baird DM. Extensive telomere erosion in the initiation of colorectal adenomas and its association with chromosomal instability. J Natl Cancer Inst 2013; 105:1202-11. [PMID: 23918447 DOI: 10.1093/jnci/djt191] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Telomere shortening, dysfunction, and fusion may facilitate the acquisition of large-scale genomic rearrangements, driving clonal evolution and tumor progression. The relative contribution that telomere dysfunction and/or APC mutation play in the chromosome instability that occurs during colorectal tumorigenesis is not clear. METHODS We used high-resolution telomere length and fusion analysis to analyze 85 adenomatous colorectal polyps obtained from 10 patients with familial adenomatous polyposis and a panel of 50 colorectal carcinomas with patient-matched normal colonic mucosa. Telomerase activity was determined using the telomeric repeat amplification protocol. Array-CGH was used to detect large-scale genomic rearrangements. Pearson correlation and Student t test were used, and all statistical tests were two-sided. RESULTS Despite the presence of telomerase activity, we observed apparent telomere shortening in colorectal polyps that correlated with large-scale genomic rearrangements (P < .0001) but was independent of polyp size and indistinguishable from that observed in colorectal carcinomas (P = .82). We also observed apparent lengthening of telomeres in both polyps and carcinomas. The extensive differences in mean telomere length of up to 4.6kb between patient-matched normal mucosa and polyps were too large to be accounted for by replicative telomere erosion alone. Telomere fusion events were detected in both polyps and carcinomas; the mutational spectrum accompanying fusion was consistent with alternative nonhomologous end joining. CONCLUSIONS Telomere length distributions observed in colorectal polyps reflect the telomere length composition of the normal originating cells from which clonal growth was initiated. Originating cells containing both short telomeres and APC mutations may give rise to polyps that exhibit short telomeres and are prone to telomere dysfunction, driving genomic instability and progression to malignancy. J Natl Cancer Inst;2013;105:1202-1211.
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Affiliation(s)
- Laureline Roger
- Institute of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
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21
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Méniel V, Song F, Phesse T, Young M, Poetz O, Parry L, Jenkins JR, Williams GT, Dunwoodie SL, Watson A, Clarke AR. Cited1 deficiency suppresses intestinal tumorigenesis. PLoS Genet 2013; 9:e1003638. [PMID: 23935526 PMCID: PMC3731217 DOI: 10.1371/journal.pgen.1003638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 06/01/2013] [Indexed: 11/23/2022] Open
Abstract
Conditional deletion of Apc in the murine intestine alters crypt-villus architecture and function. This process is accompanied by multiple changes in gene expression, including upregulation of Cited1, whose role in colorectal carcinogenesis is unknown. Here we explore the relevance of Cited1 to intestinal tumorigenesis. We crossed Cited1 null mice with Apc(Min/+) and AhCre(+)Apc(fl/fl) mice and determined the impact of Cited1 deficiency on tumour growth/initiation including tumour multiplicity, cell proliferation, apoptosis and the transcriptome. We show that Cited1 is up-regulated in both human and murine tumours, and that constitutive deficiency of Cited1 increases survival in Apc(Min/+) mice from 230.5 to 515 days. However, paradoxically, Cited1 deficiency accentuated nearly all aspects of the immediate phenotype 4 days after conditional deletion of Apc, including an increase in cell death and enhanced perturbation of differentiation, including of the stem cell compartment. Transcriptome analysis revealed multiple pathway changes, including p53, PI3K and Wnt. The activation of Wnt through Cited1 deficiency correlated with increased transcription of β-catenin and increased levels of dephosphorylated β-catenin. Hence, immediately following deletion of Apc, Cited1 normally restrains the Wnt pathway at the level of β-catenin. Thus deficiency of Cited1 leads to hyper-activation of Wnt signaling and an exaggerated Wnt phenotype including elevated cell death. Cited1 deficiency decreases intestinal tumourigenesis in Apc(Min/+) mice and impacts upon a number of oncogenic signaling pathways, including Wnt. This restraint imposed by Cited1 is consistent with a requirement for Cited1 to constrain Wnt activity to a level commensurate with optimal adenoma formation and maintenance, and provides one mechanism for tumour repression in the absence of Cited1.
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Affiliation(s)
- Valérie Méniel
- School of Biological Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Fei Song
- Department of Gastroenterology, Institute of Translational Medicine, The Henry Wellcome Laboratory, University of Liverpool, England, United Kingdom
- Institute of Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Toby Phesse
- Cell Signaling and Cell Death, Walter and Eliza Hall Institute for Medical Research, Melbourne, Victoria, Australia
| | - Madeleine Young
- School of Biological Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Oliver Poetz
- Natural and Medical Sciences Institute at the University of Tuebingen, Reutlingen, Germany
| | - Lee Parry
- School of Biological Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - John R. Jenkins
- Department of Gastroenterology, Institute of Translational Medicine, The Henry Wellcome Laboratory, University of Liverpool, England, United Kingdom
| | - Geraint T. Williams
- School of Medicine, Cardiff University, Heath Park, Cardiff, Wales, United Kingdom
| | - Sally L. Dunwoodie
- Developmental and Stem Cell Biology Division, Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, Sydney, New South Wales, Australia
| | - Alastair Watson
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | - Alan R. Clarke
- School of Biological Sciences, Cardiff University, Cardiff, Wales, United Kingdom
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Marsh V, Davies EJ, Williams GT, Clarke AR. PTEN loss and KRAS activation cooperate in murine biliary tract malignancies. J Pathol 2013; 230:165-73. [PMID: 23483557 DOI: 10.1002/path.4189] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 02/20/2013] [Accepted: 02/27/2013] [Indexed: 12/15/2022]
Abstract
Carcinomas of the biliary tract are aggressive malignancies in humans. Loss of the tumour suppressor PTEN has previously been associated with cholangiocarcinoma development in a murine model. Activation of KRAS is reported in up to one-third of human cholangiocarcinomas and 50% of gall bladder carcinomas. In this study we aimed to test the potential interaction between PTEN and KRAS mutation in biliary tract malignancy. We used an inducible Cre-LoxP-based approach to coordinately delete PTEN and activate KRAS within the adult mouse biliary epithelium. We found that activation of KRAS alone has little effect upon biliary epithelium. Loss of PTEN alone results in the development of low-grade neoplastic lesions, following long latency and at low incidence. Combination of both mutations causes rapid development of biliary epithelial proliferative lesions, which progress through dysplasia to invasive carcinoma. We conclude that activation of the PI3'K pathway following loss of PTEN is sufficient to drive slow development of low-grade biliary lesions in mice. In contrast, mutational activation of KRAS does not result in a similar phenotype, despite a prediction that this should activate both the RAF-MEK-ERK and PI3'-kinase pathways. However, mutation of both genes results in rapid tumourigenesis, arguing that PTEN normally functions as a 'brake' on the PI3'-kinase pathway, limiting the influence of KRAS activation. Mutation of both genes creates a 'permissive' environment, allowing the full effects of both mutations to be manifested. These data reveal an in vivo synergy between these mutations and provides a new mouse model of biliary tract malignancy.
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Affiliation(s)
- Victoria Marsh
- Cardiff School of Biosciences, Cardiff University, Cardiff, UK
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Pickard MR, Mourtada-Maarabouni M, Williams GT. Long non-coding RNA GAS5 regulates apoptosis in prostate cancer cell lines. Biochim Biophys Acta Mol Basis Dis 2013; 1832:1613-23. [PMID: 23676682 DOI: 10.1016/j.bbadis.2013.05.005] [Citation(s) in RCA: 268] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 05/01/2013] [Accepted: 05/06/2013] [Indexed: 12/28/2022]
Abstract
While the role of small non-coding RNAs, such as miRNAs, in apoptosis control is well established, long non-coding RNAs (lncRNAs) have received less attention. Growth Arrest-Specific 5 (GAS5) encodes multiple snoRNAs within its introns, while exonic sequences produce lncRNA which can act as a riborepressor of the glucocorticoid and related receptors. GAS5 negatively regulates the survival of lymphoid and breast cells, and is aberrantly expressed in several cancers. Although cellular GAS5 levels decline as prostate cancer cells acquire castration-resistance, the influence of GAS5 on prostate cell survival has not been determined. To address this question, prostate cell lines were transfected with GAS5-encoding plasmids or GAS5 siRNAs, and cell survival was assessed. Basal apoptosis increased, and cell survival decreased, after transfection of 22Rv1 cells with plasmids encoding GAS5 transcripts, including mature GAS5 lncRNA. Similar effects were observed in PC-3 cells. In stable clones of 22Rv1, cell death correlated strongly with cellular GAS5 levels. Induction of 22Rv1 cell death by UV-C irradiation and chemotherapeutic drugs was augmented in cells transiently transfected with GAS5 constructs, and attenuated following down-regulation of GAS5 expression. Again, in these experiments, cell death was strongly correlated with cellular GAS5 levels. Thus, GAS5 promotes the apoptosis of prostate cells, and exonic sequence, i.e. GAS5 lncRNA, is sufficient to mediate this activity. Abnormally low levels of GAS5 expression may therefore reduce the effectiveness of chemotherapeutic agents. Although several lncRNAs have recently been shown to control cell survival, this is the first report of a death-promoting lncRNA in prostate cells.
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Affiliation(s)
- M R Pickard
- School of Life Sciences, Keele University, Keele, UK.
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Feng GJ, Cotta W, Wei XQ, Poetz O, Evans R, Jardé T, Reed K, Meniel V, Williams GT, Clarke AR, Dale TC. Conditional disruption of Axin1 leads to development of liver tumors in mice. Gastroenterology 2012; 143:1650-9. [PMID: 22960659 DOI: 10.1053/j.gastro.2012.08.047] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 08/22/2012] [Accepted: 08/30/2012] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Mutations in components of the Wnt signaling pathway, including β-catenin and AXIN1, are found in more than 50% of human hepatocellular carcinomas (HCCs). Disruption of Axin1 causes embryonic lethality in mice. We generated mice with conditional disruption of Axin1 to study its function specifically in adult liver. METHODS Mice with a LoxP-flanked allele of Axin1 were generated by homologous recombination. Mice homozygous for the Axin1fl/fl allele were crossed with AhCre mice; in offspring, Axin1 was disrupted in liver following injection of β-naphthoflavone (Axin1fl/fl/Cre mice). Liver tissues were collected and analyzed by quantitative real-time polymerase chain reaction and immunoprecipitation, histology, and immunoblot assays. RESULTS Deletion of Axin1 from livers of adult mice resulted in an acute and persistent increase in hepatocyte cell volume, proliferation, and transcription of genes that induce the G(2)/M transition in the cell cycle and cytokinesis. A subset of Wnt target genes was activated, including Axin2, c-Myc, and cyclin D1. However, loss of Axin1 did not increase nuclear levels of β-catenin or cause changes in liver zonation that have been associated with loss of the adenomatous polyposis coli (APC) or constitutive activation of β-catenin. After 1 year, 5 of 9 Axin1fl/fl/Cre mice developed liver tumors with histologic features of HCC. CONCLUSIONS Hepatocytes from adult mice with conditional disruption of Axin1 in liver have a transcriptional profile that differs from that associated with loss of APC or constitutive activation of β-catenin. It might be similar to a proliferation profile observed in a subset of human HCCs with mutations in AXIN1. Axin1fl/fl mice could be a useful model of AXIN1-associated tumorigenesis and HCC.
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Affiliation(s)
- Gui Jie Feng
- School of Biosciences, Cardiff University, Cardiff, United Kingdom
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Siew EL, Chan KM, Williams GT, Ross D, Inayat-Hussain SH. Protection of hydroquinone-induced apoptosis by downregulation of Fau is mediated by NQO1. Free Radic Biol Med 2012; 53:1616-24. [PMID: 22687461 DOI: 10.1016/j.freeradbiomed.2012.05.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 05/26/2012] [Accepted: 05/30/2012] [Indexed: 01/11/2023]
Abstract
The Fau gene (Finkel-Biskis-Reilly murine sarcoma virus (FBR-MuSV)-associated ubiquitously expressed gene) was identified as a potential tumor suppressor gene using a forward genetics approach. Downregulation of Fau by overexpression of its reverse sequence has been shown to inhibit apoptosis induced by DNA-damaging agents. To address a potential role of Fau in benzene toxicity, we investigated the apoptotic effects of hydroquinone (HQ), a major benzene metabolite, in W7.2 mouse thymoma cells transfected with either a plasmid construct expressing the antisense sequence of Fau (rfau) or the empty vector (pcDNA3.1) as a control. HQ induced apoptosis via increased production of reactive oxygen species and DNA damage, measured using dihydroethidine (HE) staining and alkaline Comet assay, respectively, in W7.2 pcDNA3.1 cells. In contrast, when Fau was downregulated by the antisense sequence in W7.2 rfau cells, HQ treatment did not cause DNA damage and oxidative stress and these cells were markedly more resistant to HQ-induced apoptosis. Further investigation revealed that there was an upregulation of NAD(P)H: quinone oxidoreductase 1 (NQO1), a detoxification enzyme for benzene-derived quinones, in W7.2 rfau cells. Compromising cellular NQO1 by use of a specific mechanism-based inhibitor (MAC 220) and NQO1 siRNA resensitized W7.2 rfau cells to HQ-induced apoptosis. Silencing of Fau in W7.2 wild-type cells resulted in increased levels of NQO1, confirming that downregulation of Fau results in NQO1 upregulation which protects against HQ-induced apoptosis.
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Affiliation(s)
- E L Siew
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
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Chan DSY, Campbell F, Edwards P, Jasani B, Williams GT, Lewis WG. Relative Prognostic Value of Human Epidermal Growth Factor Receptor 2 (HER2) Expression in Operable Oesophagogastric Cancer. ISRN Surg 2012; 2012:804891. [PMID: 22900205 PMCID: PMC3412097 DOI: 10.5402/2012/804891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 06/14/2012] [Indexed: 12/21/2022]
Abstract
Aims. The aim of this study was to determine the prognostic significance of HER2 receptor expression in operable oesophagogastric adenocarcinoma.
Methods. Eighty-five consecutive patients diagnosed with oesophagogastric adenocarcinoma [18 oesophageal (OC), 32 junctional (JC) and 35 gastric (GC)] undergoing potentially curative resection were studied retrospectively. Immunohistochemistry was used to determine HER2 status at endoscopic biopsy and resection specimen. The primary outcome measure was survival.
Results. Twenty (24%) patients had HER2 positive tumours which was commoner in JC (14/32, 44% versus 2/18, 11% in OC and 4/35, 11% in GC, P = 0.003). The sensitivity, specificity, positive and negative predictive values of HER2 status at endoscopic biopsy were 56%, 93%, 63%, 91% respectively (weighted Kappa = 0.504, P < 0.0001). Five-year survival in OC HER2 positive negative was 100% and 36% (P = 0.167) compared with 14% and 44% (P = 0.0726) in JC and 50% and 46% (P = 0.942) in GC respectively. Conclusions. Endoscopic biopsy had a high specificity and negative predictive value in determining HER2 status. Patients with JC had a significantly higher rate of HER2 overexpression and this was associated with a nonsignificant poorer survival trend. A larger study is needed to confirm these findings because of the implications for neoadjuvant and adjuvant chemotherapy regimens.
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Affiliation(s)
- David S Y Chan
- Department of Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN, UK
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Shepherd NA, Novelli MR, Williams GT. Professor Bryan F Warren: an appreciation (15 April 1958-28 March 2012). J Clin Pathol 2012; 65:863-4. [PMID: 22774221 DOI: 10.1136/jclinpath-2012-200925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Neil A Shepherd
- Gloucestershire Cellular Pathology Laboratory, Cheltenham, UK.
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Shepherd NA, Novelli MR, Williams GT. Professor Bryan F Warren (15 April 1958-28 March 2012): an appreciation. J Pathol 2012; 227:e3-4. [PMID: 22674648 DOI: 10.1002/path.4048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Maughan T, Wilson RH, Williams GT, Seymour MT, Richman SD, Quirke P, Pope J, Pope M, Parmar M, Nelson A, Meade AM, Nichols LL, Jasani B, Hodgkinson E, Fisher D, Butler R, Bridgewater JA, Adams RA, Kaplan RS. FOCUS 3: A study to determine the feasibility of molecular selection of therapy using K-RAS, B-RAF, and topo-1 in patients with advanced colorectal cancer (ACRC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
563 Background: Molecular characteristics of cancer vary between individuals. In future increasing numbers of trials will require assessment of biomarkers in order to allocate patients into enriched populations in which targeted therapies are more likely to be effective. The FOCUS 3 trial is a feasibility study to assess whether tumour samples could be collected from referring hospitals’ pathology departments, sent to designated reference laboratories for biomarker evaluation, and results provided to oncologists within 10 working days. Methods: Patients with ACRC, fit for chemotherapy, were registered from 24 centres between 02.10 and 04.11. Following consent, paraffin embedded tumour samples were sent to Cardiff or Leeds for analysis of topoisomerase 1 (topo-1) by immunohistochemistry and of KRAS and BRAF mutation status, and results were forwarded to the MRC CTU. Patients were classified into 1 of 4 molecular strata, which determined the set of 2 hypothesis driven experimental therapies they could be randomised to in addition to control chemotherapy (irinotecan + 5FU). At this stage eligibility was reconfirmed and consent for randomisation obtained. Results: 332 patients were registered to participate in FOCUS 3. Biomarker results were provided to oncologists within 10 working days (wd) in 71%, within 15 wd in 91% and within 20 wd in 99% patients. A 4 stage suite of patient information sheets (PIS) was designed and implemented to avoid patient overload; separate information sheets were provided to patients at stages during the consent process and patient understanding was assessed. 93% of eligible patients gave consent to randomisation. KRAS mutation was detected in 88 (36%), BRAF in 15 (6%), 2 patients had both mutations and 133 were double wildtype. 77% of patients were high (2-3), 19% low (0-1) and 4% inconclusive for topo-1. Tumour response and toxicity results for the 244 randomised patients will be presented. Conclusions: Patient samples can be collected and analysed at designated reference laboratories within acceptable timeframes. Multi-arm designs can be made acceptable to patients through good PIS, ensured by patient and carer input into their design.
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Affiliation(s)
- Tim Maughan
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Richard H. Wilson
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Geraint T Williams
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Matthew T. Seymour
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Susan D. Richman
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Philip Quirke
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Janet Pope
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Malcolm Pope
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Mahesh Parmar
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Annmarie Nelson
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Angela M. Meade
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Laura L Nichols
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Bharat Jasani
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Elizabeth Hodgkinson
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - David Fisher
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Rachel Butler
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - John A. Bridgewater
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Richard A. Adams
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
| | - Richard S. Kaplan
- Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford, United Kingdom; Queen's University Belfast, Belfast, United Kingdom; Cardiff University, Cardiff, United Kingdom; University of Leeds, Leeds, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; Clinical Trials Unit, Medical Research Council, London, United Kingdom; Wales Cancer Trials Unit, Cardiff, United Kingdom; Medical Research Council Clinical Trials Unit, London, United Kingdom; School of Medicine, Cardiff
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Ramadas AV, Gunesh S, Thomas GAO, Williams GT, Hawthorne AB. Natural history of Crohn's disease in a population-based cohort from Cardiff (1986-2003): a study of changes in medical treatment and surgical resection rates. Gut 2010; 59:1200-6. [PMID: 20650924 DOI: 10.1136/gut.2009.202101] [Citation(s) in RCA: 291] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Benefits of immunosuppressive therapy in Crohn's disease have been demonstrated in controlled trials; however, it is unclear whether these drugs alter the longer-term natural history of this condition. AIMS AND METHODS To assess changes in disease outcomes in a population-based cohort of patients diagnosed in Cardiff from 1986 to 2003. Case notes from Crohn's disease incidence studies in Cardiff were reviewed retrospectively for disease characteristics and follow-up information on drug therapy, and the need for surgery for Crohn's disease. The study population was divided into three groups by year of diagnosis (Group A=1986-1991, Group B=1992-1997 and Group C=1998-2003). RESULTS 341 patients were included. Kaplan-Meier (KM) analysis showed increasing use of immunosuppressants over time. At 5 years after diagnosis this was 11% in Group A, 28% in Group B, and 45% in Group C (p=0.001) and the median time to start of thiopurines was 77, 21 and 11 months in Group A, B and C respectively. There was a significant reduction in long-term steroid use at 5 years post diagnosis: 45 (44%), 31 (31%) and 24 (19%) patients in Group A, B and C respectively (p=0.001). KM analysis showed a significant reduction in the cumulative probability of intestinal surgery: At 5 years this was 59% (Group A), 37% (Group B) and 25% (Group C) (p=0.001). In a multivariate Cox analysis, year of diagnosis, disease location, oral corticosteroids within 3 months of diagnosis and early thiopurine use (within the first year of diagnosis) were all independent factors affecting likelihood of intestinal surgery. CONCLUSION This population-based cohort shows marked changes in rates of surgery, and the reduction is independently associated with year of diagnosis, and associated temporally with increased and earlier thiopurine use.
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Affiliation(s)
- A V Ramadas
- Department of Gastroenterology, University Hospital of Wales Cardiff, UK
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Zimbwa T, Owen R, Thomas G, Hargest R, Williams GT. An unusual complication of colitis. Gut 2010; 59:364, 415. [PMID: 20207641 DOI: 10.1136/gut.2009.179689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- T Zimbwa
- University Hospital of Wales, Heath Park, Cardiff CF 4 4XW, UK.
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Dallosso AR, Jones S, Azzopardi D, Moskvina V, Al-Tassan N, Williams GT, Idziaszczyk S, Davies DR, Milewski P, Williams S, Beynon J, Sampson JR, Cheadle JP. The APC Variant p.Glu1317Gln predisposes to colorectal adenomas by a novel mechanism of relaxing the target for tumorigenic somatic APC mutations. Hum Mutat 2009; 30:1412-8. [PMID: 19701947 DOI: 10.1002/humu.21089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multiple rare nonsynonymous variants in APC predispose to colorectal adenomas. The mechanisms through which such variants act have been unclear, but it has been proposed that a specific ("just-right") level of beta-catenin signaling is required for colorectal tumorigenesis. This appears to be mediated by selection for APC genotypes that retain one, or rarely two, 20 amino acid beta-catenin downregulating repeats (20AARs). We investigated the mechanism through which the variant p.Glu1317Gln (c.3949G>C) contributes to colorectal tumorigenesis. We compared the patterns of somatic APC mutations in tumors from patients with attenuated familial adenomatous polyposis (AFAP) who did, or did not, coinherit p.Glu1317Gln with their AFAP-causing APC mutations. Only 8.2% (4/49) of tumors carrying p.Glu1317Gln had somatic mutations predicted to result in mutant polypeptides retaining a single 20AAR, compared to 62.1% (36/58) of those which did not carry this variant (P=5.64 x 10(-9)). Furthermore, tumors with p.Glu1317Gln often carried somatic mutations that were unusually early or late (downstream of the second 20AAR) in the APC open reading frame. These data support a novel mechanism in which p.Glu1317Gln in combination with other weak mutant APC alleles (generating polypepetides with zero, two, or three 20AARs) can provide the necessary growth advantage for colorectal tumorigenesis.
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Affiliation(s)
- Anthony R Dallosso
- Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom
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Evans DA, Roberts OR, Williams GT, Vearey-Roberts AR, Bain F, Evans S, Langstaff DP, Twitchen DJ. Diamond-metal contacts: interface barriers and real-time characterization. J Phys Condens Matter 2009; 21:364223. [PMID: 21832329 DOI: 10.1088/0953-8984/21/36/364223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A review of diamond-metal contacts is presented with reference to reported values of interfacial potential (Schottky) barriers and their dependence on macroscopic and microscopic properties of the diamond surface, the interface and the metal. No simple model can account for the overall spread of p-diamond barriers, although there are, for certain metals, correlations with metal electronegativity, interface chemistry and diamond surface preparation. Detailed studies are presented for a selected contact (Al-p-diamond) using real-time monitoring during metal growth from sub-nanometre to bulk films and subsequent in situ heating to 1000 °C. This contact, prepared in a clean vacuum environment on characterized single-crystal substrates, provides a case study for a combined in situ electrical and spectroscopic investigation using IV measurements for macroscopic diodes and real-time photoelectron spectroscopy for nanoscale metal films. Band bending during growth leads to a rectifying contact with a measured IV barrier height of 1.05 V and an ideality factor of 1.4. A transition from layered to clustered growth of the metal film is revealed in the real-time measurements and this is confirmed by AFM. For the annealed contact, a direct correlation is revealed by real-time photoemission between the onset of interfacial carbide formation and the change from a rectifying to an ohmic contact at 482 °C.
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Affiliation(s)
- D A Evans
- Institute of Mathematics and Physics, Aberystwyth University, Aberystwyth SY23 3BZ, UK
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Inayat-Hussain SH, Wong LT, Chan KM, Rajab NF, Din LB, Harun R, Kizilors A, Saxena N, Mourtada-Maarabouni M, Farzaneh F, Williams GT. RACK-1 overexpression protects against goniothalamin-induced cell death. Toxicol Lett 2009; 191:118-22. [PMID: 19698770 PMCID: PMC2845802 DOI: 10.1016/j.toxlet.2009.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 08/12/2009] [Accepted: 08/12/2009] [Indexed: 01/05/2023]
Abstract
Goniothalamin, a styryllactone, has been shown to induce cytotoxicity via apoptosis in several tumor cell lines. In this study, we have examined the potential role of several genes, which were stably transfected into T-cell lines and which regulate apoptosis in different ways, on goniothalamin-induced cell death. Overexpression of full-length receptor for activated protein C-kinase 1 (RACK-1) and pc3n3, which up-regulates endogenous RACK-1, in both Jurkat and W7.2 T cells resulted in inhibition of goniothalamin-induced cell death as assessed by MTT and clonogenic assays. However, overexpression of rFau (antisense sequence to Finkel-Biskis-Reilly murine sarcoma virus-associated ubiquitously expressed gene) in W7.2 cells did not confer resistance to goniothalamin-induced cell death. Etoposide, a clinically used cytotoxic agent, was equipotent in causing cytotoxicity in all the stable transfectants. Assessment of DNA damage by Comet assay revealed goniothalamin-induced DNA strand breaks as early as 1 h in vector control but this effect was inhibited in RACK-1 and pc3n3 stably transfected W7.2 cells. This data demonstrate that RACK-1 plays a crucial role in regulating cell death signalling pathways induced by goniothalamin.
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Affiliation(s)
- S H Inayat-Hussain
- Toxicology and Biocompatibility Laboratory, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia.
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Cols Vidal M, Hoole D, Williams GT. Characterisation of cDNAs of key genes involved in apoptosis in common carp (Cyprinus carpio L.). Fish Shellfish Immunol 2008; 25:494-507. [PMID: 18707005 DOI: 10.1016/j.fsi.2008.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 07/17/2008] [Accepted: 07/20/2008] [Indexed: 05/26/2023]
Abstract
Apoptosis is a morphologically and biochemically distinct form of eukaryotic cell death that occurs under a variety of physiological and pathological conditions. Many of the cell deaths that occur during normal embryological development and during normal tissue turnover display the morphological hallmarks of apoptosis. In the last 20 or so years a better biochemical picture of how the process occurs has been produced, at least in higher vertebrates. It is now widely accepted that many of the proteolytic cleavages occurring during apoptosis are mediated by caspases, the activation of which, in turn, has been found to be tightly regulated. The current study focuses on the sequencing and analysis of key genes involved in the apoptotic process, based on sequence similarity to known apoptosis genes from genetic models such as zebrafish (Danio rerio) and other vertebrates. The present study identifies key components of the apoptotic process in common carp (Cyprinus carpio L.), which in turn can be used, for example, to monitor the fate of the cellular components of the immune system after an immune challenge.
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Affiliation(s)
- M Cols Vidal
- CIC bioGUNE, Functional Genomics Unit, Parque Tecnológico de Bizkaia, 48160 Derio, Spain.
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Roche JC, Morris-Stiff G, Champ C, Williams GT, Lewis MH. Colonic diaphragm disease without significant non-steroidal anti-inflammatory drug use: a case report. Cases J 2008; 1:247. [PMID: 18928531 PMCID: PMC2576181 DOI: 10.1186/1757-1626-1-247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Accepted: 10/17/2008] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Colonic diaphragm disease is an uncommon condition usually associated with the long-term use of non-steroidal anti-inflammatory drugs. CASE PRESENTATION A 48-year-old woman presented as an emergency patient with abdominal pain and vomiting. Past medical history included inflammatory bowel disease of ulcerative colitis type for which she was taking azathioprine and prednisolone. On examination, she was shocked with signs of peritonism. Following resuscitation, she was taken for a laparotomy upon which a small amount of turbid fluid was identified but there was no direct evidence of an intra-abdominal perforation. A peritoneal lavage was performed and she was taken to the intensive care unit. A repeat laparotomy was performed on the sixth postoperative day, following a clinical deterioration and again no leak was identified. Given the history of ulcerative colitis, the perforation was presumed to be of colonic origin and a total colectomy and ileostomy was performed. Histopathological examination of the colectomy specimen revealed extensive colonic diaphragm disease with 30 thin-walled diaphragms, one of which reduced the lumen to a pin-hole. No perforation was identified. CONCLUSION To the best of the our knowledge, this is the first report of the development of colonic diaphragm disease in the absence of a history of non-steroidal anti-inflammatory drug ingestion. Given the history of ulcerative colitis we believe that the disease may have arisen as a result of the healing of the underlying inflamed colon rather than as a direct effect of non-steroidal anti-inflammatory drugs.
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Affiliation(s)
- Jo C Roche
- Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UK.
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Williams GT, Mourtada-Maarabouni M, Pickard MR, Hedge VL, Sutherland A. Investigation of the roles of novel apoptosis-controlling genes in breast cancer. Breast Cancer Res 2008. [PMCID: PMC3300729 DOI: 10.1186/bcr1910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
BACKGROUND The incidence of Crohn's disease rose rapidly in industralized countries over the past 50 years, but it is unclear whether the incidence is still rising or has reached a plateau. AIMS To update the long-term incidence study of Crohn's disease in Cardiff for 1996-2005, to investigate whether incidence is still rising and to study changes in disease characteristics over time. METHOD Crohn's cases identified by retrospective analysis of hospital records as in previous studies in Cardiff. RESULTS Two hundred and twelve cases were identified. Corrected incidence for this decade was 66 x 10(6) per year (95% confidence interval: 58-76), showing a continuing rise compared to previous decades. The proportion with colonic disease at presentation continues to rise (43%) with a corresponding fall in those with terminal ileal disease. There remains a strong female preponderance (F:M 1.6:1) as in previous studies. The incidence in children under age 16 continues to rise, and the median age at diagnosis has fallen slightly. CONCLUSION Crohn's disease incidence continues to rise slowly in Cardiff with a continuing increase in those presenting with colonic disease, which is now the commonest disease pattern.
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Affiliation(s)
- S Gunesh
- Department of Gastroenterology, University Hospital of Wales, Cardiff, UK
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Abstract
TNM staging has made a major contribution to the clinical management of patients with cancer over the past 50 years, but are we sure it delivers what is needed to provide adequate advice in the 21st century, and are there ways in which the system can be improved? This article, by pathologists with a special interest in colorectal cancer, is intended to offer constructive criticism towards the TNM classification of colorectal cancer, make suggestions for improvement, and recommend the adoption of a robust evidence base for this system.
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Affiliation(s)
- Philip Quirke
- Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, St James's University Hospital, University of Leeds, Leeds, UK.
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Dolwani S, Williams GT, West KP, Newman J, Stock D, Griffiths AP, Best J, Cheadle JP, Sampson JR. Analysis of inherited MYH/(MutYH) mutations in British Asian patients with colorectal cancer. Gut 2007; 56:593. [PMID: 17369389 PMCID: PMC1856848 DOI: 10.1136/gut.2006.094532] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Abstract
This review provides an update on the pathogenesis and histopathological diagnosis of endocrine tumours of the gastrointestinal tract, concentrating on three different varieties whose careful assessment by pathologists is of particular clinical significance. These are the four types of enterochromaffin-like cell tumour of the gastric corpus, the periampullary somatostatin-containing D-cell tumour of the duodenum, and the frequently chromogranin A-negative L-cell tumour of the appendix and large intestine. In addition, the value of pathological factors in predicting the behaviour of gastrointestinal endocrine tumours and selecting therapy is discussed, and the crucial role of the pathologist in the multidisciplinary team management of these neoplasms is emphasized.
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Affiliation(s)
- G T Williams
- Department of Pathology, Wales College of Medicine, Cardiff University, Cardiff, UK.
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Clarke SL, Betts GJ, Plant A, Wright KL, El-Shanawany TM, Harrop R, Torkington J, Rees BI, Williams GT, Gallimore AM, Godkin AJ. CD4+CD25+FOXP3+ regulatory T cells suppress anti-tumor immune responses in patients with colorectal cancer. PLoS One 2006; 1:e129. [PMID: 17205133 PMCID: PMC1762416 DOI: 10.1371/journal.pone.0000129] [Citation(s) in RCA: 176] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Accepted: 11/14/2006] [Indexed: 12/31/2022] Open
Abstract
Background A wealth of evidence obtained using mouse models indicates that CD4+CD25+FOXP3+ regulatory T cells (Treg) maintain peripheral tolerance to self-antigens and also inhibit anti-tumor immune responses. To date there is limited information about CD4+ T cell responses in patients with colorectal cancer (CRC). We set out to measure T cell responses to a tumor-associated antigen and examine whether Treg impinge on those anti-tumor immune responses in CRC patients. Methodology and Principal Findings Treg were identified and characterized as CD4+CD25+FOXP3+ using flow cytometry. An increased frequency of Treg was demonstrated in both peripheral blood and mesenteric lymph nodes of patients with colorectal cancer (CRC) compared with either healthy controls or patients with inflammatory bowel disease (IBD). Depletion of Treg from peripheral blood mononuclear cells (PBMC) of CRC patients unmasked CD4+ T cell responses, as observed by IFNγ release, to the tumor associated antigen 5T4, whereas no effect was observed in a healthy age-matched control group. Conclusions/Significance Collectively, these data demonstrate that Treg capable of inhibiting tumor associated antigen-specific immune responses are enriched in patients with CRC. These results support a rationale for manipulating Treg to enhance cancer immunotherapy.
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Affiliation(s)
- Sarah L. Clarke
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
- * To whom correspondence should be addressed. E-mail:
| | - Gareth J. Betts
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
| | - Andrea Plant
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
| | - Kate L. Wright
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
| | - Tariq M. El-Shanawany
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
| | | | - Jared Torkington
- Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom
| | - Brian I. Rees
- Department of Surgery, University Hospital of Wales, Cardiff, United Kingdom
| | | | - Awen M. Gallimore
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
| | - Andrew J. Godkin
- Department of Medical Biochemistry and Immunology, Cardiff University, Cardiff, United Kingdom
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Abstract
PURPOSE Appendicitis is the most commonly performed emergency abdominal surgery. The appendix can also be the site of a variety of neoplasms and unusual inflammatory conditions. A retrospective review was performed to determine the pathological diagnoses in appendicectomy specimens. METHODS This study is a retrospective analysis of 2660 appendicectomies performed from 1997 to 2003. The reports were analyzed for the following parameters: age-related incidence of acute appendicitis, seasonal variation in presentation, perforation rate, rate of negative and incidental appendicectomy, and the incidence of other pathologies encountered. RESULTS Of the 2660 appendicectomy specimens, acute appendicitis was seen in 1718 patients (64.58%), with a peak in patients in their second decade (35.09% of cases of acute appendicitis). The perforation rate was 13.9% and was significantly higher in patients aged 70 years or more (P < 0.001). The negative appendicectomy rate was 28.8%, and was significantly higher in female patients (P < 0.001) and in the 11-30 year age group (P < 0.001). Other pathologies include carcinoid (0.52%), adenocarcinoma (0.39%), and mucinous cystadenoma (0.60%). CONCLUSIONS The high rate of negative appendicectomy among female patients and the increased incidence of perforation in elderly patients reinforce the validity of the judicious use of laparoscopy in these populations. There are still a number of unusual histologies found in appendicectomy specimens supporting the continued use of routine histology.
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Affiliation(s)
- Ravi Marudanayagam
- Department of General Surgery, University Hospital of Wales, Cardiff, UK
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Goodwin RG, Kell WJ, Laidler P, Long CC, Whatley SD, McKinley M, Badminton MN, Burnett AK, Williams GT, Elder GH. Photosensitivity and acute liver injury in myeloproliferative disorder secondary to late-onset protoporphyria caused by deletion of a ferrochelatase gene in hematopoietic cells. Blood 2006; 107:60-2. [PMID: 16150949 DOI: 10.1182/blood-2004-12-4939] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Late-onset erythropoietic protoporphyria (EPP) is a rare complication of myelodysplastic syndrome (MDS) but has not been described in association with a myeloproliferative disorder (MPD). EPP is normally an inherited disorder characterized by photosensitivity that starts in early childhood and results from overproduction of protoporphyrin secondary to ferrochelatase (FECH) deficiency. Severe liver disease occurs in 1% to 2% of patients. Here we report that severe photosensitivity and cholestatic liver disease in a patient with a myeloproliferative disorder was caused by excess protoporphyrin production from a clone of hematopoietic cells in which one FECH allele had been deleted. Our observations suggest that the usual explanation for the association of late-onset EPP with MPD and MDS is acquired somatic mutation of one FECH allele in bone marrow and show for the first time that the consequent overproduction of protoporphyrin may be severe enough to cause acute liver damage.
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Affiliation(s)
- Richard G Goodwin
- Department of Dermatology, University Hospital of Wales, Cardiff, United Kingdom
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Ingram JR, Rhodes J, Collins PW, Williams GT, Newcombe RG, Thomas GAO. Plasma fibrinogen in ulcerative colitis: the effect of disease activity and nicotine therapy in a randomised controlled trial. Dig Liver Dis 2005; 37:832-7. [PMID: 16169302 DOI: 10.1016/j.dld.2005.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2004] [Accepted: 05/31/2005] [Indexed: 12/11/2022]
Abstract
BACKGROUND Smoking increases plasma fibrinogen and cardiovascular risk whereas transdermal nicotine may not. Fibrinogen is an acute phase protein and may reflect disease activity in ulcerative colitis. AIMS To examine the effect of topical nicotine on plasma fibrinogen and any relationship between fibrinogen and ulcerative colitis disease activity. PATIENTS Forty-eight non-smokers with moderately active ulcerative colitis. METHODS Patients were randomised to 6 mg nicotine enema or placebo for 6 weeks, followed by open nicotine therapy for 4 weeks. Plasma fibrinogen was measured at baseline and after 6 and 10 weeks; at each assessment sigmoidoscopy with a rectal biopsy was performed. RESULTS.: At 6 weeks median plasma fibrinogen was 3.30 g/l on nicotine compared to 3.05 g/l on placebo, P = 0.90 when adjusted for baseline values. There was a correlation between fibrinogen and the UC disease activity index (UCDAI) at weeks 0 and 10, P = 0.036 and 0.033, respectively, and between fibrinogen and sigmoidoscopic grade at each assessment, P = 0.014, 0.021 and 0.034. Changes in fibrinogen did not correlate with changes in disease severity. CONCLUSIONS There was no significant effect of nicotine enemas, in either direction, on plasma fibrinogen-this was raised in moderately active UC and correlated with the sigmoidoscopic grade of colitis and the UCDAI; however, fibrinogen was not sufficiently sensitive to be of practical clinical value.
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Affiliation(s)
- J R Ingram
- Department of Gastroenterology, University Hospital of Wales, Heath Park, Cardiff and Vale NHS Trust, Cardiff CF14 4XW, UK
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Ingram JR, Thomas GAO, Rhodes J, Green JT, Hawkes ND, Swift JL, Srivastava ED, Evans BK, Williams GT, Newcombe RG, Courtney E, Pillai S. A randomized trial of nicotine enemas for active ulcerative colitis. Clin Gastroenterol Hepatol 2005; 3:1107-14. [PMID: 16271342 DOI: 10.1016/s1542-3565(05)00849-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Ulcerative colitis (UC) is largely a disease of nonsmokers in which transdermal nicotine improves the symptoms but often causes adverse events (AEs). Nicotine enemas cause fewer AEs and were used as supplemental treatment for active UC. METHODS We treated 104 patients with active UC with either 6-mg nicotine enemas or placebo enemas for 6 weeks in a randomized double-blind study. Patients continued their oral therapy, if any, for UC: 68 patients were taking mesalamine, 15 patients were taking prednisolone, and 12 patients were taking thiopurines during the study. Clinical, sigmoidoscopic, and histologic assessments were made at baseline and at the end of the study and symptoms were recorded daily on a diary card. The primary end point was induction of clinical remission and clinical improvement also was measured by the UC disease activity index. After the study, patients then used nicotine enemas daily for 4 weeks and sigmoidoscopy with a biopsy examination was repeated. AEs and salivary cotinine levels were monitored throughout the study. RESULTS Clinical remission was achieved in 14 of 52 (27%) patients on active treatment and 14 of 43 (33%) patients on placebo (P = .55). The UC disease activity index improved by 1.45 points in the active group and by 1.65 points for those on placebo (P = .88). Only 1 patient discontinued treatment because of an AE (abdominal pain). In the 47 patients taking mesalamine only, active treatment conferred benefit that was not statistically significant; disease remission occurred in 9 of 25 patients on active therapy and 4 of 21 patients on placebo (P = .20). CONCLUSIONS Six-milligram nicotine enemas were well tolerated but were not found to be efficacious for active UC.
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Affiliation(s)
- John R Ingram
- Department of Gastroenterology, Cardiff and Vale NHS Trust, Cardiff CF14 4XW, Wales, United Kingdom
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Abstract
Vascular tumours of the stomach are rare, representing 0.9%-3.3% of all gastric neoplasms. A 58 year old man was admitted as an emergency with a one day history of haematemesis and melaena. He underwent an emergency laparotomy for a tumour in the lesser curve of the stomach. The tumour showed the characteristic histological and immunohistochemical features of epithelioid haemangioendothelioma. Surgery in the form of wide excision seems to be the treatment of choice for this rare neoplasm. This case highlights the difficulty in diagnosing this rare tumour preoperatively and emphasises the need for long term follow up in view of its uncertain metastatic potential.
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Affiliation(s)
- P Sanjay
- Department of General Surgery, Royal Glamorgan Hospital, Llantrisant, South Wales CF72 8XR, UK.
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Abstract
It has generally been assumed that apoptosis and other forms of programmed cell death evolved to regulate growth and development in multicellular organisms. However, recent work has shown that some parasitic protozoa have evolved a cell suicide pathway analogous to the process described as apoptosis in metazoa. In this review, Susan Welburn, Marcello Barcinski and Gwyn Williams discuss the possible implications of a cell suicide pathway in the vector-borne Trypanosomatids.
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Affiliation(s)
- S C Welburn
- Tsetse Research Group, Division of Molecular Genetics, Institute of Biomedical and Life Sciences, University of Glasgow, 56 Dumbarton Road, Glasgow, UK.
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Brown G, Davies S, Williams GT, Bourne MW, Newcombe RG, Radcliffe AG, Blethyn J, Dallimore NS, Rees BI, Phillips CJ, Maughan TS. Effectiveness of preoperative staging in rectal cancer: digital rectal examination, endoluminal ultrasound or magnetic resonance imaging? Br J Cancer 2004; 91:23-9. [PMID: 15188013 PMCID: PMC2364763 DOI: 10.1038/sj.bjc.6601871] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In rectal cancer, preoperative staging should identify early tumours suitable for treatment by surgery alone and locally advanced tumours that require therapy to induce tumour regression from the potential resection margin. Currently, local staging can be performed by digital rectal examination (DRE), endoluminal ultrasound (EUS) or magnetic resonance imaging (MRI). Each staging method was compared for clinical benefit and cost-effectiveness. The accuracy of high-resolution MRI, DRE and EUS in identifying favourable, unfavourable and locally advanced rectal carcinomas in 98 patients undergoing total mesorectal excision was compared prospectively against the resection specimen pathological as the gold standard. Agreement between each staging modality with pathology assessment of tumour favourability was calculated with the chance-corrected agreement given as the kappa statistic, based on marginal homogenised data. Differences in effectiveness of the staging modalities were compared with differences in costs of the staging modalities to generate cost effectiveness ratios. Agreement between staging and histologic assessment of tumour favourability was 94% for MRI (κ=0.81, s.e.=0.05; κW=0.83), compared with very poor agreements of 65% for DRE (κ=0.08, s.e.=0.068, κW=0.16) and 69% for EUS (κ=0.17, s.e.=0.065, κW=0.17). The resource benefits resulting from the use of MRI rather than DRE was £67164 and £92244 when MRI was used rather than EUS. Magnetic resonance imaging dominated both DRE and EUS on cost and clinical effectiveness by selecting appropriate patients for neoadjuvant therapy and justifies its use for local staging of rectal cancer patients.
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Affiliation(s)
- G Brown
- Department of Radiology, University Hospital of Wales, Cardiff, Wales, UK.
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