Citations

Abstract Metformin is the most widely used drug for type 2 diabetes. Metformin activates AMP-activated protein kinase (AMPK), which regulates cellular energy metabolism via its upstream kinase LKB1. Activation of AMPK has been shown extensively to cause growth arrest in multiple tumor types by inhibiting the TSC-mTOR (mammalian target of rapamycin) pathway as well as by inducing cell cycle arrest. Our data indicate that metformin exerts an anti-proliferative effect on several chemo-responsive and -resistant ovarian cancer cell lines (A2780, CP70, C200, OV202, OVCAR3 and SKVO3ip, PE01, PE04), which is accompanied by activation of AMPK and cell cycle arrest. Interestingly, we have also determined that metformin is able to inhibit proliferation of ovarian cancer cells when AMPK is silenced by siRNA, where both the expression and activation of AMPK is significantly reduced. Also, metformin was able to attenuate proliferation of AMPK (−/−) mefs, although to a lesser degree in AMPK (+/+) mefs. Additional results indicate that metformin activates p21 and inhibits cyclinD1 activities partially in AMPK (−/) mefs. These data suggest a novel mechanism of metformin action, namely, an AMPK independent pathway which can modulate proliferation and possibly cell cycle regulated events in ovarian cancer. Whether the AMPK independent effects of metformin require LKB1 activity is currently under investigation. Collectively, our preliminary observations indicate that metformin can modulate proliferation and cell cycle arrest in an AMPK independent manner. Citation Information: Cancer Res 2009;69(23 Suppl):C38.

Abstract The central importance of the ERBB/RAS signal transduction cascade has been well established in human cancer. As such, novel approaches to counteract activated ERBB/RAS signals constitute important measures to reverse tumorigenesis and metastasis in human cancers. Instead of targeting an upstream signaling module such as ERBB/RAS/MEK/MAPK/AKT/mTOR, we targeted the most downstream signaling module in the ERBB/RAS pathway called the SIAH-dependent proteolytic machinery. SIAHs are the human homologs of Seven-In-Absentia (SINA), an evolutionarily conserved RING E3 ligase, an essential downstream signaling module and a critical “gatekeeper” required for proper Drosophila RAS signal transduction. Guided by the insights and principles learned from Drosophila RAS signaling pathway, we conducted preclinical studies to examine SIAH function in the context of RAS-mediated tumorigenesis and metastasis in human cancer cells.We found that (1) SIAH is a novel biomarker for human cancer, i.e. it specifically decorates proliferating tumor cells (not stromal cells in the tumor microenvironment). SIAH expression is progressively and markedly upregulated as human cancer progresses to the advanced stages in human pancreatic, lung, breast and prostate cancers; and (2) inhibiting the proteolytic function of SIAH is highly effective to abolish tumorigenesis and metastasis in eight of the most aggressive human cancer cell lines known in the literature that include pancreatic cancer cells (MiaPaCa and Panc-1), lung cancer cells (A549), invasive breast cancer cells (MDA-MB-231, MDA-MB-468 and MDA-MB-435) and hormonal-refractory prostate cancer cells (PC-3 and DU-145) in soft agar as well as in athymic nude mice. These findings suggest that SIAH may be an attractive new therapeutic target for novel anti-RAS and anti-cancer therapy in human cancer. As a highly evolutionarily conserved E3 ligase and consistent with its “gatekeeper” function identified in the ERBB/RAS signaling pathway, SIAH is well positioned to become a next-generation and potent anticancer drug target to block the tumor-promoting RAS pathway and to treat the most aggressive types of human cancers. “Using anti-SIAH molecules to block active RAS signaling in human cancer” may be another example of “from the bench [basic science from fruitflies (model organism) to human cancers] to the bedside story [translational medicine in the near future]”. Anti-SIAH-based anticancer strategy may aid in expanding our arsenal of novel anticancer therapies. By attacking the oncogenic ERBB/RAS pathway using multi-pronged synergistic inhibitions at upstream (EGFR/HER2 membrane receptors), midstream (RAS/RAF/MEK/mTOR) and downstream (SIAH E3 ligase) signaling modules in parallel, we may be in a great position to halt the genesis, progression and metastasis of the most aggressive and lethal types of human cancers. If successful, we hope to translate our findings to the cancer clinics to treat many cancer patients with metastatic diseases in the future. Citation Information: Cancer Res 2009;69(23 Suppl):A1.

Abstract It is believed that multiple genetic variants with small individual effects contribute to the risk of alcohol dependence. Such polygenic effects are difficult to detect in genome-wide association studies that test for association of the phenotype with each single nucleotide polymorphism (SNP) individually. To overcome this challenge, gene-set analysis (GSA) methods that jointly test for the effects of pre-defined groups of genes have been proposed. Rather than testing for association between the phenotype and individual SNPs, these analyses evaluate the global evidence of association with a set of related genes enabling the identification of cellular or molecular pathways or biological processes that play a role in development of the disease. It is hoped that by aggregating the evidence of association for all available SNPs in a group of related genes, these approaches will have enhanced power to detect genetic associations with complex traits. We performed GSA using data from a genome-wide study of 1165 alcohol-dependent cases and 1379 controls from the Study of Addiction: Genetics and Environment (SAGE), for all 200 pathways listed in the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Results demonstrated a potential role of the ‘synthesis and degradation of ketone bodies’ pathway. Our results also support the potential involvement of the ‘neuroactive ligand–receptor interaction’ pathway, which has previously been implicated in addictive disorders. These findings demonstrate the utility of GSA in the study of complex disease, and suggest specific directions for further research into the genetic architecture of alcohol dependence.

New vibration pulses are proposed to increase the power of shear waves induced by ultrasound radiation force in a tissue region with a preferred spectral distribution. The new pulses are sparsely sampled from an orthogonal frequency wave composed of several sinusoidal signals. Those sinusoidal signals have different frequencies and are orthogonal to each other. The phase and amplitude of each sinusoidal signal are adjusted to control the shape of the orthogonal frequency wave. Amplitude of the sinusoidal signal is increased as its frequency increases to compensate for higher loss at higher frequency in the tissue region. The new vibration pulses and detection pulses can be interleaved for array transducer applications. The experimental results show that the new vibration pulses significantly increases induced tissue vibration with the same peak ultrasound intensity, compared with the binary vibration pulses.

Airway smooth muscle contraction is the main driving mechanism in asthma. However, in the dynamic environment of the ASM passive dynamics play an important role. The main aim of this research is to investigate the relative contribution of passive dynamics to ASM tissue dynamics and to characterize this behavior. The major finding of this study is the ability of the principle of logarithmic superposition to describe a wide range of dynamic behavior in relaxed (unstimulated) ASM and to a lesser extend in contracted ASM. The ability of this model to describe the force response to length oscillations in contracted muscle shows that cross-bridge cycling in ASM when fully contracted is not affected by oscillations. We hypothesize that this could be caused either by a very slow cross-bridge cycling rate, or by a large degree of non-contractile cross-linking which results in a greatly increased passive force.

GnIH was first identified in avian species, and there is now strong evidence that it is operant in mammals as an inhibitor of reproduction. Mammalian gonadotropin-inhibitory hormone (GnIH)-3 is encoded by the RFRP gene in neurons of the dorsomedial nucleus. These neurons project to the median eminence, predicting a role as a secreted neurohormone and regulation of the pituitary gonadotropes. To determine whether GnIH-3 is a secreted neurohormone, we measured its concentration in hypophyseal portal blood in ewes during the nonbreeding (anestrous) season and during the luteal and follicular phases of the estrous cycle in the breeding season. Paired portal and jugular blood samples were collected and plasma prepared for RIA using an ovine GnIH-3 antibody. Pulsatile GnIH-3 secretion was observed in the portal blood of all animals. Mean GnIH-3 pulse amplitude and pulse frequency was higher during the nonbreeding season. GnIH-3 was virtually undetectable in peripheral blood plasma. There was a lack of association between secretory pulses of GnIH-3 (portal) and LH (peripheral). To determine the role of secreted GnIH-3, we examined its effects on GnRH-stimulated LH secretion in hypothalamo-pituitary-disconnected ewes; a significant reduction in the LH response to GnRH was observed. Finally, to identify cellular targets in the pituitary, the expression of GnIH receptor [G protein-coupled receptor 147 (GPR147)] in fractions enriched for gonadotropes somatotropes, and lactotropes was examined; expression was observed in each cell type. These data show GnIH-3 is secreted into portal blood to act on pituitary gonadotropes, reducing the action of GnRH.

Background— The clinical significance of incomplete coronary revascularization (ICR) after percutaneous coronary intervention in patients with acute coronary syndromes is unknown. Methods and Results— We performed quantitative angiography of the entire coronary tree in 2954 patients with acute coronary syndromes in the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial. ICR was variably defined if any lesion with diameter stenosis (DS) cutoffs ranging from ≥30% to ≥70% with reference vessel diameter ≥2.0 mm remained after percutaneous coronary intervention. The primary outcome was 1-year composite rate of major adverse cardiac events (death, myocardial infarction, or ischemia-driven unplanned revascularization). With the use of DS cutoffs ≥30%, ≥40%, ≥50%, ≥60%, and ≥70%, the prevalence of ICR after percutaneous coronary intervention was 75%, 55%, 37%, 25%, and 17%, respectively. The 1-year major adverse cardiac event rate was increased among patients with ICR using all of the DS cutoffs. ICR (≥50% DS) was associated with higher 1-year rates of myocardial infarction (12.0% versus 8.2%; hazard ratio, 1.50; 95% confidence interval, 1.18–1.89; P =0.0007) and ischemia-driven unplanned revascularization (15.7% versus 10.2%; hazard ratio, 1.58; 95% confidence interval, 1.28–1.96; P <0.0001), with a trend toward increased mortality (3.1% versus 2.2%; hazard ratio, 1.43; 95% confidence interval, 0.90–2.27; P =0.13). By multivariable analysis, ICR (≥50% DS) was an independent predictor of 1-year major adverse cardiac events (hazard ratio, 1.36; 95% confidence interval, 1.12–1.64; P =0.002). The impact of ICR on major adverse cardiac events was similar regardless of chronic total occlusion presence, but it was more pronounced with a greater number of nonrevascularized lesions. Conclusions— Depending on the threshold of percent DS, ICR was present in 17% to 75% of patients with acute coronary syndromes after percutaneous coronary intervention. Regardless of the threshold, ICR was strongly associated with 1-year myocardial infarction, ischemia-driven unplanned revascularization, and major adverse cardiac events. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00093158.

Aplasia cutis congenita (ACC) is a rare disorder that is estimated to affect approximately three newborns in every 10,000 live births. It is usually detected at birth and most commonly affects the scalp as a solitary lesion. The type of lesion may be classified into one of nine groups. Membranous types and those with a “hair collar” are at highest risk to be associated with underlying neurodevelopmental abnormalities. In rare cases, associated abnormalities and syndromes may also be seen. Appropriate evaluation can be undertaken depending on clinical signs and symptoms. Treatment is often conservative, but more aggressive treatment may be indicated for some larger scalp lesions.

Abstract POEMS syndrome is a paraneoplastic syndrome whose acronym stands for less than half of the defining features of the disease, that is, polyradiculoneuropathy, organomegaly, potentially including coexisting Castleman disease, endocrinopathy, monoclonal plasma cell neoplasm, and skin changes. The other important features include papilledema, extravascular volume overload, sclerotic bone lesions, thrombocytosis, elevated VEGF, and abnormal pulmonary function. The diagnosis is based on having both the polyradiculoneuropathy and the monoclonal plasma cell disorder, and at least 1 of the other 3 major criteria (Castleman disease, sclerotic bone lesions, or elevated VEGF) and at least one minor criterion. The diagnosis is often delayed with intervening incorrect diagnoses of chronic inflammatory demyelinating polyradiculoneuropathy, myeloproliferative disorder, and monoclonal gammopathy of undetermined significance. Prompt treatment directed at the underlying plasma cell clone produces dramatic responses in the majority of patients. Although there are no randomized clinical trial data to direct best therapy, for patients with disseminated disease, high-dose chemotherapy with peripheral blood transplantation has yielded durable benefit, whereas radiation therapy is typically effective for patients with a more localized presentation. More universal recognition of and more scientific inquiry into the underpinnings of the disease will provide direction toward the best treatment strategies in the future.