EphA4 promotes cell proliferation and cell adhesion-mediated drug resistance via the AKT pathway in multiple myeloma.

Eph receptor A4 (EphA4), a member of the erythropoietin-producing hepatocellular (Eph) family, has been reported to upregulate in several tumors. However, the role of EphA4 in multiple myeloma has not been clarified yet. In this study, we found that EphA4 promoted proliferation of multiple myeloma cells via the regulation of cell cycle. Besides, EphA4 was closely related to cell adhesion of multiple myeloma cells and promoted cell adhesion-mediated drug resistance by enhancing the phosphorylation levels of Akt (p-AKT) expression in multiple myeloma. More interestingly, we discovered that EphA4 can interact with cyclin-dependent kinase 5 (CDK5) and regulate its expression in multiple myeloma. CDK5 has been reported to be overexpressed in multiple myeloma which mediated bortezomib resistance and also participated in AKT pathway. And we have also proved the fact. So, we supposed that EphA4 interacted with CDK5 and promoted its expression which in turn enhanced p-AKT expression and promoted cell adhesion-mediated drug resistance in multiple myeloma. Therefore, this study clarifies the molecular mechanism of cell adhesion-mediated drug resistance and may be useful in identifying potential target for treatment of multiple myeloma.

ADP-ribosylation factor 1 (ARF1) takes part in cell proliferation and cell adhesion-mediated drug resistance (CAM-DR).

Cell adhesion-mediated drug resistance (CAM-DR) remains the primary obstacle in human multiple myeloma (MM) therapy. In this study, we aimed at investigating the expression and biologic function of ARF1 in MM. We determined that ARF1 expression was positively correlated with cell proliferation and knockdown of ARF1 contributed to CAM-DR. The enhancement in the adhesion of MM cells to fibronectin (FN) or the bone marrow stroma cell line HS-5 cells translated to an increased CAM-DR phenotype. Importantly, we showed that this CAM-DR phenotype was correlated with the phosphorylation of Akt and ERK in MM cells. Moreover, we sought to determine whether ARF1 could interact with p27 in RPMI8226 cells. Knockdown of ARF1 also significantly decreased pT157-p27 protein expression in RPMI8226 cells. Our research shows ARF1 may reverse CAM-DR by regulating phosphorylation of p27 at T157 in MM. Taken together, our data shed new light on the molecular mechanism of CAM-DR in MM, and targeting ARF1 may be a novel therapeutic approach for improving the effectiveness of chemotherapy in MM.

Simulation and evaluation of increased imaging service capacity at the MRI department using reduced coil-setting times.

The wait times for patients from their appointments to receiving magnetic resonance imaging (MRI) are usually long. To reduce this wait time, the present study proposed that service time wastage could be reduced by adjusting MRI examination scheduling by prioritizing patients who require examinations involving the same type of coil. This approach can reduce patient wait times and thereby maximize MRI departments' service times. To simulate an MRI department's action workflow, 2,447 MRI examination logs containing the deidentified information of patients and radiation technologists from the MRI department of a medical center were used, and a hybrid simulation model that combined discrete-event and agent-based simulations was developed. The experiment was conducted in two stages. In the first stage, the service time was increased by adjusting the examination schedule and thereby reducing the number of coil changes. In the second stage, the maximum number of additional patients that could be examined daily was determined. The average number of coil changes per day for the four MRI scanners of the aforementioned medical center was reduced by approximately 27. Thus, the MRI department gained 97.17 min/d, which enabled them to examine three additional patients per month. Consequently, the net monthly income of the hospital increased from US$17,067 to US$30,196, and the patient wait times for MRI examinations requiring the use of flexible torso and head, shoulder, 8-inch head, and torso MRI coils were shortened by 6 d and 23 h, 2 d and 15 h, 2 d and 9 h, and 16 h, respectively. Adjusting MRI examination scheduling by prioritizing patients that require the use of the same coil could reduce the coil-setting time, increase the daily number of patients who are examined, increase the net income of the MRI department, and shorten patient wait times for MRI examinations. Minimizing the operating times of specific examinations to maximize the number of services provided per day does not require additional personnel or resources. The results of the experimental simulations can be used as a reference by radiology department managers designing scheduling rules for examination appointments.

Cell adhesion induces overexpression of chromodomain helicase/ATPase DNA binding protein 1-like gene (CHD1L) and contributes to cell adhesion-mediated drug resistance (CAM-DR) in multiple myeloma cells.

Previous studies have shown that chromodomain helicase/ATPase DNA binding protein 1-like gene (CHD1L) exerts its anti-apoptotic function in many solid cancers. However, its role in human multiple myeloma (MM) has not been thoroughly elucidated. In this study, we investigate the role of CHD1L in MM. Preliminarily, up-regulation and down-regulation assay verified that CHD1L exerts its anti-apoptotic role through the apoptotic pathway involving caspase-9-caspase-3 apoptotic pathway in MM cells. In addition, we determined that CHD1L expression is increased when MM cells were adhered to fibronectin (FN) or bone marrow stromal cell line HS-5 cells and cell adhesion assay indicated that CHD1L siRNA reversed the high cell adhesion rate. Consistent with the reduced adhesion rate, the cells translated to a compromised cell adhesion-mediated drug resistance (CAM-DR) phenotype in MM. In summary, we will propose strategies for developing a CHD1L inhibitor for potential treatment of MM.