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Lochbaum R, Trainotti S, Hoffmann TK, Greve J, Hahn J. A clinical evaluation of patients with known mutations (plasminogen and factor XII) with a focus on prophylactic treatment. J DERMATOL TREAT 2024; 35:2290362. [PMID: 38086754 DOI: 10.1080/09546634.2023.2290362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Hereditary angioedema with normal C1-inhibitor (HAE-nC1-INH) is a rare genetic disease. The symptoms can resemble other forms of hereditary angioedema (HAE), but the specific laboratory values are inconspicuous. The knowledge about treatment strategies in HAE-nC1-INH remains insufficient; most of the drugs are only licensed and approved for other types of HAE. METHODS An analysis of all patients with HAE-nC1-INH was carried out in a certified angioedema treatment center in southern Germany. Only patients with a confirmed HAE-nC1-INH mutation were included. The impact of disease was monitored with validated questionnaires. RESULTS Eighteen patients were included: two families with a factor XII mutation and seven families with a plasminogen mutation. All individuals received icatibant for on-demand therapy-efficient treatment response was reported. Three patients were severely affected, and prophylaxis was initiated with lanadelumab. According to the questionnaires, the clinical course and symptoms improved significantly under this prophylactic regime. CONCLUSION This is one of the first descriptions of the clinical outcomes as a response to prophylactic treatment with lanadelumab in HAE-nC1-INH patients with a known mutation. The therapeutic management of HAE-1 and HAE-2 should also be the basis of HAE-nC1-INH, including prophylaxis.
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Affiliation(s)
- Robin Lochbaum
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Susanne Trainotti
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Janina Hahn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
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Wu Y, Wang T, Guo C, Zhang D, Ge X, Huang Z, Zhou X, Li Y, Peng Q, Li J. Plasminogen improves lung lesions and hypoxemia in patients with COVID-19. QJM 2020; 113:539-545. [PMID: 32275753 PMCID: PMC7184376 DOI: 10.1093/qjmed/hcaa121] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Lungs from patients with coronavirus disease 2019 (COVID-19) have shown typical signs of acute respiratory distress syndrome (ARDS), formation of hyaline membrane mainly composed of fibrin and 'ground-glass' opacity. Previously, we showed plasminogen itself is a key regulator in fibrin degradation, wound healing and infection. AIM We aimed to investigate whether plasminogen can improve lung lesions and hypoxemia of COVID-19. DESIGN Thirteen clinically moderate, severe or critical COVID-19 patients were treated with atomization inhalation of freeze-dried plasminogen. METHODS Levels of their lung lesions, oxygen saturation and heart rates were compared before and after treatment by computed tomography scanning images and patient monitor. RESULTS After plasminogen inhalation, conditions of lung lesions in five clinically moderate patients have quickly improved, shown as the decreased range and density of 'ground glass' opacity. Improvements of oxygen saturation were observed in six clinically severe patients. In the two patients with critical conditions, the oxygen levels have significantly increased from 79-82% to 91% just about 1 h after the first inhalation. In 8 of 13 patients, the heart rates had slowed down. For the five clinically moderate patients, the difference is even statistically significant. Furthermore, a general relief of chest tightness was observed. CONCLUSION Whereas it is reported that plasminogen is dramatically increased in adults with ARDS, this study suggests that additional plasminogen may be effective and efficient in treating lung lesions and hypoxemia during COVID-19 infections. Although further studies are needed, this study highlights a possible hope of efficiently combating this rapid epidemic emergency.
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Affiliation(s)
- Y Wu
- Department of Basic Research, Talengen Institute of Life Sciences, Shenzhen, P.R. China
| | - T Wang
- Department of Basic Research, Talengen Institute of Life Sciences, Shenzhen, P.R. China
| | - C Guo
- Department of Basic Research, Talengen Institute of Life Sciences, Shenzhen, P.R. China
| | - D Zhang
- Department of Respiratory Medicine, Beijing Chang’an Chinese and Western Integrated Medicine Hospital, Beijing, P.R. China
| | - X Ge
- Department of Basic Research, Talengen Institute of Life Sciences, Shenzhen, P.R. China
| | - Z Huang
- Department of Basic Research, Talengen Institute of Life Sciences, Shenzhen, P.R. China
| | - X Zhou
- Department of Respiratory Medicine, Suixian Hongshan Hospital, Suizhou, Hubei Province, P.R. China
| | - Y Li
- Department of Respiratory Medicine, Xiaogan Hospital, Affiliated to Wuhan University of Science and Technology, Xiaogan, Hubei Province, P.R. China
- Address correspondence to J. Li PhD, Department of Basic Research, Talengen Institute of Life Sciences, Room C602G, 289 Digital Peninsula, Shunfeng Industrial Park, No.2 Red Willow Road, Futian District, Shenzhen, P.R. China.
| | - Q Peng
- Department of Respiratory Medicine, Xiaogan Hospital, Affiliated to Wuhan University of Science and Technology, Xiaogan, Hubei Province, P.R. China
| | - J Li
- Department of Basic Research, Talengen Institute of Life Sciences, Shenzhen, P.R. China
- Address correspondence to J. Li PhD, Department of Basic Research, Talengen Institute of Life Sciences, Room C602G, 289 Digital Peninsula, Shunfeng Industrial Park, No.2 Red Willow Road, Futian District, Shenzhen, P.R. China.
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Fallah M, Viklund E, Bäckman A, Brodén J, Lundskog B, Johansson M, Blomquist M, Wilczynska M, Ny T. Plasminogen is a master regulator and a potential drug candidate for the healing of radiation wounds. Cell Death Dis 2020; 11:201. [PMID: 32205839 PMCID: PMC7089956 DOI: 10.1038/s41419-020-2397-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/24/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 12/18/2022]
Abstract
Around 95% of cancer patients undergoing radiotherapy experience cutaneous side effects, and some develop radiation wounds or fibrosis. Currently, there is no effective treatment for these indications. We show here that plasminogen administration enhanced the healing of radiation wounds via pleiotropic effects on gene expression. Using RNA sequencing, we found that plasminogen downregulated the expression of genes in the TLR, TNF, WNT, MAPK, and TGF-β signaling pathways, and enhanced the anti-inflammatory effect of arachidonic acid, leading to significantly decreased inflammation and improved remodeling of granulation tissue compared with placebo treatment. In addition, plasminogen induced metabolic changes, including decreased glycolysis. Importantly, many of the factors downregulated by plasminogen are pro-fibrotic. Therefore, in radiation wounds with excessive inflammation, plasminogen is able to enhance and redirect the healing process, such that it more closely resembles physiological healing with significantly reduced risk for developing fibrosis. This makes plasminogen an attractive drug candidate for the treatment of radiation wounds in cancer patients.
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Affiliation(s)
- Mahsa Fallah
- Department of Medical Biochemistry and Biophysics, Umeå University, 901-87, Umeå, Sweden
| | - Emil Viklund
- Department of Medical Biochemistry and Biophysics, Umeå University, 901-87, Umeå, Sweden
| | | | | | - Bertil Lundskog
- Department of Medical Biosciences, Pathology, Umeå University, 901-87, Umeå, Sweden
| | - Michael Johansson
- Department of Radiation Sciences, Umeå University, 901-87, Umeå, Sweden
| | - Michael Blomquist
- Department of Radiation Sciences, Umeå University, 901-87, Umeå, Sweden
| | - Malgorzata Wilczynska
- Department of Medical Biochemistry and Biophysics, Umeå University, 901-87, Umeå, Sweden
- Omnio AB, Tvistevägen 48, 907-36, Umeå, Sweden
| | - Tor Ny
- Department of Medical Biochemistry and Biophysics, Umeå University, 901-87, Umeå, Sweden.
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Tenbrock K, Lehmann S, Schrading S, Moran J. Replacement Therapy with Glu-Plasminogen for the Treatment of Severe Respiratory and Auditory Complications of Congenital Plasminogen Deficiency. Acta Haematol 2019; 141:146-147. [PMID: 30783057 DOI: 10.1159/000495336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 11/13/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Klaus Tenbrock
- Department of Pediatrics, Division of Pediatric Pulmonology, Allergy and Immunology, RWTH Aachen University, Aachen, Germany,
| | - Sylvia Lehmann
- Department of Pediatrics, Division of Pediatric Pulmonology, Allergy and Immunology, RWTH Aachen University, Aachen, Germany
| | | | - John Moran
- Prometic Life Sciences, Laval, Québec, Québec, Canada
- Stanford University School of Medicine, Stanford, California, USA
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Cai WB, Zhang Y, Cheng R, Wang Z, Fang SH, Xu ZM, Yang X, Yang ZH, Ma JX, Shao CK, Gao GQ. Dual inhibition of plasminogen kringle 5 on angiogenesis and chemotaxis suppresses tumor metastasis by targeting HIF-1α pathway. PLoS One 2012; 7:e53152. [PMID: 23300882 PMCID: PMC3534244 DOI: 10.1371/journal.pone.0053152] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [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] [Received: 06/05/2012] [Accepted: 11/26/2012] [Indexed: 11/26/2022] Open
Abstract
We had demonstrated that plasminogen kringle 5 (K5), a potent angiogenic inhibitor, inhibited retinal neovascularization and hepatocellular carcinoma growth by anti-angiogenesis. The current study investigated the effects and the underlying mechanisms of K5 on both tumor growth and spontaneous pulmonary metastasis in Lewis lung carcinoma (LLC) implanted mouse model. Similarly, K5 could decrease expression of VEGF in LLC cells and grafted tissues and suppress tumor angiogenesis and growth. K5 had no direct effect on proliferation and apoptosis of LLC. However, K5 could significantly inhibit SDF-1α-induced chemotaxis movement of LLC cells and resulted in a great reduction of surface metastatic nodules and micrometastases in the lungs of LLC tumor-bearing mice. K5 also decreased expression of chemokine (C-X-C motif) receptor 4 (CXCR4) in LLC cells and grafted tissues. Furthermore, K5 down-regulated SDF-1α expression in metastatic lung tissues of LLC-bearing mice. Therefore, K5 may suppress tumor pulmonary metastasis through inhibiting SDF-1α-CXCR4 chemotaxis movement and down-regulation of VEGF. Moreover, the role of hypoxia inducible factor-1α (HIF-1α), a crucial transcriptional factor for both VEGF and CXCR4 expression, was evaluated. The siRNA of HIF-1α attenuated expression of VEGF and CXCR4 and inhibited LLC migration. K5 decreased HIF-1α protein level and impaired nuclear HIF-1α accumulation. These results showed for the first time that K5 inhibits LLC growth and metastasis via the dual effects of anti-angiogenesis and suppression of tumor cell motility by targeting the pivotal molecule, HIF-1α.
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Affiliation(s)
- Wei-Bin Cai
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yang Zhang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Rui Cheng
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Zheng Wang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Shu-Huan Fang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- DME Center, Clinical Pharmacology Institute, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zu-Min Xu
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Xia Yang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Functional Molecules from Marine Microorganisms (Sun Yat-sen University), Department of Education of Guangdong Province, Guangzhou, China
| | - Zhong-Han Yang
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jian-Xing Ma
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Chun-Kui Shao
- Department of Pathology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- * E-mail: (GQG); (CKS)
| | - Guo-Quan Gao
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- China Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China
- * E-mail: (GQG); (CKS)
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Zea M, Bermejo PE, Carrillo F. [Relationship between fibrinolytic system and neurological diseases]. Rev Neurol 2010; 51:295-301. [PMID: 20669129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The fibrinolytic system, also named plasminogen system is formed by a group of molecules that transforms plasminogen in its active form plasmine, which is able to participate in a number of pathophysiological processes. AIM To carry out a review of the literature and an analysis of the relationship between fibrinolytic system and neurological diseases and its potential therapeutic implications. DEVELOPMENT The fibrinolytic system has been involved in many different pathologies. Although its role in neurological diseases has always been thought to be scarce, many relations have been recently established. This way, fibrinolytic system seems to be involved not only in cerebrovascular diseases but also in epilepsy, inflammatory diseases such as multiple sclerosis, alterations of the dopaminergic system, learning disorders and several lesions of the peripheral nervous system. Different genotypes of several components of this system have been related as risk or protector factors to the development of these neurological diseases and information to this respect is rapidly increasing. CONCLUSIONS A better knowledge about the relations between the fibrinolytic system and neurological diseases could clarify several aspects about their pathophysiology and it could suppose future prevention and treatment lines.
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Affiliation(s)
- M Zea
- Hospital del Henares, Coslada, Madrid, Espana.
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Park K, Chen Y, Hu Y, Mayo AS, Kompella UB, Longeras R, Ma JX. Nanoparticle-mediated expression of an angiogenic inhibitor ameliorates ischemia-induced retinal neovascularization and diabetes-induced retinal vascular leakage. Diabetes 2009; 58:1902-13. [PMID: 19491211 PMCID: PMC2712783 DOI: 10.2337/db08-1327] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of the study is to evaluate the effect of nanoparticle-mediated gene delivery of angiogenic inhibitors on retinal inflammation, vascular leakage, and neovascularization in diabetic retinopathy. RESEARCH DESIGN AND METHODS An expression plasmid of plasminogen kringle 5 (K5), a natural angiogenic inhibitor, was encapsulated with poly(lactide-coglycolide) to form K5 nanoparticles (K5-NP). Expression of K5 was determined by Western blot analysis and immunohistochemistry, and retinal vascular leakage was measured by permeability assay. Retinal neovascularization was evaluated using fluorescein-angiography and counting preretinal vascular cells in rats with oxygen-induced retinopathy. Effects of K5-NP on retinal inflammation were evaluated in streptozotocin-induced diabetic rats by leukostasis assay and Western blot analysis of intracellular adhesion molecule and vascular endothelial growth factor. Possible toxicities of K5-NP were evaluated using histology examination, retinal thickness measurement, and electroretinogram recording. RESULTS K5-NP mediated efficient expression of K5 and specifically inhibited growth of endothelial cells. An intravitreal injection of K5-NP resulted in high-level expression of K5 in the inner retina of rats during the 4 weeks they were analyzed. Injection of K5-NP significantly reduced retinal vascular leakage and attenuated retinal neovascularization, when compared with the contralateral eyes injected with Control-NP in oxygen-induced retinopathy rats. K5-NP attenuated vascular endothelial growth factor and intracellular adhesion molecule-1 overexpression and reduced leukostasis and vascular leakage for at least 4 weeks after a single injection in the retina of streptozotocin-induced diabetic rats. No toxicities of K5-NP were detected to retinal structure and function. CONCLUSIONS K5-NP mediates efficient and sustained K5 expression in the retina and has therapeutic potential for diabetic retinopathy.
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Affiliation(s)
- Kyoungmin Park
- Department of Medicine, Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ying Chen
- Department of Medicine, Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Yang Hu
- Department of Medicine, Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Aaron S. Mayo
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, Nebraska
| | - Uday B. Kompella
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, Nebraska
| | - Richard Longeras
- Department of Medicine, Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jian-xing Ma
- Department of Medicine, Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Corresponding author: Jian-xing Ma,
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Jin GH, Ma DY, Wu N, Marikar FMMT, Jin SZ, Jiang WW, Liu Y, Hua ZC. Combination of human plasminogen kringle 5 with ionizing radiation significantly enhances the efficacy of antitumor effect. Int J Cancer 2007; 121:2539-46. [PMID: 17680563 DOI: 10.1002/ijc.22708] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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: 11/09/2022]
Abstract
Antiangiogenic therapy could destroy tumor vasculature and inhibit tumor growth. It might inhibit tumor growth significantly when used as a single treatment modality and its therapeutic benefit may even be greater when used in combination with established treatment modalities such as radiation therapy (RT). In the present report, we investigated the effect of recombinant human plasminogen kringle 5 domain (rhK5) in combination with ionizing radiation on angiogenesis, tumor growth and survival in a murine Lewis lung carcinoma (LLC) tumor model. Combined treatment using rhK5 and radiotherapy displayed obvious suppressive effect on LLC tumor growth as compared with single treatment with either modality (p < 0.05), and resulted in a more additive effect on tumor growth delay in this model. In addition, combined treatment significantly enhanced the survival of mice and no toxic effect, such as weight loss, was observed. The significant antitumor effect of rhK5 plus radiation was associated with a direct suppression effect on early neoangiogenesis and tumor cell apoptosis. Furthermore, the expression of VEGF and HIF-1alpha in tumor tissue correlated well with decreased vessel density. The results suggest that rhK5 significantly enhances the antitumor activity of RT and could be a potent adjuvant therapeutic approach to improve the efficacy of radiotherapy for lung cancer.
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Affiliation(s)
- Guang-Hui Jin
- The State Key Laboratory of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, People's Republic of China
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9
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Abstract
PURPOSE To generate microplasmin (microPlm) using recombinant microplasminogen (microPlg) and recombinant tissue plasminogen activator (rt-PA) before intravitreous injection and to investigate the efficacy of microPlm in inducing posterior vitreous detachment (PVD). METHODS Forty-eight female or male New Zealand white rabbits were randomized into three groups. Recombinant human microPlg was incubated with rt-PA with a 200:1 molar ratio at 37 degrees C for 40 min. The right eyes of groups 1, 2, and 3, were injected with 0.5, 1.0, and 1.5 U microPlm in 0.1 ml respectively, and 0.1 ml balanced salt solution (BSS) was injected into the left eye as controls. Scanning electron microscopy (SEM), gross specimen examination, B-ultrasonography and optical coherence tomography (OCT) were performed to detect vitreoretinal interface. RESULTS Over eighty percent of recombinant human microPlg could be activated to active microPlm by rt-PA after 40 min incubation. Complete PVD was found at vitreous posterior pole of microPlm-treated eyes without morphological change of retina. Complete PVD of 25, 75, and 87.5% rabbit eyes was induced by 0.5, 1.0 and 1.5 U recombinant microPlm respectively on day 1. The remnants of vitreous cortex at the posterior pole were dependent on the concentration of microPlm. Among the four approaches for detecting PVD, SEM, gross specimen examination, and B-ultrasonography were more effective methods than OCT. CONCLUSION Intravitreous injection of 1.5 U microPlm can effectively induce complete PVD in rabbit eyes on day 1 without morphological change of retina.
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Affiliation(s)
- W Chen
- Department of Molecular Genetics, Shanghai Medical School and Key Laboratory of Molecular Medicine, Ministry of Education, Fudan University, Shanghai, PR China
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Zhang Z, Ma JX, Gao G, Li C, Luo L, Zhang M, Yang W, Jiang A, Kuang W, Xu L, Chen J, Liu Z. Plasminogen Kringle 5 Inhibits Alkali-Burn–Induced Corneal Neovascularization. ACTA ACUST UNITED AC 2005; 46:4062-71. [PMID: 16249481 DOI: 10.1167/iovs.04-1330] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [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] [Indexed: 11/24/2022]
Abstract
PURPOSE Plasminogen kringle 5 (K5) is a potent angiogenic inhibitor. The purpose of the present study was to evaluate the therapeutic effect of K5 on alkali-burn-induced corneal neovascularization (NV) and to investigate its mechanism of action. METHODS Corneal NV was induced in rabbits by NaOH. The rabbits received eye drops containing K5 or vehicle alone, four times per day. Corneal NV and inflammation were monitored every other day with a slit lamp microscope, and the length of the vessels in the cornea and the area of NV were measured. Vascular endothelial growth factor (VEGF) was determined by immunohistochemical and Western blot analyses. The TUNEL assay was used to assess the apoptosis of endothelial cells. The effects of K5 on primary bovine aortic endothelial cells (BAECs) were determined by MTT assay, flow cytometry, transmission electron microscopy, and DNA fragmentation assay. RESULTS Alkali-burn-induced progressive corneal NV and inflammation in the cornea. K5 delayed the onset of corneal NV (P < 0.05) and decreased NV areas (P < 0.05) in a dose-dependent manner. K5 treatment, after the formation of corneal NV, induced regression of newly formatted vessels in the cornea. K5 decreased the inflammatory index in the corneas at different time points after the alkali burn. Corneal VEGF levels were reduced by K5 treatment. K5 inhibits proliferation and induces apoptosis in BAECs. CONCLUSIONS Topical application of K5 may have therapeutic potential for the chemical burn-induced corneal NV and inflammation. The inhibitory effect of K5 on corneal NV may be by downregulation of VEGF expression.
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Affiliation(s)
- Zhihong Zhang
- Zhongshan Ophthalmic Center, Zhongshan University, Guangzhou, People's Republic of China
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Kamali F. V-10153 (Vernalis). Curr Opin Investig Drugs 2005; 6:951-5. [PMID: 16187695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Vernalis is developing V-10153, a recombinant plasminogen activator stimulator, for the potential treatment of thrombotic disorders and cardiovascular disease. By March 2004, a phase II trial in acute myocardial infarction had been completed, and by July 2005, Vernalis intended to initiate a phase II trial in stroke later that same year.
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Affiliation(s)
- Farhad Kamali
- Wolfson Unit of Clinical Pharmacology, University of Newcastle-upon-Tyne, NE1 7RU, UK.
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Tefs K, Hügle B, Schuster V. Therapeutic approaches in the treatment of ligneous conjunctivitis, the most common clinical manifestation of a systemic disease, caused by severe type I plasminogen deficiency. Am J Ophthalmol 2004; 138:699; author reply 699-700. [PMID: 15488842 DOI: 10.1016/j.ajo.2004.05.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang SX, Sima J, Shao C, Fant J, Chen Y, Rohrer B, Gao G, Ma JX. Plasminogen kringle 5 reduces vascular leakage in the retina in rat models of oxygen-induced retinopathy and diabetes. Diabetologia 2004; 47:124-31. [PMID: 14666366 DOI: 10.1007/s00125-003-1276-4] [Citation(s) in RCA: 40] [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: 06/06/2003] [Revised: 06/06/2003] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS Retinal vascular leakage is an early pathological feature in diabetic retinopathy and can lead to macular oedema and loss of vision. Previously we have shown that plasminogen kringle 5 (K5), an angiogenic inhibitor, inhibits retinal neovascularisation in the rat model of oxygen-induced retinopathy (OIR). The purpose of this study was to examine the effect of K5 on vascular leakage in the retina. METHODS Neonatal rats were exposed to hyperoxia to induce OIR. Diabetes was induced in adult rats by injecting streptozotocin. Vascular permeability was measured by Evans blue method. Expression of vascular endothelial growth factor (VEGF) was evaluated using immunohistochemistry and western blot analysis. RESULTS Rats with OIR and diabetes showed abnormal vascular hyperpermeability in the retina and iris. Intravitreal injection of K5, reduced vascular permeability in both animal models, but did not affect permeability in normal rats. K5 reduced vascular permeability at doses substantially lower than that required for inhibition of retinal neovascularisation. The K5-induced reduction in vascular permeability correlated with its down-regulation of VEGF expression in the retina. Moreover, K5 inhibited IGF-1-induced hyperpermeability, which is known to arise through up-regulation of endogenous VEGF expression. However, K5 had no effect on the hyperpermeability induced by injection of exogenous VEGF. CONCLUSIONS/INTERPRETATION Very low doses of K5 reduce pathological vascular leakage in the retina. K5 thus has therapeutic potential in the treatment of diabetic macular oedema. This effect can be ascribed, at least in part, to the down-regulation of endogenous VEGF expression.
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Affiliation(s)
- S X Zhang
- Department of Medicine, The University of Oklahoma Health Science Center, 941 Stanton L. Young Blvd., BSEB 328B, Oklahoma City, OK 73104-5043, USA
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Abstract
Antiangiogenic therapy is a highly promising new strategy in the treatment of cancer. One of the first angiogenesis inhibitors described was angiostatin, a 38-kDa internal proteolytically generated fragment of plasminogen. In a previous study we found that angiostatin affected physiological angiogenesis as well as tumor angiogenesis. It impaired healing when administered during repair of experimental colonic anastomoses, as reflected by a decrease in mechanical strength. On histology, we observed a decrease in factor VIII-stained vessel amount and volume in angiostatin-treated colonic anastomoses. The exact working mechanism of angiostatin has not been elucidated. Based on the available studies on proposed working mechanisms of angiostatin, we have attempted to address histological differences in physiological angiogenesis between the tissues of colonic anastomoses of mice with impaired healing and control mice. After angiostatin treatment there was more inflammatory tissue as a result of impaired healing. Furthermore, we found fewer vessels in the granulation tissue after angiostatin treatment. However, especially with respect to extracellular matrix (ECM), endothelial cell apoptosis, proliferation, or neutrophil influx, no gross differences were discerned 1 week following surgery, using histology and immunohistochemistry techniques.
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Affiliation(s)
- Elisabeth A te Velde
- Department of Surgery, University Medical Center Utrecht, 3508 6A Utrecht, The Netherlands
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Radema SA, Witteveen PO, Gebbink MB, Voest EE. [The clinical perspective of angiogenesis inhibitors]. Ned Tijdschr Geneeskd 2003; 147:1675-80. [PMID: 14513538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
An important development in the treatment of cancer is the recognition that the tumour's microenvironment, notably its vasculature, may be an attractive target for therapy. In the eighties of the last century, the concept of angiogenesis (the formation of new blood vessels from existing vasculature) was developed. Angiogenesis is the driving force behind tumour growth and metastasis. Recent angiogenesis research has elucidated the role of growth factors (vascular endothelial growth factor (VEGF), epidermal growth factor), metalloproteinases and endogenous proteins such as angiostatin and endostatin. This new knowledge has led to the rapid development of several angiogenesis inhibiting strategies. Although these new strategies showed very promising results in preclinical animal studies, early clinical studies with individual angiogenesis inhibitors have shown no antitumour effect so far. However, in recent studies blocking VEGF in addition to conventional chemotherapy has led to an increase in disease-free survival time and in response rate to chemotherapy. Angiogenesis research has contributed to the knowledge of the biology of cancer, the design of modified clinical studies and the development of surrogate markers that can be used as pharmacodynamic end points in future studies.
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Affiliation(s)
- S A Radema
- Universitair Medisch Centrum Utrecht, afd. Medische Oncologie, Postbus 85.500, 3508 GA Utrecht
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16
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Kurjak A. [The story of angiostatin and how controversy is useful in science]. Acta Med Croatica 2003; 57:145-8. [PMID: 12879695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Angiogenesis is the formation of new capillary blood vessels. It has a very important role not only in physiological conditions but also in the process of malignant human growth. Latest data suggesting that drugs inhibiting angiogenesis can stop the growth of malignant tumors have made the research on tumorous angiogenesis a hot topic recently. The pioneers in the field of angiogenesis, Judah Folkman and his team, have been challenged ever since they began the research. Several articles questioned the effectiveness of systemic gene therapy with anglostatin as an anticancer treatment in a mouse model of transduced hematopoletic stem cells. In a recent issue of Nature Medicine, Folkman has elegantly answered all the difficult questions of his criticizers showing impressively how criticism and controversies in scientific work represent the main generator of new ideas.
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Affiliation(s)
- Asim Kurjak
- Klinika za ginekologiju i porodnistvo Medicinskog fakulteta Sveucilista u Zagrebu, Opća bolnica Sveti Duh, Sveti Duh 64, 10000 Zagreb, Hrvatska
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Dell'Eva R, Pfeffer U, Indraccolo S, Albini A, Noonan D. Inhibition of tumor angiogenesis by angiostatin: from recombinant protein to gene therapy. Endothelium 2003; 9:3-10. [PMID: 12901356 DOI: 10.1080/10623320210712] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Tumor growth, local invasion, and metastatic dissemination are dependent on the formation of new microvessels. The process of angiogenesis is regulated by a balance between pro-angiogenic and anti-angiogenic factors, and the shift to an angiogenic phenotype (the "angiogenic switch") is a key event in tumor progression. The use of anti-angiogenic agents to restore this balance represents a promising approach to cancer treatment. Known physiological inhibitors include trombospondin, several interleukins, and the proteolytic break-down products of several proteins. Angiostatin, an internal fragment of plasminogen, is one of the more potent of this latter class of angiogenesis inhibitors. Like endostatin, another anti-angiogenic peptide derived from collagen XVIII, angiostatin can induce tumor vasculature regression, leading to a complete cessation of tumor growth. Inhibitors of angiogenesis target normal endothelial cells, therefore the development of resistance to these drugs is unlikely. The efficacy of angiostatin has been demonstrated in animal models for many different types of solid tumors. Anti-angiogenic cancer therapy with angiostatin requires prolonged administration of the peptide. The production of the functional polypeptides is expensive and technical problems related to physical properties and purity are frequently encountered. Gene transfer represents an alternative method to deliver angiostatin. Gene therapy has the potential to produce the therapeutic agent in high concentrations in a local area for a sustained period, thereby avoiding the problems encountered with long-term administration of recombinant proteins, monoclonal antibodies, or anti-angiogenic drugs. In this review we compare the different gene therapy strategies that have been applied to angiostatin, with special regard to their ability to provide sufficient angiostatin at the target site.
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Affiliation(s)
- Raffaella Dell'Eva
- Laboratory of Molecular Biology, National Cancer Research Institute, Genoa, Italy
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Vincent L, Varet J, Pille JY, Bompais H, Opolon P, Maksimenko A, Malvy C, Mirshahi M, Lu H, Vannier JP, Soria C, Li H. Efficacy of dendrimer-mediated angiostatin and TIMP-2 gene delivery on inhibition of tumor growth and angiogenesis: in vitro and in vivo studies. Int J Cancer 2003; 105:419-29. [PMID: 12704680 DOI: 10.1002/ijc.11105] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [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: 11/10/2022]
Abstract
Gene transfer is an attractive approach to fight cancer by targeting cancer cells or their vasculature. Our study reports the inhibition of tumor growth and angiogenesis by a nonviral method using dendrimers associated with 36-mer anionic oligomers (ON36) for delivering angiostatin (Kringle 1-3) and tissue inhibitor of metalloproteinase (TIMP)-2 genes. The optimal concentrations of dendrimers and ON36 for an efficient green fluorescent protein (GFP) plasmid delivery in endothelial cells (HMEC-1) and cancer cells (MDA-MB-435) were first chosen. Then the efficacy of transfection was determined by testing angiostatin and TIMP-2 secretion by Western blot and the biologic effects were evaluated. Angiostatin gene transfer markedly reduced in vitro (i) HMEC-1 but not MDA-MB-435 proliferation; (ii) HMEC-1 and MDA-MB-435 wound healing reparation; and (iii) capillary tube formation. TIMP-2 gene transfer did not affect cell proliferation but strongly inhibited (i) wound healing of HMEC-1 and MDA-MB-435 cells; and (ii) capillary tube formation. Supernatants of transfected-MDA-MB-435 cells also inhibited the formation of angiogenic networks on Matrigel, indicating a paracrine effect. In vivo, intratumoral angiostatin or TIMP-2 gene delivery using dendrimers associated with ON36 effectively inhibited tumor growth by 71% and 84%, respectively. Combined gene transfer resulted in 96% inhibition of tumor growth. Tumor-associated vascularization was also greatly reduced. These findings provide a basis for the further development of nonviral delivery of genes to fight cancer.
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Affiliation(s)
- Loïc Vincent
- Laboratoire de Différenciation Hématopoïétique, Faculté de Médecine et Pharmacie, Rouen, France
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19
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Cáceres W, González S. Angiogenesis and cancer: recent advances. P R Health Sci J 2003; 22:149-51. [PMID: 12866139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Recent studies have shown the possibility to treat cancer with drugs that affect the formation of new blood vessels instead of attacking directly the malignant cell. This relatively new field in the area of oncology on angiogenesis inhibition has expanded the therapeutic option for malignant diseases. We will discuss several antiangiogenesis drugs in clinical development and their mechanism of action. Some of these drugs include: angiostatin, metalloproteinase inhibitors, thalidomide, tamoxifen, interferons and others. The use of antiangiogenic agents, both in combination with other treatment modalities in the acute setting as well as long-term maintenance or prevention of cancer, is at present one of the better promises in the war against cancer.
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Affiliation(s)
- William Cáceres
- San Juan Veterans Affairs Medical Center, 10 Calle Casia, San Juan, Puerto Rico 00921.
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21
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Abstract
The institution of combined modality therapy for unresected solid tumors has resulted in significant improvements in tumor control and survival benefit compared with radiotherapy (RT) alone. A number of chemotherapy agents that can enhance the effectiveness of RT, such as cisplatin and 5-fluorouracil, are now considered standard treatment for patients with a number of cancer types. There is growing interest in a number of additional agents that have also been found to have radiosensitizing ability. These include paclitaxel, docetaxel, irinotecan, gemcitabine, and vinorelbine, as well as biologic agents. Other agents may be of value because they act to counter dose-limiting toxicities associated with RT. This article provides an update of some important, recently completed and ongoing clinical trials evaluating novel chemoradiation protocols, with examples taken primarily from studies conducted by the Radiation Therapy Oncology Group (RTOG). Theoretical approaches to the development of new agents and combined modality regimens are also discussed.
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Affiliation(s)
- Walter J Curran
- Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pa. 19107-5097, USA.
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Abstract
PURPOSE OF REVIEW Growth, invasion and metastasis of malignant tumors depend on angiogenesis, which is therefore considered an attractive therapeutic target and indicator of clinical outcome. Summarizing the results of very recent studies, we discuss the clinical relevance of vascularization of breast and gynecological tumors. RECENT FINDINGS The prognostic values of directly assessed vascularity (microvessel density) and angiogenic factors have been confirmed for these malignancies, despite few contradictory results that may be due to methodological inaccuracy. In addition, many studies point to a role of angiogenesis as a predictor of response to both antiangiogenic and conventional chemotherapy or radiotherapy. For a conclusive evaluation, however, further studies covering all clinically relevant subgroups of patients are needed. Novel therapeutic approaches with inhibitors of angiogenesis are promising, although the adaptation of most experimentally proven approaches to clinical practice appears to be a laborious process. Furthermore, for an appropriate clinical evaluation of these drugs, newly defined endpoints of treatment and new monitoring systems reflecting their mode of action and the anticipated biological effects are required. SUMMARY The prognostic and predictive value of angiogenic factors and microvessel density has been confirmed. Antiangiogenic therapy will most likely play an important role in future clinical management of malignant diseases.
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Affiliation(s)
- Georg Sauer
- Department of Gynecology and Obstetrics, University of Ulm Medical School, Germany.
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Abstract
BACKGROUND As a result of the more effective treatment of primary tumours, the incidence of leptomeningeal metastases (LM) is increasing. Current treatment modalities have little effect on the survival of patients with LM. We investigated whether antiangiogenic treatment inhibits the progression of leptomeningeal tumours. MATERIALS AND METHODS To assess the role of angiogenesis in leptomeningeal tumours, we inoculated melanoma cells in the subarachnoid space in balb/c mice. At different stages, the mice were sacrificed and the microvessel density was determined. Human specimens of LM were compared with the mouse model. For the intervention studies, the mice were treated with the angiogenesis inhibitor angiostatin. Survival was the endpoint in these studies. RESULTS Tumour seeding in the early disease stages was concentrated around the pre-existent arachnoid vasculature. In the more advanced stages, the tumour masses covered larger areas of the leptomeninges. Arachnoidal microvessel density in this advanced stage was increased compared with control mice. Systemic treatment of the mice with LM with angiostatin (100 mg kg-1 day-1) resulted in prolonged survival compared with mice treated with vehicle and with approximately one-fifth of the long-term survivors of the angiostatin-treated group. CONCLUSIONS This study shows that neovascularization is important in the growth of LM in mice. Systemic targeting of the vascular compartment may be a useful approach in novel therapeutic strategies for patients with LM.
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Affiliation(s)
- J C Reijneveld
- Department of Neurology, University Medical Center, 3508 GA Utrecht, the Netherlands
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Benelli R, Morini M, Brigati C, Noonan DM, Albini A. Angiostatin inhibits extracellular HIV-Tat-induced inflammatory angiogenesis. Int J Oncol 2003; 22:87-91. [PMID: 12469189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
The HIV-Tat protein can be released extracellularly where it is able to recruit leukocytes and induce angiogenesis. These activities are mediated by the direct interaction of Tat with VEGFR2 on endothelial cells and chemokine receptors on leukocytes. We have recently shown that angiostatin, an anti-angiogenic peptide fragment of plasminogen, is able to inhibit the recruitment of neutrophils induced by bacterial fMLP and alpha chemokines both in vitro and in vivo. In vivo this was associated with an inhibition of the angiogenic response by angiostatin. These observations suggested that angiostatin could be a suitable inhibitor of Tat-induced angiogenesis, as it acts on both endothelial and neutrophil at the same time. In vitro, chemotaxis assays demonstrated that angiostatin inhibited Tat-induced chemotaxis of neutrophils with an inverse bell shaped profile. In vivo the injection of matrigel plugs containing Tat or its chemokine-like peptide (CysL24-51) caused the infiltration of neutrophils and a strong angiogenic response. Angiostatin completely blocked this inflammatory response, inhibiting the recruitment of inflammatory and endothelial cells inside the implant. Taken together, these results indicate that angiostatin can act as an inhibitor of both endothelial and neutrophil recruitment. As these cell types are also the targets of extracellularly released Tat, angiostatin could be used to contrast Tat-associated vasculopathies.
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Affiliation(s)
- Roberto Benelli
- Molecular Biology Laboratory, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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Abstract
Angiogenesis is required for invasive tumor growth and metastasis and constitutes an important point in the control of cancer progression. Its inhibition may be a valuable new approach to cancer therapy. Avascular tumors are severely restricted in their growth potential because of the lack of a blood supply. For tumors to develop in size and metastatic potential they must make an "angiogenic switch" through perturbing the local balance of proangiogenic and antiangiogenic factors. Frequently, tumors overexpress proangiogenic factors, such as vascular endothelial growth factor, allowing them to make this angiogenic switch. Two strategies used in the development of antiangiogenic agents involve the inhibition of proangiogenic factors (eg, anti-vascular endothelial growth factor monoclonal antibodies) as well as therapy with endogenous inhibitors of angiogenesis, such as endostatin and angiostatin. Therapy with endogenous angiogenic inhibitors such as endostatin and angiostatin may reverse the angiogenic switch preventing growth of tumor vasculature. Preclinical studies have shown that endostatin effectively inhibits tumor growth and shrinks existing tumor blood vessels. Phase 1 clinical trials of endostatin and angiostatin are ongoing, and preliminary results show minimal toxicities.
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Affiliation(s)
- Judah Folkman
- Departments of Surgery and Cell Biology, Harvard Medical School, Boston, MA, USA
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Li M, Huang X, Zhu Z, Zhao Q, Wong M, Gorelik E. The therapeutic efficacy of angiostatin against weakly- and highly-immunogenic 3LL tumors. In Vivo 2002; 16:577-82. [PMID: 12494903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Antiagiogenesis represents a promising approach to cancer therapy. We have previously demonstrated that the antitumor effects of endostatin, one of the most potent angiostatic agents, could be enhanced when combined with immunotherapy. Our current study evaluated whether anti-tumor immune response could also potentiate the therapuetic efficacy of another antiangiogenic drug, angiostatin. METHODS AND RESULTS Using Matrigel assay, we showed that our preparation of recombinant angiostatin possessed potent anti-angiogenic activity in vivo. The antitumor effects of recombinant angiostatin were tested against weakly-immunogenic 3LL Lewis lung carcinoma versus its highly immunogenic variant 3LL-C75. We showed that angiostatin inhibited the growth of 3LL-C75 more potently than that of 3LL tumor, suggesting that the host's immune response potentiates the antitumor effects of angiostatin. This conclusion was further supported by the finding that the antitumor activity of angiostatin against 3LL-C75 tumor was lower in immunodeficient nude mice in comparison with immunocompetent mice. Immunization of C57BL/6 mice with 3LL-C75 cells stimulated the antitumor immunity and inhibited the growth of parental 3LL tumor. Angiostatin treatment of immunized mice further enhanced the antitumor effect of tumor vaccination. CONCLUSION Antitumor immune response could complement the therapeutic efficacy of angiostatin.
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Affiliation(s)
- Mengfeng Li
- Department of Pathology, University of Pittsburgh, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15123, USA
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Abstract
Endometriosis, the growth of ectopic endometrial tissue, is a chronic recurrent disease affecting 10% of the female population causing dyspareunia, pelvic pain, dysmenorrhea, and infertility. Suppression of ovarian activity is the cornerstone of medical therapy with limited benefit and severe adverse effects. Angiogenesis plays a major role in the development of endometriosis suggesting that anti-angiogenic therapy would offer a new therapeutic approach. We report successful treatment of endometriosis in estrogen-supplemented ovariectomized mice by transient overexpression (6 to 10 days of duration) of the gene for a natural angiogenesis inhibitor angiostatin, delivered to the peritoneum by a replication-deficient adenovirus vector (AdAngiostatin). Established endometriosis was eradicated in 14 of 14 AdAngiostatin-treated animals, whereas 11 of 13 control animals showed full disease development. Administered to normal cycling mice for the same transient period, AdAngiostatin caused impaired ovarian function with suppressed corpus luteum development, decreased production of estradiol and progesterone, decreased ovarian and uterine weight, and increased body weight. AdAngiostatin treatment lowered the levels of sex steroids but did not induce total castration. Gene therapy with angiogenic inhibitors is a highly effective treatment for endometriosis, even in a host with preserved estrogen levels. However, local or targeted delivery of the gene must be considered to avoid prolonged systemic effects and impaired ovarian function.
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Affiliation(s)
- Charlotta Dabrosin
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Ambati BK, Joussen AM, Ambati J, Moromizato Y, Guha C, Javaherian K, Gillies S, O'Reilly MS, Adamis AP. Angiostatin inhibits and regresses corneal neovascularization. Arch Ophthalmol 2002; 120:1063-8. [PMID: 12149060 DOI: 10.1001/archopht.120.8.1063] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To determine the ability of angiostatin and the angiostatin-producing low-metastatic (LM) clone of Lewis lung carcinoma (LLC) to inhibit and regress corneal neovascularization, as compared with the non-angiostatin-producing high-metastatic (HM) clone. METHODS Three groups of C57BL6/J mice underwent chemical and mechanical denudation of corneal and limbal epithelium. One group remained tumor free while the other 2 were implanted with LLC cells (either the HM or LM clones) subcutaneously the day before, 2 weeks after, or 4 weeks after denudation. Corneas were harvested 2 weeks after tumor implantation (at 2, 4, and 6 weeks after denudation for tumor-free mice). Neovascularization was quantified by CD31 immunostaining. In a second experiment, recombinant angiostatin was delivered continuously for 2 weeks via an osmotic pump in mice with established corneal neovascularization. RESULTS The mean percentages of neovascularized corneal area in mice 2 weeks after LM-LLC implantation were 4.6%, 3.7%, and 37.0%, at 2, 4, and 6 weeks after scraping, respectively. In contrast, in the mice implanted with HM-LLC, the corresponding values were 45.4% (P =.01), 90.1% (P =.03), and 80.3% (P =.005). For tumor-free mice, the corresponding values were 62.0% (P =.003), 68.9% (P =.03), and 59.3% (P =.06). Mice implanted with angiostatin pumps had a 37.7% neovascularized corneal area 2 weeks after implantation and 4 weeks after scraping while mice implanted with sham pumps had 60.5% (P =.007). CONCLUSION Angiostatin inhibits and regresses corneal neovascularization induced by mechanical and alkali corneal injury. CLINICAL RELEVANCE This appears to be the first evidence of biologically induced regression of corneal neovascularization, and the first direct demonstration of angiostatin-induced regression of neovascularization in any tissue.
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Affiliation(s)
- Balamurali K Ambati
- Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, MA 02114, USA
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Murota SI. [Opening to the age of regenerative medicine--the mechanism of angiogenesis]. Kokubyo Gakkai Zasshi 2002; 69:81-8. [PMID: 12136664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- Sei-itsu Murota
- Department of Maxillofacial Biology, Division of Maxillofacial/Neck Reconstruction, Graduate School, Tokyo Medical and Dental University
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Watts P, Suresh P, Mezer E, Ells A, Albisetti M, Bajzar L, Marzinotto V, Andrew M, Massicotle P, Rootman D. Effective treatment of ligneous conjunctivitis with topical plasminogen. Am J Ophthalmol 2002; 133:451-5. [PMID: 11931777 DOI: 10.1016/s0002-9394(01)01433-7] [Citation(s) in RCA: 60] [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: 11/28/2022]
Abstract
PURPOSE The etiology of ligneous conjunctivitis is now known to be due to an underlying type 1 plasminogen deficiency. We hereby report the clinical features of three cases and their response to topically administered plasminogen. DESIGN Observational case series. METHODS Two Caucasian females aged 5 years and an 18-month male of north African descent presented with a membranous conjunctivitis, which recurred after surgical excision. Case 1 presented before the association with plasminogen deficiency was known with a bilateral chronic membranous mucopurulent conjunctivitis from the age of 14 months associated with bronchiolitis and gingival hyperplasia. A diagnosis of ligneous conjunctivitis was entertained and a number of drops were instituted. At the age of 4 years plasminogen levels were ordered. Case 2 presented at the age of 4 years with a unilateral chronic membranous conjunctivitis. Plasminogen levels were requested as soon as a diagnosis of ligneous conjunctivitis was suspected. Case 3 was born with congenital hydrocephalus. Conjunctivitis was treated with antibiotics from the age of 1 month. He presented to the eye clinic at the age of 5 months when a clinical diagnosis of ligneous conjunctivitis was entertained and treated with a number of medications. Plasminogen levels were available at 9 months of age. RESULTS The two female patients returned plasminogen levels of 0.25 U/ml and 0.3 U/ml, well below the normal level of 0.7-1.0 U/ml. Functional plasminogen levels in the male infant were not recordable with plasminogen antigen levels of 0.125 U/ml (normal range, 0.52-1.82). All cases have responded well to excision of the membranes and institution of topical plasminogen drops. There has been no recurrence with more than 12 months' follow-up. CONCLUSIONS With the knowledge of the etiology of ligneous conjunctivitis, efforts are underway to identify the best method of delivery of plasminogen. Topical plasminogen concentrate from fresh frozen plasma holds promise as the definitive treatment for this chronic membranous conjunctivitis
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Affiliation(s)
- Patrick Watts
- Department of Ophthalmology, The Hospital for Sick Children and Toronto Western Hospital, Toronto, Ontario, Canada
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31
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van Dam FSAM, Renckens CNM. [Information about cancer treatment and the media]. Ned Tijdschr Geneeskd 2002; 146:524-5. [PMID: 11925804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
A 'hopeful' development in cancer treatment (angiostatin) was reported in the Dutch press, which led to considerable disquiet amongst patients. There were no scientific articles that warranted this press publication. It has previously been stated that it is unethical for medical researchers to inform the press about treatments which have not been scrutinized by the medical community. The press on the other hand, should maintain a more responsible attitude toward medical claims and double-check medical information, even when it comes from renowned medical researchers. The main distinction between mainstream medicine and medical quackery is that the former is based on the results of controlled published research. When physicians propagate results in the popular press that have not been critically evaluated by the medical community, the distinction between quackery and mainstream medicine is undermined.
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Abstract
Ovarian cancer claims the lives of more women in North America each year than all other gynecologic malignancies combined. Despite the high initial response rates of patients with advanced ovarian cancer to aggressive primary surgical debulking followed by combination chemotherapy, the majority of patients will ultimately develop disease recurrence. The high risk of relapse and nearly guaranteed incurability after relapse is due to genetic instability and a high mutation rate of neoplastic cells that together allow for a high risk of selection for drug resistance. Given the seemingly insurmountable obstacle that acquired drug resistance presents in a setting of minimal, often undetectable, residual tumor burden in women with ovarian cancer, antiangiogenic-targeted therapies offer an attractive strategy for enhanced long-term disease-free survival. The past decade has witnessed a substantial proliferation in our knowledge regarding tumor angiogenesis, which has spurred interest in antiangiogenesis drug development. Current clinical trials are evaluating these agents in a variety of solid tumors, including ovarian cancer. Preliminary work has provided hope that the addition of antiangiogenic therapies may be incorporated into the treatment of women afflicted with ovarian cancer and may translate into enhanced survival.
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Affiliation(s)
- Pamela J Paley
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Box 356460, Seattle, WA 98195, USA.
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Margetts PJ, Gyorffy S, Kolb M, Yu L, Hoff CM, Holmes CJ, Gauldie J. Antiangiogenic and antifibrotic gene therapy in a chronic infusion model of peritoneal dialysis in rats. J Am Soc Nephrol 2002; 13:721-728. [PMID: 11856777 DOI: 10.1681/asn.v133721] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.0] [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: 11/03/2022] Open
Abstract
To identify the relative importance of peritoneal fibrosis and angiogenesis in peritoneal membrane dysfunction, adenoviral mediated gene transfer of angiostatin, a recognized angiogenesis inhibitor, and decorin, a transforming growth factor-beta-inhibiting proteoglycan, were used in a daily infusion model of peritoneal dialysis. A peritoneal catheter and subcutaneous port were inserted in rats. Five and fourteen d after insertion, adenovirus-expressing angiostatin, decorin, or AdDL70, a null control virus, were administered. Daily infusion of 4.25% Baxter Dianeal was initiated 7 d after catheter insertion and continued until day 35. Three initial doses of lipopolysaccharide were administered on days 8, 10, and 12 to promote an inflammatory response. Net ultrafiltration was used as a measure of membrane function, and peritoneum-associated vasculature and mesenteric collagen content was quantified. Ultrafiltration dysfunction, angiogenesis, and fibrosis were observed in daily infusion control animals. Animals treated with AdAngiostatin demonstrated an improvement in net ultrafiltration (-3.1 versus -7.8 ml for control animals; P = 0.0004) with a significant reduction in vessel density. AdDecorin-treated animals showed a reduction in mesenteric collagen content (1.8 versus 2.9 microg/mg; P = 0.04); however, AdDecorin treatment had no effect on net ultrafiltration. In a rodent model of peritoneal membrane failure, net ultrafiltration was significantly improved and peritoneal-associated blood vessels were significantly reduced by using adenovirus-mediated gene transfer of angiostatin. Decorin, a transforming growth factor-beta-inhibiting proteoglycan, reduced collagen content but did not affect net ultrafiltration. Improvement in the function of the peritoneum as a dialysis membrane after treatment with angiostatin has implications for treatment of peritoneal membrane dysfunction seen in patients on long-term dialysis.
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Affiliation(s)
- Peter J Margetts
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Steve Gyorffy
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Martin Kolb
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Lisa Yu
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Catherine M Hoff
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Clifford J Holmes
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
| | - Jack Gauldie
- *Centre for Gene Therapeutics, Department of Pathology and Molecular Medicine and Division of Nephrology, McMaster University, Hamilton, Canada; and Baxter Healthcare Renal Division Scientific Affairs, Baxter Healthcare Corporation, McGaw Park, Illinois
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Uthman I, Al-Kutoubi A, Sawaya J. Recurrent venous thrombosis in Behçet's disease: successful endovascular treatment with thrombolysis and stent. Clin Rheumatol 2002; 20:267-9. [PMID: 11529634 DOI: 10.1007/pl00011202] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report the case of a patient with Behçet's disease (BD) and recurrent venous thrombosis in the right subclavian vein, successfully treated with balloon dilatation and the insertion of a Wallstent. Subsequent follow up at 6 months showed no evidence of reocclusion. Endovascular stents should be considered as a possible interventional modality in BD patients with aneurysms or recurrent venous or arterial thrombosis.
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Affiliation(s)
- I Uthman
- Department of Internal Medicine, American University of Beirut, Lebanon.
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35
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36
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Ma HI, Lin SZ, Chiang YH, Li J, Chen SL, Tsao YP, Xiao X. Intratumoral gene therapy of malignant brain tumor in a rat model with angiostatin delivered by adeno-associated viral (AAV) vector. Gene Ther 2002; 9:2-11. [PMID: 11850717 DOI: 10.1038/sj.gt.3301616] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2001] [Accepted: 10/11/2001] [Indexed: 01/29/2023]
Abstract
We have utilized a recombinant adeno-associated viral (AAV) vector carrying the angiostatin gene as an anti-angiogenesis strategy to treat the malignant brain tumor in a C6 glioma/Wistar rat model. Angiostatin, as a potent angiogenesis inhibitor, shows high promises as an anti-cancer drug through the inhibition of tumor neovessel formation. However, sustained in vivo protein delivery is required to achieve the therapeutic effects. The AAV vector has been proven to be able to deliver sustained and high-level gene expression in vivo, and therefore, is well suited to such a purpose. In this study, we implanted 5 x 10(5) C6 glioma cells into the rat brain 7 days before gene therapy. Intratumoral injection of a high-titer AAV-angiostatin vector has rendered efficacious tumor suppression and resulted in long-term survival in 40% of the treated rats, whereas the control AAV-GFP vector did not have any therapeutic benefits. In addition, we have investigated the combined gene therapy of an adenoviral vector carrying the suicidal thymidine kinase gene along with the AAV-angiostatin vector. The combined therapy offered the best tumor-suppressive effects and increased long-term survival to 55% in the treated rats. Our study has demonstrated the potential of using AAV as a safe and effective vector for anti-angiogenic gene therapy of brain tumors.
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Affiliation(s)
- H-I Ma
- Department of Molecular Genetics and Biochemistry, University of Pittsburgh, Pittsburgh, PA 15213, USA
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37
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Hori T, Ido A, Tsubouchi H. [Tumor dormancy therapy for hepatocellular carcinoma]. Nihon Rinsho 2001; 59 Suppl 6:824-8. [PMID: 11762064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- T Hori
- Department of Internal Medicine II, Miyazaki Medical College
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38
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Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy that is now the sixth most common neoplasm in the world. Despite numerous advances in treatment, the long-term survival has remained the same for the last 25 years. Angiogenesis has been shown to be important for HNSCC tumour growth and metastasis. Therefore, inhibitors of angiogenesis are a new class of anti-neoplastic substances that might be a powerful complement to conventional therapy in HNSCC. MATERIAL AND METHODS The role of angiogenesis in HNSCC as well as preclinical and clinical trials concerning inhibitors of tumor-angiogenesis are discussed here. RESULTS Many of the investigated angiogenesis inhibitors demonstrated anti-tumor effects in preclinical and clinical trials. In a few cases, partial remission was observed. CONCLUSIONS Anti-angiogenic therapy will undoubtly have the potential to change standard tumor therapies. Some anti-angiogenic substances appear to be promising candidates for a clinical use in the therapy of HNSCC.
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Affiliation(s)
- F Riedel
- Universitäts-Hals-Nasen-Ohren-Klinik Mannheim, Klinikum, Mannheim.
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39
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Fan X, Guo X, Han B. [Vascular growth and non-small cell lung cancer]. Zhonghua Jie He He Hu Xi Za Zhi 2001; 24:499-502. [PMID: 11718044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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40
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Abstract
Tumor growth is an angiogenesis-dependent process and therapeutic strategies aimed at inhibiting angiogenesis are theoretically attractive. Angiostatin has been shown to potently inhibit endothelial proliferation in vitro and tumor growth in vivo. We now show that a shift in the balance of tumor angiogenesis by gene transfer of a cDNA coding for mouse angiostatin into mouse squamous cell carcinoma NRS-1 and SCC-VII cells suppresses tumor growth in vivo. The inhibition of an angiostatin-transfected tumor was accompanied by a marked reduction in vascularity and the presence of many apoptotic tumor cells. However, transfected-angiostatin cDNA does not affect the expression of the vascular endothelial growth factor (VEGF) and VEGF-R2 in the vascular endothelium. The inhibition mechanisms of neovascularization may be mediated independent of VEGF:VEGF-R2 complex. Our data may provide a useful approach for human oral cancer therapy by gene therapy with angiostatin.
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MESH Headings
- Angiostatins
- Animals
- Apoptosis/physiology
- Blotting, Northern/methods
- Blotting, Western/methods
- Carcinoma, Squamous Cell/blood supply
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/therapy
- DNA, Complementary
- Endothelial Growth Factors/metabolism
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Female
- Gene Transfer Techniques
- Genetic Therapy/methods
- Lymphokines/metabolism
- Mice
- Mice, Inbred C3H
- Peptide Fragments/genetics
- Peptide Fragments/therapeutic use
- Plasminogen/genetics
- Plasminogen/therapeutic use
- Platelet Endothelial Cell Adhesion Molecule-1/metabolism
- Polymerase Chain Reaction/methods
- Receptor Protein-Tyrosine Kinases/metabolism
- Receptors, Growth Factor/metabolism
- Receptors, Vascular Endothelial Growth Factor
- Tumor Cells, Cultured
- Vascular Endothelial Growth Factor A
- Vascular Endothelial Growth Factors
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Affiliation(s)
- G Matsumoto
- First Department of Oral Surgery, Kanagawa Dental College, 82 Inaoka, Yokosuka, Kanagawa 238-8580, Japan.
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41
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Ono M, Kuwano M. [Tumor angiogenesis and tumor angiogenesis inhibitors]. Gan To Kagaku Ryoho 2001; 28:584-90. [PMID: 11383205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
It is important to survey the molecular targets which are involved in tumor angiogenesis for the development of antiangiogenic agents as one of the cancer therapy. This article is meant to review the recent molecular targets of tumor angiogenesis and the molecular mechanism of antiangiogenic agents in human clinical trials.
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Affiliation(s)
- M Ono
- Dept. of Medical Biochemistry, Graduate School of Medical Sciences, Kyushu University
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42
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Meneses PI, Hajjar KA, Berns KI, Duvoisin RM. Recombinant angiostatin prevents retinal neovascularization in a murine proliferative retinopathy model. Gene Ther 2001; 8:646-8. [PMID: 11320411 DOI: 10.1038/sj.gt.3301423] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [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: 09/30/2000] [Accepted: 12/20/2000] [Indexed: 11/08/2022]
Abstract
Retinal neovascularization is central to the pathogenesis of proliferative diabetic retinopathy, the leading cause of blindness among the middle-aged population. Angiostatin, a proteolytic fragment of plasminogen is one of the most promising inhibitors of angiogenesis currently in clinical trials. Here we show that recombinant angiostatin can inhibit retinal neovascularization in a mouse model of proliferative retinopathy. Because proliferative diabetic retinopathy is a recurrent disease, effective therapy will need to be sustained. Recombinant adeno-associated viruses permit long-term expression of transfected genes; however, they can only accommodate a small insert sequence. Thus, we engineered and tested a shortened recombinant angiostatin derivative containing a signal sequence to permit secretion. Recombinant protein was purified from the medium of transfected HEK293 cells and injected subcutaneously into treated animals. The retinal vasculature was analyzed in retinal flat mounts and using immunohistochemically stained sections. Both methods demonstrate that this short, secreted form of angiostatin is effective in reducing the development of blood vessels in a nontumor environment and has therapeutic potential for neovascular retinopathies such as diabetic retinopathy, retinopathy of prematurity, retinal vein occlusion and, possibly, age-related macular degeneration.
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Affiliation(s)
- P I Meneses
- Department of Microbiology, Weill Medical College of Cornell University, New York, NY, USA
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Abstract
The study of angiogenesis, and the promise of angiogenesis inhibition as a means of cancer therapy, has dramatically accelerated in the last several years. The discovery and publication of angiostatin by O'Reilly and colleagues in Judah Folkman's lab in 1994 has greatly contributed to this progress. Angiostatin is a kringle-containing fragment of plasminogen, which is a potent inhibitor of angiogenesis in vivo, and selectively inhibits endothelial cell proliferation and migration in vitro. There have been a number of proposed proteolytic mechanisms by which plasminogen is cleaved to form angiostatin, and the resulting cleavage products contain different NH2 and COOH termini of the angiostatin. Therefore, it is possible that there are more than one angiostatin isoforms (or angiostatin-related proteins) which occur in one or more normal or pathophysiological situations. It is also possible that some of the proteolytic processes which can convert plasminogen to angiostatin-like proteins are simply laboratory artifacts. Angiostatin-related proteins exert potent endothelial cell inhibitory activity, including the induction of apoptosis, and inhibition of migration, and the intact kringle structures are believed to be necessary for the antiangiogenic activity. Efforts are now underway to translate the understanding of the biology of angiostatin to clinical practice, which includes phase 1 clinical trials with recombinant angiostatin K1-3 (kringles 1-3) as well as phase 1 trials of an Angiostatin Cocktail, which induces the direct in vivo conversion of plasminogen to angiostatin 4.5 (kringles 1-4, plus most of kringle 5). The translation of the basic science of angiostatin and angiostatin-related proteins to clinical trial promises to provide an important new tool in the treatment of cancer by inhibition of angiogenesis.
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Affiliation(s)
- G A Soff
- Division of Hematology/Oncology, Robert Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, IL 60611, USA.
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44
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Abstract
Considerable progress has been made in the understanding of the molecular structure and mechanistic aspects of Angiostatin and Endostatin, endogenous angiogenesis inhibitors that have been shown to regress tumors in murine models. The growing body of literature surrounding these molecules and on the efficacy of these proteins is in part due to the ability to generate these proteins in recombinant systems as well characterized molecules. Recombinant human Angiostatin and Endostatin are in Phase I trials, following the manufacture of clinical grade material at large scale. This review highlights the recent advances made on understanding the structure and function of Angiostatin and Endostatin.
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Affiliation(s)
- B K Sim
- EntreMed Inc, Rockville, MD 20850, USA
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45
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Abstract
The DNA sequence coding for plasminogen kringle 5 (pK5), an inhibitor of angiogenesis, was fused with that coding for interferon gamma and over-produced in the form of inactive inclusion bodies in E. coli. The amount of fusion protein was about 40% of total protein produced. The fusion protein contained in the inclusion bodies was solubilized in 8 M urea and purified by anion-exchange chromatography. We employed the orthogonal experimental design L16(4(5)) (5 factors, 4 levels, 16 experiments) procedure for researching the influence of denaturant, aggregation suppressor L-arginine, NaCl, pH, and glycine on the refolding procedure. Our results suggest that the presence of appropriate L-arginine, NaCl, and denaturant in the refolding buffer inhibits the aggregation of the fusion protein and increases the yield of renatured protein with biological activity. The refolded fusion protein, gammaIFN/pk5, has in vitro anti-endothelial cell proliferation activity.
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Affiliation(s)
- H Lu
- Institute of Genetics, School of Life Sciences, Fudan University of Shanghai, People's Republic of China.
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46
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Scappaticci FA, Smith R, Pathak A, Schloss D, Lum B, Cao Y, Johnson F, Engleman EG, Nolan GP. Combination angiostatin and endostatin gene transfer induces synergistic antiangiogenic activity in vitro and antitumor efficacy in leukemia and solid tumors in mice. Mol Ther 2001; 3:186-96. [PMID: 11237675 DOI: 10.1006/mthe.2000.0243] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [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] [Indexed: 12/24/2022] Open
Abstract
Angiostatin and endostatin are potent endothelial cell growth inhibitors that have been shown to inhibit angiogenesis in vivo and tumor growth in mice. However, tumor shrinkage requires chronic delivery of large doses of these proteins. Here we report synergistic antitumor activity and survival of animals when these factors are delivered in combination to tumors by retroviral gene transfer. We have demonstrated this efficacy in both murine leukemia and melanoma models. Complete loss of tumorigenicity was seen in 40% of the animals receiving tumors transduced by the combination of angiostatin and endostatin in the leukemia model. The synergy was also demonstrated in vitro on human umbilical vein endothelial cell differentiation and this antiangiogenic activity may suggest a mechanism for the antitumor activity in vivo. These findings imply separate pathways by which angiostatin and endostatin mediate their antiangiogenic effects. Together, these data suggest that a combination of antiangiogenic factors delivered by retroviral gene transfer may produce synergistic antitumor effects in both leukemia and solid tumors, thus avoiding long-term administration of recombinant proteins. The data also suggest that novel combinations of antiangiogenic factors delivered into tumors require further investigation as therapeutic modalities.
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Affiliation(s)
- F A Scappaticci
- Department of Pathology, Stanford University Medical Center, Stanford, California 94305, USA
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47
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Abstract
The formation of new blood vessels (angiogenesis) is crucial for the growth and persistence of primary solid tumors and their metastases. Furthermore, angiogenesis is also required for metastatic dissemination, since an increase in vascular density will allow easier access of tumor cells to the circulation. Induction of angiogenesis precedes the formation of malignant tumors, and increased vascularization seems to correlate with the invasive properties of tumors and thus with the malignant tumor phenotype. In the last few years, the discovery and characterization of tumor-derived angiogenesis modulators greatly contributed to our understanding of how tumors regulate angiogenesis. However, although angiogenesis appears to be a rate-limiting event in tumor growth and metastatic dissemination, a direct connection between the induction of angiogenesis and the progression to tumor malignancy is less well understood. In this review, we discuss the most recent observations concerning the modulation of angiogenesis and their implications in tumor progression, as well as their potential impact on cancer therapy.
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Affiliation(s)
- U Cavallaro
- Research Institute of Molecular Pathology, Vienna, Austria
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48
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Abstract
Preterm infants with respiratory distress syndrome develop fibrin-rich hyaline membranes within the alveoli and have depressed fibrinolytic activity, which is thought to be due to a relative deficiency of plasminogen. Local fibrin deposition inhibits surfactant function and amplifies inflammation. We hypothesized that plasminogen administration to surfactant-treated preterm lambs would prevent fibrin-rich hyaline membrane formation, resulting in the amelioration of lung pathology and improved lung function. We randomly treated preterm lambs (gestational age 127-129 days) with either 16 mg of lysine-plasminogen (n = 10) or saline (n = 10), and ventilated them for 5 h. There were no significant differences in physiologic measurements of lung function (ventilation efficiency index, oxygenation index, dynamic compliance, quasi-static pressure volume curve), measures of lung injury (alveolar wash protein content and (125)I-albumin recovery) or surfactant pool size. The degree and extent of bronchiolar erosion and hyaline membrane formation were similar in the two groups. Plasminogen administration did not improve lung function or prevent hyaline membrane formation in surfactant-treated lambs.
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Affiliation(s)
- V Bhat
- Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA
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49
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Abstract
The use of angiogenesis inhibitors may offer novel strategies in brain tumor therapy. In contrast to traditional cancer treatments that attack tumor cells directly, angiogenesis inhibitors target at the formation of tumor-feeding blood vessels that provide continuous supply of nutrients and oxygen. With respect to brain tumor therapy, inhibitors of angiogenesis display unique features that are unknown to conventional chemotherapeutic agents. The most important features are independence of the blood-brain barrier, cell type specificity, and reduced resistance. Malignant brain tumors, especially malignant gliomas, are among the most vascularized tumors known. Despite multimodal therapeutic approaches, the prognosis remains dismal. Thus, angiogenesis inhibitors may be highly effective drugs against these tumors. In a clinical setting, they could be applied in the treatment of multiple tumors or postsurgically as an adjuvant therapy to prevent recurrence. This article provides an overview of current anti-angiogenic treatment strategies with emphasis on substances already in clinical trials or candidate substances for clinical trials. The cellular and molecular basis of these substances is reviewed.
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MESH Headings
- Angiogenesis Inhibitors/therapeutic use
- Angiopoietin-1
- Angiopoietin-2
- Angiostatins
- Brain Neoplasms/blood supply
- Brain Neoplasms/drug therapy
- Brain Neoplasms/surgery
- Chemotherapy, Adjuvant
- Clinical Trials as Topic
- Collagen/chemistry
- Collagen/therapeutic use
- Combined Modality Therapy
- Cyclohexanes
- Endostatins
- Endothelial Growth Factors/antagonists & inhibitors
- Endothelial Growth Factors/physiology
- Fatty Acids, Unsaturated/therapeutic use
- Glioma/blood supply
- Glioma/drug therapy
- Glioma/surgery
- Humans
- Integrins/antagonists & inhibitors
- Integrins/physiology
- Lymphokines/antagonists & inhibitors
- Lymphokines/physiology
- Matrix Metalloproteinase 2/chemistry
- Matrix Metalloproteinase Inhibitors
- Matrix Metalloproteinases/physiology
- Membrane Glycoproteins/antagonists & inhibitors
- Membrane Glycoproteins/physiology
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/physiology
- Neovascularization, Pathologic/drug therapy
- Peptide Fragments/therapeutic use
- Plasminogen/therapeutic use
- Proteins/antagonists & inhibitors
- Proteins/physiology
- Receptor Protein-Tyrosine Kinases/antagonists & inhibitors
- Receptor Protein-Tyrosine Kinases/physiology
- Receptor, TIE-2
- Receptors, Cell Surface/antagonists & inhibitors
- Receptors, Cell Surface/physiology
- Receptors, Growth Factor/antagonists & inhibitors
- Receptors, Growth Factor/physiology
- Receptors, TIE
- Receptors, Vascular Endothelial Growth Factor
- Sesquiterpenes
- Suramin/therapeutic use
- Thalidomide/therapeutic use
- Thrombospondins/therapeutic use
- Vascular Endothelial Growth Factor A
- Vascular Endothelial Growth Factors
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Affiliation(s)
- M Kirsch
- Klinik und Poliklinik für Neurochirurgie, Technische Universität Dresden, Germany.
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50
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Abstract
The poor prognosis of patients with malignant brain tumors in spite of aggressive multimodality therapy has led to the search for novel therapeutic strategies. Among the targets for such treatment approaches, tumor angiogenesis has captured the attention of not only the medical field but also of the lay public because of its conceptual departure from traditional methods of cancer therapy. Angiogenesis and vascular proliferation are particularly important in the growth and progression of malignant gliomas and are used as indicators of the degree of malignancy. Recent studies have helped us gain a better understanding of the molecular mediators of this process. It is now evident that after the initial formation of malignancy the continued growth of a glioma is critically dependent on its angiogenic potential. Hence, several approaches to control angiogenesis are being developed and tested. In the present review, we examine some of these approaches from a therapeutic perspective and summarize the findings from early human trials of such agents.
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Affiliation(s)
- V K Puduvalli
- Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
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