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Uncommon Cause of ST Elevation
Gard, Joseph J., Bader, Wajdi, Enriquez‐Sarano, Maurice , Frye, Robert L. , Michelena, Héctor I. , Enriquez-Sarano, Maurice

Circulation | March 8, 2011 | Volume: 123 | Issue: 9 | Pages: No page available

10.1161/circulationaha.110.002477 | PMID 21382898 Get It

Persistent kidney dysfunction in swine renal artery stenosis correlates with outer cortical microvascular remodeling
Eirin, Alfonso , Zhu, Xiang-Yang, Urbieta-Caceres, Victor H., Grande, Joseph P. , Textor, Stephen C., Lerman, Lilach O. , Lerman, Amir , Eirin, Alfonso

American Journal of Physiology-Renal Physiology | March 3, 2011 | Volume: 300 | Issue: 6 | Pages: F1394-F1401

10.1152/ajprenal.00697.2010 | PMID 21367913 Get It

Percutaneous transluminal renal stenting (PTRS) does not consistently improve renal function in patients with atherosclerotic renovascular disease, but the mechanisms underlying irreversible kidney injury have not been fully elucidated. We hypothesized that renal dysfunction after PTRS is linked to ongoing renal microvascular (MV) remodeling. Pigs were studied after 10 wk of atherosclerosis and renal artery stenosis (ARAS), ARAS treated with PTRS 4 wk earlier, and normal controls ( n = 10 each). Renal blood flow (RBF) and glomerular filtration rate (GFR) were studied using multidetector computer tomography. Renal microvascular architecture (micro-CT), angiogenic activity, oxidative stress, and fibrosis were evaluated ex vivo. Four weeks after PTRS, blood pressure was normalized. However, GFR and RBF remained similarly decreased in untreated ARAS and ARAS+PTRS ( P < 0.05 vs. normal). MV rarefaction was unaltered after revascularization, and the spatial density of outer cortical microvessels correlated with residual GFR. Interstitial fibrosis and altered expression of proangiogenic and profibrotic factors persisted after PTRS. Tubulointerstitial injury in ARAS persisted 4 wk after mechanically successful PTRS, and vessel loss correlated with residual renal dysfunction. MV loss and fibrosis in swine ARAS might account for persistent renal dysfunction after PTRS and underscore the need to assess renal parenchymal disease before revascularization.
n-3 Fatty acids block TNF-α-stimulated MCP-1 expression in rat mesangial cells
Encarnación, Montserrat M. Díaz , Warner, Gina M., Gray, Catherine , Nath, Karl A. , Grande, Joseph P. , Cheng, Jingfei

American Journal of Physiology-Renal Physiology | March 3, 2011 | Volume: 300 | Issue: 5 | Pages: F1142-F1151

10.1152/ajprenal.00064.2011 | PMID 21367920 Get It

Monocyte chemoattractant protein 1 (MCP-1) is a CC cytokine that fundamentally contributes to the pathogenesis of inflammatory renal disease. MCP-1 is highly expressed in cytokine-stimulated mesangial cells in vitro and following glomerular injury in vivo. Interventions to limit MCP-1 expression are commonly effective in assorted experimental models. Fish oil, an abundant source of n-3 fatty acids, has anti-inflammatory properties, the basis of which remains incompletely defined. We examined potential mechanisms whereby fish oil reduces MCP-1 expression and thereby suppresses inflammatory responses to tissue injury. Cultured mesangial cells were treated with TNF-α in the presence of the n-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA); equimolar concentrations of the n-6 fatty acids LA and OA served as controls. MCP-1 mRNA expression was assessed by Northern blotting, and transcriptional activity of the MCP-1 promoter was assessed by transient transfection. The involvement of the ERK and NF-κB pathways was evaluated through transfection analysis and the use of the MEK inhibitor U0126. DHA and EPA decreased TNF-α-stimulated MCP-1 mRNA expression by decreasing transcription of the MCP-1 gene. DHA and EPA decreased p-ERK expression and nuclear translocation of NF-κB, both of which are necessary for TNF-α-stimulated MCP-1 expression. Both NF-κB and AP-1 sites were involved in transcriptional regulation of the MCP-1 gene by DHA and EPA. We conclude that DHA and EPA inhibit TNF-α-stimulated transcription of the MCP-1 gene through interaction of signaling pathways involving ERK and NF-κB. We speculate that such effects may contribute to the salutary effect of fish oil in renal and vascular disease.
The Memory Club: Providing Support to Persons with Early-Stage Dementia and Their Care Partners
Gaugler, Joseph E. , Gallagher-Winker, Karen, Kehrberg, Kathy, Lunde, Angela , Marsolek, Connie M., Ringham, Kathryn, Thompson, Gerise, Barclay, Michelle, Gaugler, Joseph E

American Journal of Alzheimer's Disease & Other Dementias® | March 2, 2011 | Volume: 26 | Issue: 3 | Pages: 218-226

10.1177/1533317511399570 | PMID 21362755 Get It

There is a growing emphasis on delivering services for persons with early-stage dementia (ie, ‘‘persons with memory loss,’’ or PWMLs) and their family members (care partners). The goal of this evaluation was to determine whether participation in the Memory Club, a 10- to 13-session joint support group, would result in decreased distress, enhanced preparation for care, and improved feelings of confidence managing the challenges of early-stage dementia. The single group, pre-/post-test evaluation included 63 PWMLs and 61 care partners who participated in three Memory Club sites in Minnesota. Paired T-test results found that care partners reported significant (P < .05) increases in preparation activities, feelings of preparation, and confidence in managing memory loss. The results suggest that the Memory Club can fill an important gap in early-stage dementia care by offering care partners the opportunity to plan, prepare, and increase coping skills in the face of early dementia progression.
Abstract 1250: Inhibition of FAK and engagement of migration leads to similar changes in patterns of transcription factor activation in glioma cells
Tran, Nhan L. , Loftus, Joseph C. , Berens, Michael E. , Tran, Nhan L

Cancer Research | February 25, 2011 | Volume: 70 | Issue: 8_Supplement | Pages: 1250-1250

10.1158/1538-7445.am10-1250 Get It

Abstract Malignant dispersion of glioma cells is a nemesis to clinical management, provoking the need for a better understanding of the underlying molecular drivers of invasion. The changes in signal transduction and consequent alterations in activation/de-activation of Transcription Factors (TFs) in glioma cells were investigated coincident to migration-engagement or impaired FAK kinase function by small molecule inhibition (PF-562,271). Earlier work showed that FAK and Pyk2 affect proliferation and migration in reciprocal ways in glioma cells (Lipinski CA, et al 2008; Loftus JC, et al 2009). The interaction of FAK and Pyk2 with specific downstream signaling effectors and the resultant activation of disparate signaling pathways is likely to script a signaling “signature” that will reveal to what extent glioma cell malignant behaviors are dependent on these kinases. Inhibition of FAK leads to diminution of signaling by pSrc, pJnk, and pNFkB, and variable activation of pAkt, and pp38. Of the 20 TFs assayed (Marligen, Inc.), the activation state of 7 TFs showed significant and consistent patterns of change across 6 primary GBM cell strains following FAK inhibition. Across a panel of 6 human GBM xenograft lines SP1, p53, E2F1-5, and NFκB evidenced strong activation (heightened nuclear localization), while AR (androgen receptor), Myc-Max, and CREB activation levels dropped by more than 2-fold following PF-562,271 treatment. Separate studies of established glioma cell lines under conditions of sparse plating (migration) and of dense crowded plating (migration-constrained), showed that p53, E2F1-5, and NFκB were standouts for activation accompanying migration, also associated by strong reduced activation of AR, Myc-Max, and CREB. (Because glioma cells following FAK knockdown or FAK inhibition show reduced entry into cell cycle, the signaling linkage between FAK and Myc-Max activation and also between FAK signaling and CREB activation suggest mechanistic ties to phenotype. E2F1 is a transcription factor that regulates genes involved in cell proliferation and cell survival and has even been suggested to fit a paradigm of oncogene addiction in glioma cells. Our findings demonstrate phenotypic responses in glioma cells downstream of FAK signaling linked to the activation or inactivation of specific transcription factors. If these patterns of TF activation state, and the signaling pathways upstream of that activation, associate (or account for) patterns of glioma cell invasion or proliferation in situ, they will suggest points of vulnerability in the underlying pathological processes of this disease. Supported by NIH NS042262 (Berens) and NIH CA103956 (Loftus). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1250.
Abstract 5128: Identification of RhoGEFs within the TWEAK-R (Fn14)-Rac1 signaling pathway that mediate glioblastoma cell invasion
Ennis, Matthew, McDonough, Wendy S., Symons, Marc , Winkles, Jeffrey A. , Salhia, Bodour , Loftus, Joseph C. , Chan, Amanda Y. , Tran, Nhan L.

Cancer Research | February 25, 2011 | Volume: 70 | Issue: 8_Supplement | Pages: 5128-5128

10.1158/1538-7445.am10-5128 Get It

Abstract Glioblastoma multiforme (GBM) is the most malignant primary adult brain tumor. Despite efforts at surgical resection of the glioma mass, invasive cells are always left behind and the tumor will inevitably recur and kill the patient. As such, novel therapeutics targeting pro-invasive factors could improve neurological outcomes and survival for these patients. This requires a detailed understanding of the mechanisms driving glioma migration and invasion. We have been investigating whether the multifunctional cytokine tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and its receptor fibroblast growth factor-inducible 14 (Fn14) regulate glioma cell invasive activity. We have previously demonstrated that Fn14 expression was elevated in the invasive rim of GBM specimens and migrating glioma cells in vitro. The Fn14 signaling axis is known to drive glioma invasion via Rac1. We have previously reported that Ect2, a guanine nucleotide exchange factor (GEF) for Rho family GTPases, including Rac1 and Cdc42, is overexpressed in GBM, and that overexpression of Ect2 correlates directly with tumor grade and inversely with patient survival. In this study we show that Ect2 regulates Rac1 activation downstream of Fn14. Depletion of Ect2 by siRNA duplexes abrogates Fn14-induced Rac1 activation and subsequent glioma cell migration and invasion. We also found that Cdc42 activation by TWEAK is directly mediated by Ect2. Interestingly, depletion of Cdc42 expression impairs TWEAK-induced Rac1 activation and also results in a significant reduction of glioma cell migration and invasion. This suggests that Cdc42 is, in part, important for Rac1 activation downstream of the TWEAK-Fn14 signaling pathway and argues that another GEF(s) may be involved in the Fn14-Rac1 signaling axis. Recently, we have identified Trio as an additional GEF that activates Rac1 downstream of Cdc42. It is also known that Trio expression correlates directly with brain tumor grade and inversely with patient survival. siRNA-mediated depletion of Trio inhibits TWEAK-induced Rac1 activation but not TWEAK-induced Cdc42 activation. Therefore, delineating the mechanisms of Fn14-RhoGEF-RhoGTPase signaling pathway, may lead to identification of novel targets that can serve as possible points of therapeutic intervention. (Supported by NIH R01-CA130940) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5128.
Abstract 4549: Plasma pharmacokinetics and oral bioavailability of the 3,4,5,6-tetrahydrouridine (THU) prodrug, triacetyl-THU (taTHU), in mice
Eiseman, Julie L., Gilbert, Judith A, Holleran, Julianne L. , Yellow-Duke, Archibong E., Clausen, Dana M. , Ames, Matthew M. , Parise, Robert A. , Bai, Lihua, Covey, Joseph M. , Egorin, Merrill J., Beumer, Jan Hendrik , D’Argenio, David Z. , Hershberger, Pamela A.

Cancer Research | February 25, 2011 | Volume: 70 | Issue: 8_Supplement | Pages: 4549-4549

10.1158/1538-7445.am10-4549 Get It

Abstract Introduction Cytidine drugs, such as gemcitabine, undergo rapid, inactivating catabolism by cytidine deaminase (CD). 3,4,5,6-tetrahydrouridine (THU), a potent CD inhibitor, has been applied preclinically and clinically as a modulator of cytidine drug metabolism. However, p.o. THU is at most 20% bioavailable (Beumer et al.), which limits its preclinical evaluation and clinical use. Therefore, the more lipophilic prodrug triacetyl THU (taTHU) was developed. We characterized THU pharmacokinetics after administration of taTHU to mice. Methods Mice were dosed 150 mg/kg taTHU i.v. or p.o. Plasma and urine THU concentrations were quantitated with a validated LC-MS/MS assay. Plasma and urine pharmacokinetic parameters and p.o. bioavailability were calculated non-compartmentally and compartmentally. We assessed taTHU inhibition of metabolism of gemcitabine by recombinant CD. ResultsTHU parameterstaTHU i.v. 150 mg/kgtaTHU p.o. 150 mg/kgCmax (µg/mL)10611.8Tmax (min)560Half-life (min)235122AUC0-inf (mg/mL*min)7.553.36Vd/F (L/kg)4.495.26Cl/F (mL/min/kg)13.229.8F-THUi.v. (%)68.030.3% dose in 0-16 h urine405.6% dose in 0-24 h urine5512 THU, after 150 mg/kg taTHU i.v., had a 235 min terminal half-life and produced plasma THU concentrations &gt;1 µg/mL, the concentration shown to inhibit CD, for 10 h. A multi-compartment model fit the data best. 150 mg/kg p.o. taTHU produced a concentration versus time profile with a plateau of approximately 10 µg/mL from 0.5-2 h, followed by a decline with a 122 min half-life. Approximately 68% of i.v. taTHU was converted to THU. Approximately 30% of p.o. taTHU reached the systemic circulation as THU. After i.v dosing, renal excretion accounted for 40-55% of the taTHU dose, 26-35% as THU and an additional 14-19% as acetylated forms of THU. After p.o. dosing, the renal excretion percentages were 6-12%, 5.2-11%, and 0.42-0.71%, respectively. taTHU did not inhibit recombinant CD. Conclusion The availability of THU after p.o. taTHU in mice is 30%, as compared to the 20% achieved after p.o. THU. Clinical studies are warranted to evaluate availability of THU from taTHU in humans. Support: N01-CM07106, N01-CM52202, P30-CA47904 from the NCI and P41-EB001978. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4549.
Abstract 3748: Perfusion MRI estimation of glioma microvascular density to predict tumor recurrence and treatment response: Validation study through stereotactic tissue analysis
Hu, Leland , Eschbacher, Jennifer , Liu, Seban, Heiserman, Joseph E., Smith, Kris A. , Karis, John P. , Coons, Stephen W., Baxter, Leslie C. , Nakaji, Peter , Dueck, Amylou C. , Feuerstein, Burt G.

Cancer Research | February 25, 2011 | Volume: 70 | Issue: 8_Supplement | Pages: 3748-3748

10.1158/1538-7445.am10-3748 Get It

Abstract Purpose: This study uses spatially accurate image-guided tissue analysis to evaluate the correlation between Perfusion MRI (pMRI) and tissue microvascular density parameters as markers for tumor recurrence and treatment response in high-grade glioma (HGG). Methods: Following Institutional Review Board approval, we recruited previously treated (including chemo-radiation therapy) HGG patients undergoing surgical re-resection of new enhancing lesions on surveillance MRI. Preoperatively, we acquired pMRI and contrast-enhanced stereotactic T1-Weighted (T1W) MRI data sets. Intraoperatively, we recorded stereotactic locations of multiple biopsies based on T1W data sets that guided surgery. Following surgery, we coregistered pMRI and T1W data sets to calculate localized relative cerebral blood volume (rCBV) for each stereotactic specimen location. For each specimen, we performed 1) standard H&E staining to diagnose tumor recurrence or post-treatment radiation effect (PTRE); and 2) immunohistochemical analysis with CD34 to highlight tissue vessels. We analyzed CD-34 stained slides with Axiovision Automeasure 3.4 (Zeiss, Germany) to calculate both total microvessel number (MVN) and total microvessel area (MVA), each normalized to total slide specimen area (μm2). We calculated Pearson correlations to establish relationships between a) rCBV and MVN; and b) rCBV and MVA. We also performed t-test to compare MVN, MVA, and rCBV values between tumor and PTRE samples. A neuroradiologist performed all coregistration and pMRI calculations, and a neuropathologist analyzed all tissue specimens, without knowledge of corresponding data. A biostatistician performed all statistical comparisons. Results: In this preliminary study, we included 16 tissue specimens (from 8 subjects), each diagnosed as either tumor (n=7) or PTRE (n=9). We successfully calculated localized rCBV and determined both MVA and MVN for each specimen. The rCBV values showed highest correlation with total vessel area (MVA) (r=0.65, p=0.007) and slightly less correlation with vessel number (MVN) (r=0.52, p=0.04). Tumor showed significantly higher values than PTRE for all parameters: rCBV (1.87 + 0.82 versus 0.78 + 0.2, p=.002); MVA (0.22 + 0.03 versus 0.04 + 0.007, p=0.0001); and MVN (0.0068 + 0.001 versus. 0.0016 + 0.0006, p=0.0004). Conclusion: These preliminary results show the promise of Perfusion MRI to non-invasively estimate tissue microvessel density and distinguish tumor recurrence from treatment effects. The current study is ongoing to confirm results in a larger patient population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3748.
Driving and Neurologic Disorders
Drazkowski, Joseph F., Sirven, Joseph I

Neurology | February 15, 2011 | Volume: 76 | Issue: 7_supplement_2 | Pages: No page available

10.1212/wnl.0b013e31820c360c | PMID 21321351 Get It