Abstract Purpose: Clear cell ovarian carcinoma (CCOC) is an aggressive disease that often demonstrates resistance to standard chemotherapies. Approximately 25% of patients with CCOC show a strong APOBEC mutation signature. Here, we determine which APOBEC3 enzymes are expressed in CCOC, establish clinical correlates, and identify a new biomarker for detection and intervention. Experimental Designs: APOBEC3 expression was analyzed by IHC and qRT-PCR in a pilot set of CCOC specimens (n = 9 tumors). The IHC analysis of APOBEC3B was extended to a larger cohort to identify clinical correlates (n = 48). Dose-response experiments with platinum-based drugs in CCOC cell lines and carboplatin treatment of patient-derived xenografts (PDXs) were done to address mechanistic linkages. Results: One DNA deaminase, APOBEC3B, is overexpressed in a formidable subset of CCOC tumors and is low or absent in normal ovarian and fallopian tube epithelial tissues. High APOBEC3B expression associates with improved progression-free survival (P = 0.026) and moderately with overall survival (P = 0.057). Cell-based studies link APOBEC3B activity and subsequent uracil processing to sensitivity to cisplatin and carboplatin. PDX studies extend this mechanistic relationship to CCOC tissues. Conclusions: These studies demonstrate that APOBEC3B is overexpressed in a subset of CCOC and, contrary to initial expectations, associated with improved (not worse) clinical outcomes. A likely molecular explanation is that APOBEC3B-induced DNA damage sensitizes cells to additional genotoxic stress by cisplatin. Thus, APOBEC3B is a molecular determinant and a candidate predictive biomarker of the therapeutic response to platinum-based chemotherapy. These findings may have broader translational relevance, as APOBEC3B is overexpressed in many different cancer types.
Prevalence and Associations of Central-Peripheral Rivalry–Type Diplopia in Patients With Epiretinal Membrane
We executed a genome-wide association scan for age-related macular degeneration (AMD) in 2,157 cases and 1,150 controls. Our results validate AMD susceptibility loci near CFH ( P < 10 −75 ), ARMS2 ( P < 10 −59 ), C2/CFB ( P < 10 −20 ), C3 ( P < 10 −9 ), and CFI ( P < 10 −6 ). We compared our top findings with the Tufts/Massachusetts General Hospital genome-wide association study of advanced AMD (821 cases, 1,709 controls) and genotyped 30 promising markers in additional individuals (up to 7,749 cases and 4,625 controls). With these data, we identified a susceptibility locus near TIMP3 (overall P = 1.1 × 10 −11 ), a metalloproteinase involved in degradation of the extracellular matrix and previously implicated in early-onset maculopathy. In addition, our data revealed strong association signals with alleles at two loci ( LIPC , P = 1.3 × 10 −7 ; CETP , P = 7.4 × 10 −7 ) that were previously associated with high-density lipoprotein cholesterol (HDL-c) levels in blood. Consistent with the hypothesis that HDL metabolism is associated with AMD pathogenesis, we also observed association with AMD of HDL-c—associated alleles near LPL ( P = 3.0 × 10 −3 ) and ABCA1 ( P = 5.6 × 10 −4 ). Multilocus analysis including all susceptibility loci showed that 329 of 331 individuals (99%) with the highest-risk genotypes were cases, and 85% of these had advanced AMD. Our studies extend the catalog of AMD associated loci, help identify individuals at high risk of disease, and provide clues about underlying cellular pathways that should eventually lead to new therapies.
Contribution of Copy Number Variation in the Regulation of Complement Activation Locus to Development of Age-Related Macular Degeneration
ABSTRACT Purpose. A widely advocated approach to increasing spectacle magnification in minus lenses is to increase center thickness and reduce vertex distance. Conventionally, a steeper base curve is to be avoided because of the accompanying increased vertex distance in a minus lens and the reduction of spectacle magnification that results. This approach works when small amounts of spectacle magnification are needed. However, when large amounts are needed for high minus lenses with flat base curves, the conventional approach does not provide sufficient magnification. Facial features such as eyelash length limit the contribution of reducing vertex distance, and the flat base curves limit the efficacy of increasing center thickness. Steeper base curves are required to increase the optical “leverage” of increasing center thickness. Methods. Through use of an example, a steeper base curve is shown to increase the spectacle magnification of a high minus lens. The gain in spectacle magnification is preserved by maintaining a nearly constant vertex distance through bevel location. Results. In the example, changing the base curve of a −6.50‐D lens by +4.50 D while increasing the center thickness by 4.1 mm resulted in a +4.4% increase in spectacle magnification. The lens bevel was kept as close as possible to the front surface, allowing the increased center thickness to keep the back vertex at essentially a constant vertex distance in the presence of the steeper base curve. Without the steeper base curve, it was not possible to attain the needed spectacle magnification. Conclusions. When large amounts of spectacle magnification are needed for high minus lenses, both steeper base curves and increased center thicknesses are necessary. The reduction in spectacle magnification from increased vertex distance that is expected with steeper base curves can be neutralized by keeping the bevel close to the front surface on the thicker lens.