Citations

Diastolic dysfunction is characterized by the stiffening of the left-ventricular myocardium. An imaging technique capable of quantifying viscoelasticity of the left-ventricle would aid clinicians in evaluating diastolic function. Lamb wave dispersion ultrasound vibrometry (LDUV) is an ultrasound-based method for measuring viscoelasticity of plate-like materials by exciting Lamb waves and measuring change of wave velocity as a function of frequency (dispersion). Lamb wave dispersion equation is fit to the dispersion data to estimate mechanical properties. We report in vivo transthoracic studies aimed at quantifying elasticity and viscosity of a beating porcine left-ventricle using LDUV. A single ultrasound probe operating at 5 MHz was used for impulse excitation in the myocardium and to track the wave motion. A Fourier space-time analysis of the motion was used to obtain Lamb wave velocity dispersion. ECG-gated transthoracic in vivo measurements of group velocity, elasticity, and viscosity throughout a single heart cycle were obtained. Group velocity, elasticity, and viscosity in the frequency range from 50 to 500 Hz increased by at least two-fold from diastole to systole, consistent with contraction and relaxation of the myocardium.

Abstract Gain-of-function mutations of the receptor tyrosine kinase KIT play a key role in the pathogenesis of systemic mastocytosis (SM), gastrointestinal stromal tumors (GISTs), and some cases of acute myeloid leukemia (AML). Whereas KIT juxtamembrane domain mutations seen in most patients with GIST are highly sensitive to imatinib, the kinase activation loop mutant D816V, frequently encountered in SM, hampers the binding ability of imatinib. We investigated the inhibitory activity of the novel tyrosine kinase inhibitor EXEL-0862 against 2 subclones of human mast cell line-1 (HMC-1)—HMC-1.1, harboring the juxtamembrane domain mutation V560G, and HMC-1.2, carrying V560G and the activation loop mutation D816V, found in more than 80% of patients with SM. EXEL-0862 inhibited the phosphorylation of KIT in a dose-dependent manner and decreased cell proliferation in both mast cell lines with higher activity against HMC-1.2 cells. The phosphorylation of KIT-dependent signal transducer and activator of transcription-3 (STAT3) and STAT5 was abrogated upon exposure to nanomolar concentrations of EXEL-0862. In addition, EXEL-0862 induced a time- and dose-dependent proapoptotic effect in both mast cell lines and caused a significant reduction in mast-cell content in bone marrow samples from patients with SM harboring D816V and from those without the D816V mutation. We conclude that EXEL-0862 is active against KIT activation loop mutants and is a promising candidate for the treatment of patients with SM and other KIT-driven malignancies harboring active site mutations.