Abstract 1001: Urinary metabolite diagnostic and prognostic liquid biopsy biomarkers of lung cancer - never smokers versus tobacco smokers

Introduction: Never smokers account for 10-13% of all lung cancer cases in the United States. The etiology is attributed to multiple causes including exposure to passive smoking, parental smoking, asbestos and radon. However, these lung cancer cases do not fit the current United States Government-funded criterion of low-dose computed tomography that identifies early stages of lung cancer with higher survival following surgical removal.

Methods: The cancer urinary biomarkers, creatine riboside (CR) and N-acetylneuraminic acid (NANA), were analyzed and quantified by liquid chromatography-mass spectrometry to determine if never smokers with non-small cell lung cancer (NSCLC) can also be identified alongside tobacco smoker NSCLC cases as compared with gender and age-matched non-cancer population controls.

Results: These cancer biomarkers were significantly higher and comparable in never-smokers and tobacco smokers cases compared to population controls. Receiver Operating Characteristics (ROC) analysis in never smokers was equivalent for CR and NANA levels area under the curve (AUC) 0.91. In contrast, combined CR and NANA levels resulted in better predictive performance (AUC 0.94). Kaplan-Meier survival curves showed that high levels of CR and NANA were associated (p<0.05) with increased cancer-specific death in never-smokers and tobacco smokers. Therefore these metabolites are independent of Tobacco smoking. NANA metabolite category factor, histology and stage were independent predictors of survival (p<0.05) in multivariate analyses for never smokers as shown in Table 1.

Conclusions: These results indicate that measuring CR and NANA in liquid biopsy urine could identify never-smoking lung cancer candidates for LDCT screening and warrant prospective studies of these biomarkers in high-risk environments.

Table 1. Univariate and multivariate regression analysis for factors associated with survival in the never smokers population Univariate Analysis Multivariate analysis Factors Levels N HR 95%CI P-value HR 95%CI P-value Stage Early Stage (I & II); Late Stage (III & IV) 145 3.52 2.3, 5.3 <0.001 3.94 2.2, 6.8 <0.001 Histology Adenocarcinoma; Squamous cell carcinoma 114 1.62 0.7, 3.5 0.26 3.42 1.4, 7.9 0.01 CR Category Low; High 166 1.34 0.8-2.1 0.19 1.67 0.9, 3.0 0.08 NANA Category Low; High 166 2.11 1.1-3.9 0.009 2.31 1.0, 5.0 0.02 Age N=166 166 1.00 0.9, 1.0 0.50 0.99 0.9, 1.0 0.4 Sex Male; Female 166 0.87 0.5, 1.2 0.49 0.90 0.5, 1.5 0.7 Race African American; European American 166 0.82 0.2, 2.5 0.75 0.40 0.1, 1.3 0.2

Citation Format: Bhavik Dalal, Takeshi Tada, Daxesh P. Patel, Mohammed Khan, Takahiro Oike, Yasuyuki Kanke, Amelia Parker, Majda Haznadar, Leila Toulabi, Kristopher Krausz, Ana Robles, Elise Bowman, Frank Gonzalez, Curtis Harris. Urinary metabolite diagnostic and prognostic liquid biopsy biomarkers of lung cancer - never smokers versus tobacco smokers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1001.

Adrenoceptor-related decrease in serum triglycerides is independent of PPARα activation

Adrenoceptor (AR)-linked pathways belong to the major components of the stress response system and are associated with the pathophysiology of diseases within the spectrum of metabolic syndrome. In this study, the role of adrenoceptor stimulation in serum triglyceride (TG) regulation in mice was investigated. For this purpose, α₁ -ARs were activated with phenylephrine (PH) and β_1/2 -ARs with isoprenaline (ISOP). Both AR agonists markedly reduced serum TG levels independently of PPARα activation. These drugs also significantly activated the hormone-sensitive lipase in the white adipose tissue indicating increased mobilization of TGs in this tissue. In addition, PH and ISOP up-regulated Lpl, Nr4A, Dgat1, Mttp, Aadac and Cd36 genes, critical in TG regulation, whereas the observed decrease in serum TG levels was independent of the hepatic very low-density lipoprotein (VLDL)-TG secretion. Interestingly, PH and ISOP also inactivated the hepatic insulin/PI3k/AKT/FoxO1 signaling pathway, holding a critical role in the regulation of genes involved in TG synthesis. Taken together, the findings of the present study indicate that stimulation of α₁ - and β_1/2 -ARs markedly reduced serum TG steady-state levels as a result of alterations in TG synthesis, uptake, transport, hydrolysis, metabolism and clearance, an effect induced by PPARα independent mechanisms.

Quercetin inhibits radiation-induced skin fibrosis

Radiation induced fibrosis of the skin is a late toxicity that may result in loss of function due to reduced range of motion and pain. The current study sought to determine if oral delivery of quercetin mitigates radiation-induced cutaneous injury. Female C3H/HeN mice were fed control chow or quercetin-formulated chow (1% by weight). The right hind leg was exposed to 35 Gy of X rays and the mice were followed serially to assess acute toxicity and hind leg extension. Tissue samples were collected for assessment of soluble collagen and tissue cytokines. Human and murine fibroblasts were subjected to clonogenic assays to determine the effects of quercetin on radiation response. Contractility of fibroblasts was assessed with a collagen contraction assay in the presence or absence of quercetin and transforming growth factor-β (TGF-β). Western blotting of proteins involved in fibroblast contractility and TGF-β signaling were performed. Quercetin treatment significantly reduced hind limb contracture, collagen accumulation and expression of TGF-β in irradiated skin. Quercetin had no effect on the radioresponse of fibroblasts or murine tumors, but was capable of reducing the contractility of fibroblasts in response to TGF-β, an effect that correlated with partial stabilization of phosphorylated cofilin. Quercetin is capable of mitigating radiation induced skin fibrosis and should be further explored as a therapy for radiation fibrosis.

Monoclonal Antibodies and Multifunctional Cytochrome P450: Drug Metabolism as Paradigm

Monoclonal antibodies are reagents par excellence for analyzing the role of individual cytochrome P450 isoforms in multifunctional biological activities catalyzed by cytochrome P450 enzymes. The precision and utility of the monoclonal antibodies have heretofore been applied primarily to studies of human drug metabolism. The unique and precise specificity and high inhibitory activity toward individual cytochrome P450s make the monoclonal antibodies extraordinary tools for identifying and quantifying the role of each P450 isoform in the metabolism of a drug or nondrug xenobiotic. The monoclonal antibodies identify drugs metabolized by individual, several, or polymorphic P450s. A comprehensive collection of monoclonal antibodies has been isolated to human P450s: 1A1, 1A2, 2A6, 2B6, 2C8, 2C9, 2C family, 2C19, 2D6, 2E1, 3A4/5, and 2J2. The monoclonal antibodies can also be used for identifying drugs and/or metabolites useful as markers for in vivo phenotyping. Clinical identification of a patient's phenotype, coupled with precise knowledge of a drug's metabolism, should lead to a reduction of adverse drug reactions and improved drug therapeutics, thereby promoting advances in drug discovery.

CYP2C subfamily, primarily CYP2C9, catalyses the enantioselective demethylation of the endocrine disruptor pesticide methoxychlor in human liver microsomes: use of inhibitory monoclonal antibodies in P450 identification

1. The endocrine disruptor pesticide methoxychlor undergoes O-demethylation by mammalian liver microsomes forming chiral mono-phenolic (1,1,1-trichloro-2-(4-hydroxyphenyl)-2-(4-methoxyphenyl)ethane, i.e. mono-OH-M) and achiral bis-phenolic oestrogenic metabolites. Human liver microsomes (HLM) generated primarily the S-mono-OH-M. 2. Inhibitory monoclonal antibodies (MAb) identified those P450s catalysing the enantioselective O-demethylation of methoxychlor. In HLM, O-demethylation was inhibited by MAb anti-2C9 (30-40%), diminishing the per cent of S-mono-OH-M from about 80 to 55-60%. MAb anti-CYP1A2, 2A6, 2B6, 2C8, 2C19, 2D6 and 3A4 did not affect the demethylation rate in HLM. Nevertheless, MAb anti-CYP1A2 decreased the formation of R-mono-OH-M from 21-23 to 10-17%, indicating that CYP1A2 exhibits a role in generating the R-enantiomer. 3. Among cDNA-expressed human P450s (supersomes), CYP2C19 was the most active in demethylation, but in HLM, CYP2C19 appeared inactive (no inhibition by MAb anti-CYP2C19). There was a substantial difference in the per cent inhibition of demethylation by MAb anti-CYP2C9 and anti-rat CYP2C (MAb inhibiting all human CYP2C forms) and in altering the enantioselectivity, suggesting that demethylation by combined CYP2C8, 2C18 and 2C19 was significant (20-30%). 4. Polymorphism of methoxychlor demethylation was examined with supersomes and HLM-expressing CYP2C9 allelic variants. CYP2C9*1 and 2C9*2 were highly active; however, CYP2C9*3 appeared inactive.

Identification of CYP1A2 as the main isoform for the phase I hydroxylated metabolism of genistein and a prodrug converting enzyme of methylated isoflavones

This study determined the cytochrome P450 (P450) isoforms responsible for metabolism of isoflavones using human liver microsomes (HLM) and expressed P450s. The primary metabolite of genistein is 3'-OH-genistein, as identified with an authentic chemically synthesized standard. CYP1A2 was predominantly responsible for 3'-OH-genistein formation since its formation was inhibited (>50%, p < 0.05) by a monoclonal antibody specific for CYP1A2, was correlated with CYP1A2 activities of HLM, and was catalyzed by expressed CYP1A2. In addition to CYP1A2, CYP2E1 also catalyzed, although to a lesser extent, its formation. The contribution of these P450s to the formation of 3'-OH-genistein was also confirmed with a panel of expressed enzymes. Methylated isoflavones biochanin A, prunetin, and formononetin (10-100 microM) were rapidly converted by HLM and expressed CYP1A2 to more active genistein and daidzein. The conversion of biochanin A to genistein appears to be mainly mediated by CYP1A2 because of the strong correlation between the conversion rates and CYP1A2 activities in HLM. Thus, CYP1A2 is an effective prodrug-converting enzyme for less active methylated isoflavones. CYP1A2-catalyzed conversion of biochanin A to genistein (Km, 7.80 microM; Vmax, 903 pmol/min/mg of protein; Vmax/Km, 116 microl/min/mg of protein) was much faster than 3'-hydroxylation of genistein (Km, 12.7 microM and Vmax, 109 pmol/min/mg of protein; Vmax/Km, 8.6 microl/min/mg of protein). The interaction studies showed that genistein inhibited formation of acetaminophen from phenacetin with an IC50 value of 16 microM. Additional studies showed that phenacetin and genistein were mutually inhibitory. In conclusion, CYP1A2 and CYP2E1 metabolized genistein and CYP1A2 acted as prodrug-converting enzymes for other less active methylated isoflavones.