Abstract P4-04-13: Comparison of tumor and stroma CD73 expression with TLR9 and survival in breast cancer

CD73 is a 5' ectonuclease that catalyzes the conversion of cyclic AMP into the highly immunosuppressive adenosine in extracellular space. In addition to the cells of the immune system, CD73 is highly expressed in various cancer cell lines and clinical cancer tissues. Toll like receptor-9 (TLR9) is a cellular DNA-receptor that is highly expressed in breast cancer. Both CD73 and TLR9 expression have recently been associated with TNBC prognosis but the mechanisms how these proteins possibly contribute to TNBC pathophysiology remains poorly understood. TLR9 and CD73 expression has been shown to be mutually regulated in various cell types. Whether this is the case in cancer is unknown. The aim of this study was to investigate the mutual role of TLR9 and CD73 in breast cancer (BC). Specifically our hypothesis was that TLR9 and CD73 expression correlate in TNBC. We compared immunohistological tumor TLR9 and CD73 expression scores using a previously characterized breast cancer (BC) cohort (n=184) with follow-up time of > 10 years. We did not discover a connection between TLR9 and CD73 expression in tumor cells in BC. There was a trend for increased survival among patients that had high tumor cell CD73 expression, as compared with the lower tumor cell CD73 expression groups. There was a trend for a better survival among TNBC patients that had lower stromal CD73 expression, as compared with those TNBC patients that had higher stromal CD73 expression. No such difference was detected among patients with non-TNBC tumors. Our results suggest that stromal vs. tumor cell CD73 expression have opposite effects on survival in TNBC, but there is no connection between CD73 and TLR9 expression. Our conclusions are limited by low sample numbers.

Citation Format: Selander K, Mella M, Kauppila J, Karihtala P, Jukkola-Vuorinen A, Auvinen P, Soini Y, Kauppila S, Haapasaari K-M, Harris K, Vuopala K. Comparison of tumor and stroma CD73 expression with TLR9 and survival in breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-04-13.

Alendronate disturbs vesicular trafficking in osteoclasts

The nitrogen-containing bisphosphonate alendronate inhibits osteoclast-mediated bone resorption through inhibition of the mevalonate pathway. This results in impaired protein prenylation and may affect the function of small GTPases in osteoclasts. Since these proteins are important regulators of vesicle transport in cells, we investigated the possible interference of alendronate with these processes in isolated rat osteoclasts. We show here that alendronate-induced inhibition of bone resorption coincides with accumulation of tartrate-resistant acid phosphatase- and electron dense material-containing tubular vesicles in osteoclasts. Alendronate-induced changes in osteoclasts also included widening of the sealing zone areas and incomplete organization of tight attachments and ruffled borders. Osteoclasts also appeared partially detached from the bone surface, and organic matrix was typically dissolved only at the edges of the resorption pits on alendronate-coated bone slices. In contrast, resorption pits on the control and clodronate-coated bone slices were thoroughly resorbed. Inhibition of bone resorption by alendronate was not, however, related to a decrease in osteoclast number. In conclusion, our findings suggest that alendronate inactivates osteoclasts by mechanisms that impair their intracellular vesicle transport, apoptosis being only a secondary phenomenon to this.

Low cell motility induced by hsp27 overexpression decreases osteolytic bone metastases of human breast cancer cells in vivo

The mechanisms controlling the formation of osteolytic bone metastases in patients with breast cancer are still poorly understood. To explore the role of motility in the establishment of osteolytic bone metastases, we have used a model of bone metastasis in which MDA-MB-231 breast cancer cells exhibiting low (hsp27-transfectants) and high (control-transfectant) endogenous cell motility were compared. We found that MDA-MB-231 cells exhibiting low cell motility were less capable of establishing osteolytic lesions. The number and the area of the osteolytic lesions in mice inoculated with low motility cells were both significantly smaller. Histomorphometry of bone lesions also demonstrated less tumor area in mice bearing hsp27 transfectants although there was no difference in the osteoclast number per square millimeter of tumor-bone interface. These data suggest that cell motility may be an important mechanism in the metastatic cascade of breast cancer cells to the bone and that controlling cell motility may be a useful target to prevent the establishment of osteolytic bone metastases.

TGF-beta signaling blockade inhibits PTHrP secretion by breast cancer cells and bone metastases development

Breast cancer frequently metastasizes to the skeleton, and the associated bone destruction is mediated by the osteoclast. Growth factors, including transforming growth factor-beta (TGF-beta), released from bone matrix by the action of osteoclasts, may foster metastatic growth. Because TGF-beta inhibits growth of epithelial cells, and carcinoma cells are often defective in TGF-beta responses, any role of TGF-beta in metastasis is likely to be mediated by effects on the surrounding normal tissue. However, we present evidence that TGF-beta promotes breast cancer metastasis by acting directly on the tumor cells. Expression of a dominant-negative mutant (TbetaRIIDeltacyt) of the TGF-beta type II receptor rendered the human breast cancer cell line MDA-MB-231 unresponsive to TGF-beta. In a murine model of bone metastases, expression of TbetaRIIDeltacyt by MDA-MB-231 resulted in less bone destruction, less tumor with fewer associated osteoclasts, and prolonged survival compared with controls. Reversal of the dominant-negative signaling blockade by expression of a constitutively active TGF-beta type I receptor in the breast cancer cells increased tumor production of parathyroid hormone-related protein (PTHrP), enhanced osteolytic bone metastasis, and decreased survival. Transfection of MDA-MB-231 cells that expressed the dominant-negative TbetaRIIDeltacyt with the cDNA for PTHrP resulted in constitutive tumor PTHrP production and accelerated bone metastases. These data demonstrate an important role for TGF-beta in the development of breast cancer metastasis to bone, via the TGF-beta receptor-mediated signaling pathway in tumor cells, and suggest that the bone destruction is mediated by PTHrP.

The effects of bisphosphonates on the resorption cycle of isolated osteoclasts

Binding sites for wheat germ agglutinin (WGA)-lectin have been shown to become revealed in the demineralized resorption lacunae that osteoclasts excavate on bone substrate. Peroxidase-conjugated WGA-lectin, which binds to bone matrix glycoconjugates and proteoglycans, was used in pit formation assays to assess the activity of isolated osteoclasts cultured on either 3-amino-1,1-hydroxypropylidene-bisphosphonate (APD)-or dichloromethylene bisphosphonate (Cl2MBP)-covered bone slices. Immunofluorescence and histochemical techniques were also used to study the effects of bone-bound bisphosphonates on isolated rat osteoclasts. Neither APD nor Cl2MBP interfered with the special organization of actin or vinculin in osteoclasts when the cells were initializing their resorption cycle. After 24 hours of culture, the number of resorbing osteoclasts increased strongly on control slices, but remained low on either APD- or Cl2MBP-treated slices. At this time, the actin and vinculin rings in osteoclasts also started to exhibit abnormal, more diffuse staining. Both bisphosphonates studied resulted in signs of cytotoxicity: the number of osteoclasts decreased on APD- or Cl2MBP-covered bone during the course of the study and those remaining attached exhibited severe cytoplasmic retractions. The total areas of resorption remained at significantly lower levels in both experimental groups studied, and this was due to decreases in both the number and sizes of individual resorption pits. The size of the most extensive lacunae detected on the Cl2MBP slices did not exceed 5 x 10(3) microns 2, whereas on the control slices, resorption pits bigger than 15 x 10(3) microns 2 were frequently discovered.

Long-term controlled trial with diphosphonate in patients with osteolytic bone metastases

Thirty-four normocalcaemic women with multiple osteolytic bone metastases from breast cancer were randomly allocated to treatment with disodium dichloromethylene diphosphonate (Cl2MDP) 1600 mg/day orally (17) or placebo (17) for 3-9 months. Fasting urinary hydroxyproline/creatinine and calcium/creatinine ratios declined in the Cl2MDP group but not in the placebo group. Four patients in the placebo group died from hypercalcaemia. New bone metastases were more common in patients on placebo and these patients also required more analgesic drugs than those on Cl2MDP. Cl2MDP seemed to reduce bone pain and bone resorption and prevent the development of hypercalcaemia caused by osteolytic metastases. The formation of new bone metastases and the growth of old ones seemed to be retarded by Cl2MDP.

Steroid receptors in normal and neoplastic female reproductive tissues

The presence of cytosol estrogen (ER) and progestin (PR) receptors in specimens of normal uterine cervix, endometrium, myometrium, Fallopian tubes and corpora lutei or in samples of neoplastic female reproductive tissues was investigated. The material consisted of PR and ER measurements of tissue samples obtained from fertile and postmenopausal women, receptor assays were performed by a dextran-coated charcoal technique. The radio PR/ER was highest in specimens from the Fallopian tubes (44) and endometrium (4-10),2-3 in specimens of uterine ecto- or endocervical epithelium and about 4 in the myometrium. No ER or PR were found in the four corpora lutei examined. PR or PR/ER ratio in specimens of myoma tissues did not differ from that found in the myometrium specimens. The highest ER and PR values in the endometrium were measured in specimens taken during the late proliferative or intermediate phase of the menstrual cycle. The PR values in specimens from postmenopausal myometrium were lower in comparison with the samples taken from the myometrium of fertile women in contrast to ER values. In the specimens of carcinoma of the vulva and the uterine cervix ER levels were very low, with no measureable values of PR. In the endometrial carcinoma samples the PR/ER ratio was lower than in the normal endometrium. 4 out of 7 specimens taken from ovarian adenocarcinoma had a measureable amount of ER and in 2 out of 7 cases PR.

LH(hCG) receptor in benign and malignant tumors of human ovary

LH(hCG) receptors were identified with [125I]hCG in 38 benign and 26 malignant ovarian tumors of the human ovary. Eighteen per cent of all the benign and 27% of all the malignant tumors were LH(hCG) receptor-positive. Four of 12 benign serous tumors and 3 of 17 benign mucinous tumors displayed definitive binding of [125I]hCG. Two Brenner tumors failed to bind [125I]hCG. Six of 21 malignant epithelial tumors displayed definitive binding of [125I]hCG. Only one out of 4 malignant granulosa cell tumors bound [125I]hCG, while the other sex cord stromal tumors as well as one dysgerminoma failed to bind [125I]hCG. LH(hCG) receptor content in the benign and malignant receptor-positive tumors was low compared with the normal ovarian tissue. The presence of LH(hCG) receptors in certain benign and malignant ovarian tumors may be a sign of the gonadotropic control of these tumors. The possible applications of these findings for the diagnosis and treatment of human ovarian tumors is discussed.

Catecholamines and dopamine-beta-hydroxylase activity during therapeutic abortion induced by sulprostone

To evaluate the changes in circulating norepinephrine (NE), epinephrine (E) and dopamine-beta-hydroxylase (DBH) caused by an intravenous infusion of a derivate of PGE2, sulprostone, in connection with legal termination of pregnancy, serial plasma samples were analyzed for six gravidae. Plasma catecholamines were measured by a sensitive radioenzymatic method (9,10) and DBH activities by a photometric assay (11). Intravenous infusion of sulprostone, in abortifacient doses as an intravenous infusion of 3-4 microgram per minute for six to eight hours produced a decrease in circulating norepinephrine. No significant alteration was found in plasma epinephrine or dopamine-beta-hydroxylase activity. The finding suggests an inhibitory effect of sulprostone on the release of norepinephrine from the adrenergic terminals without inhibition of the adrenal medulla.

Induction of labour with sulprostone after foetal death and in hydatidiform mole

Induction of uterine contractions was carried out with an intravenous infusion of sulprostone, a 16-phenoxy derivate of methylsulphonylamid prostaglandin E2 in 21 patients after intrauterine foetal death and in seven patients having hydatidiform mole. The mean total dose of sulprotone was estimated as 1100-1300 microgram in different groups. The mean induction-delivery time was 7-13 hours. Expellation of the foetus occurred in 20 out of 21 cases during 24 hours after commencement of sulprostone infusion. In all patients having molar pregnancy uterine contractions induced with sulprostone opened the uterine cervix for evacuation. The drug was clinically well tolerated without any serious side-effects.

Abortion with sulprostone, a prostaglandin E2 derivative

Sulprostone, a prostaglandin E2 derivative, was used in a multicenter trial to terminate 478 pregnancies of 8-21 weeks' gestation. The compound was clinically well accepted without premedication in extraovular, intravenous and intramuscular routes of administration. At 24 hours after treatment, 67%-88% of the patients had aborted, with a low average incidence of side effects. Sulprostone is preferred clinically to primary prostaglandins. Intravenous infusion was found to be the safest route, but intramuscular injection proved to be the most practical.

Gynaecological state of health of 2 654 women in Nurmes 1970-71. A clinical outpatient study

The present report describes a gynaecological open care study intended to determine the incidence of gynaecological diseases in the 15–60 year old population of Nurmes and shed light on the effects on gynaecological morbidity of age, parity, certain habits in sexual behavior, socioeconomic situation and previous care. The series comprised 2 654 women who agreed to undergo an examination, i.e. 72.8% of the women 15–60 years of age listed in the census and 80.9% of those in the locality during the study period. The research methods used were: a written anamnesis, personal interview, gynaecological Pap test, clinical gynaecological examination, laboratory tests, histological tests and, when necessary, tests in a central hospital. The final result of the study on gynaecological state of health was the division of the subjects into the following four groups: (1) gynaecologically healthy, (2) subjectively gynaecologically ailing, (3) gynaecologically ill, and (4) asymptomatic persons suffering from gynaecological diseases. Gynaecological morbidity was also measured by the number of those in need of gynaecological treatment. These figures were compared with the number of those who, at some time in their life, had suffered from a gynaecological illness. Of the population studied, 21% were found gynaecologically healthy, 13% were subjectively gynaecologically ailing, 48% were ill and 18% were asymptomatic persons suffering from gynaecological diseases. Of the factors studied, those with the most profound effect on gynaecological morbidity were age and parity. In the younger age groups, up to 25, there were significantly more gynaecologically healthy than gynaecologically ill, after which age the number of those suffering from diseases exceeded the number of healthy subjects. Parous subjects had significantly more gynaecological diseases than nulliparous subjects. The number of births was not related to the total number of gynaecological diseases. Sexual relations increased gynaecological morbidity, though to a lesser degree than parity. Gynaecological morbidity in the different social classes was uniform. Those in the highest income classes accounted, relatively, for the largest number of cured gynaecological diseases.