The prediction of sagittal chin point relapse following two-jaw surgery using machine learning.

The study aimed to identify critical factors associated with the surgical stability of pogonion (Pog) by applying machine learning (ML) to predict relapse following two-jaw orthognathic surgery (2 J-OGJ). The sample set comprised 227 patients (110 males and 117 females, 207 training and 20 test sets). Using lateral cephalograms taken at the initial evaluation (T0), pretreatment (T1), after (T2) 2 J-OGS, and post treatment (T3), 55 linear and angular skeletal and dental surgical movements (T2-T1) were measured. Six ML modes were utilized, including classification and regression trees (CART), conditional inference tree (CTREE), and random forest (RF). The training samples were classified into three groups; highly significant (HS) (≥ 4), significant (S) (≥ 2 and < 4), and insignificant (N), depending on Pog relapse. RF indicated that the most important variable that affected relapse rank prediction was ramus inclination (RI), CTREE and CART revealed that a clockwise rotation of more than 3.7 and 1.8 degrees of RI was a risk factor for HS and S groups, respectively. RF, CTREE, and CART were practical tools for predicting surgical stability. More than 1.8 degrees of CW rotation of the ramus during surgery would lead to significant Pog relapse.

Orthognathic surgical planning using graph CNN with dual embedding module: External validations with multi-hospital datasets.

BACKGROUND AND OBJECTIVE: Despite recent development of AI, prediction of the surgical movement in the maxilla and mandible by OGS might be more difficult than that of tooth movement by orthodontic treatment. To evaluate the prediction accuracy of the surgical movement using pairs of pre-(T0) and post-surgical (T1) lateral cephalograms (lat-ceph) of orthognathic surgery (OGS) patients and dual embedding module-graph convolution neural network (DEM-GCNN) model. METHODS: 599 pairs from 3 institutions were used as training, internal validation, and internal test sets and 201 pairs from other 6 institutions were used as external test set. DEM-GCNN model (IEM, learning the lat-ceph images; LTEM, learning the landmarks) was developed to predict the amount and direction of surgical movement of ANS and PNS in the maxilla and B-point and Md1crown in the mandible. The distance between T1 landmark coordinates actually moved by OGS (ground truth) and predicted by DEM-GCNN model and pre-existed CNN-based Model-C (learning the lat-ceph images) was compared. RESULTS: In both internal and external tests, DEM-GCNN did not exhibit significant difference from ground truth in all landmarks (ANS, PNS, B-point, Md1crown, all P > 0.05). When the accumulated successful detection rate for each landmark was compared, DEM-GCNN showed higher values than Model-C in both the internal and external tests. In violin plots exhibiting the error distribution of the prediction results, both internal and external tests showed that DEM-GCNN had significant performance improvement in PNS, ANS, B-point, Md1crown than Model-C. DEM-GCNN showed significantly lower prediction error values than Model-C (one-jaw surgery, B-point, Md1crown, all P < 0.005; two-jaw surgery, PNS, ANS, all P < 0.05; B point, Md1crown, all P < 0.005). CONCLUSION: We developed a robust OGS planning model with maximized generalizability despite diverse qualities of lat-cephs from 9 institutions.

Comparison of short-term condylar positional changes in mandibular prognathism after surgery-first approach: Symmetric setback versus asymmetric setback.

The aim of this study was to compare how the displacement of the mandibular condyle changed after symmetric or asymmetric mandibular setback surgery using the surgery-first approach (SFA). Patients who underwent mandibular setback surgery using the SFA were selected and divided into a symmetry group (n = 18) with differences of less than 2 mm between the right and left setback, and an asymmetry group (n = 18) with a difference of greater than 2 mm. Cone-beam computed tomography (CBCT)-generated cephalograms were obtained after three-dimensional superimposition of CBCT images taken before surgery (T0), within one week after surgery (T1), and seven months after surgery (T2). The condylar positions were measured. Condylar positional changes according to time were compared between the two groups and correlation analysis was performed. There were significant positional changes in mandibular condyles over time in both groups. However, most of these changes returned to their initial state. In the asymmetry group, there was a greater internal rotation of the mandibular condyle on the lesser setback side. The correlation analysis results revealed that only the setback difference was associated with rotational displacement of the condyle on the lesser setback side at two time points (T1-T0, T2-T0). In the SFA, significant condylar displacement occurred immediately after both symmetric and asymmetric mandibular setback surgery, and the right/left difference in mandibular setback showed a significant positive correlation with rotational displacement. Although more significant rotational displacement of the mandibular condyle was observed after asymmetric mandibular setback surgery, the amount was not large enough to be clinically significant.

Accuracy of artificial intelligence-assisted landmark identification in serial lateral cephalograms of Class III patients who underwent orthodontic treatment and two-jaw orthognathic surgery.

Objective: To investigate the pattern of accuracy change in artificial intelligence-assisted landmark identification (LI) using a convolutional neural network (CNN) algorithm in serial lateral cephalograms (Lat-cephs) of Class III (C-III) patients who underwent two-jaw orthognathic surgery. Methods: A total of 3,188 Lat-cephs of C-III patients were allocated into the training and validation sets (3,004 Lat-cephs of 751 patients) and test set (184 Lat-cephs of 46 patients; subdivided into the genioplasty and non-genioplasty groups, n = 23 per group) for LI. Each C-III patient in the test set had four Lat-cephs: initial (T0), pre-surgery (T1, presence of orthodontic brackets [OBs]), post-surgery (T2, presence of OBs and surgical plates and screws [S-PS]), and debonding (T3, presence of S-PS and fixed retainers [FR]). After mean errors of 20 landmarks between human gold standard and the CNN model were calculated, statistical analysis was performed. Results: The total mean error was 1.17 mm without significant difference among the four time-points (T0, 1.20 mm; T1, 1.14 mm; T2, 1.18 mm; T3, 1.15 mm). In comparison of two time-points ([T0, T1] vs. [T2, T3]), ANS, A point, and B point showed an increase in error (p < 0.01, 0.05, 0.01, respectively), while Mx6D and Md6D showeda decrease in error (all p < 0.01). No difference in errors existed at B point, Pogonion, Menton, Md1C, and Md1R between the genioplasty and non-genioplasty groups. Conclusions: The CNN model can be used for LI in serial Lat-cephs despite the presence of OB, S-PS, FR, genioplasty, and bone remodeling.

Sclerostin in periodontal ligament: Homeostatic regulator in biophysical force-induced tooth movement.

AIM: To study the role of sclerostin in periodontal ligament (PDL) as a homeostatic regulator in biophysical-force-induced tooth movement (BFTM). MATERIALS AND METHODS: BFTM was performed in rats, followed by microarray, immunofluorescence, in situ hybridization, and real-time polymerase chain reaction for the detection and identification of the molecules. The periodontal space was analysed via micro-computed tomography. Effects on osteoclastogenesis and bone resorption were evaluated in the bone-marrow-derived cells in mice. In vitro human PDL cells were subjected to biophysical forces. RESULTS: In the absence of BFTM, sclerostin was hardly detected in the periodontium except in the PDL and alveolar bone in the furcation region and apex of the molar roots. However, sclerostin was up-regulated in the PDL in vivo by adaptable force, which induced typical transfiguration without changes in periodontal space as well as in vitro PDL cells under compression and tension. In contrast, the sclerostin level was unaffected by heavy force, which caused severe degeneration of the PDL and narrowed periodontal space. Sclerostin inhibited osteoclastogenesis and bone resorption, which corroborates the accelerated tooth movement by the heavy force. CONCLUSIONS: Sclerostin in PDL may be a key homeostatic molecule in the periodontium and a biological target for the therapeutic modulation of BFTM.

Vertical bony step between proximal and distal segments after mandibular setback is related with relapse: A cone-beam computed tomographic study.

INTRODUCTION: Vertical bony step (VBS) occurs between proximal and distal segments of the mandible during mandibular setback surgery with bilateral sagittal split ramus osteotomy. The purpose of this study was to investigate whether VBS is correlated with the relapse of mandibular setback using 3-dimensional models constructed from cone-beam computed tomography. METHODS: The subjects consisted of 30 patients who underwent bilateral sagittal split ramus osteotomy for a mandibular setback. Double jaw surgery was performed in 18 patients, and isolated mandibular setback surgery was performed in 12 patients. Cone-beam computed tomography scans were taken at pretreatment (T0), postsurgery (T1), and posttreatment (T2). Treatment changes and the correlations between measurements were evaluated. RESULTS: The mean mandibular setback was -11.9 mm, and the mean VBS was -5.6 mm. Correlations with the relapse of mandibular setback were found in the amount of mandibular setback (T1 - T0), development of VBS (T1 - T0), posterior movement of the proximal segment (T1 - T0), counterclockwise rotation of symphysis (T2 - T1), and the resolution of VBS (T2 - T1). CONCLUSIONS: The development and resolution of VBS were correlated with the relapse of mandibular setback. Minimizing VBS is recommended to reduce the relapse of mandibular setback.

Comparison of one-jaw and two-jaw orthognathic surgery in patients with skeletal Class III malocclusion using data from 10 multi-centers in Korea: Part I. Demographic and skeletodental characteristics.

OBJECTIVE: To investigate demographic and skeletodental characteristics of one-jaw (1J-OGS) and two-jaw orthognathic surgery (2J-OGS) in patients with skeletal Class III malocclusion. METHODS: 750 skeletal Class III patients who underwent OGS at 10 university hospitals in Korea between 2015 and 2019 were investigated; after dividing them into the 1J-OGS (n = 186) and 2J-OGS groups (n = 564), demographic and skeletodental characteristics were statistically analyzed. RESULTS: 2J-OGS was more frequently performed than 1J-OGS (75.2 vs. 24.8%), despite regional differences (capital area vs. provinces, 86.6 vs. 30.7%, p < 0.001). Males outnumbered females, and their mean operation age was older in both groups. Regarding dental patterns, the most frequent maxillary arch length discrepancy (ALD) was crowding in the 1J-OGS group (52.7%, p < 0.001) and spacing in the 2J-OGS group (40.4%, p < 0.001). However, the distribution of skeletal pattern was not significantly different between the two groups (all p > 0.05). The most prevalent skeletal patterns in both groups were hyper-divergent pattern (50.0 and 54.4%, respectively) and left-side chin point deviation (both 49.5%). Maxillary spacing (odds ratio [OR], 3.645; p < 0.001) increased the probability of 2J-OGS, while maxillary crowding (OR, 0.672; p < 0.05) and normo-divergent pattern (OR, 0.615; p < 0.05) decreased the probability of 2J-OGS. CONCLUSIONS: In both groups, males outnumbered females, and their mean operation age was older. The most frequent ALD was crowding in the 1J-OGS group, and spacing in the 2J-OGS group, while skeletal characteristics were not significantly different between the two groups.

The Potential Role of Human NME1 in Neuronal Differentiation of Porcine Mesenchymal Stem Cells: Application of NB-hNME1 as a Human NME1 Suppressor.

This study aimed to investigate the effects of the human macrophage (MP) secretome in cellular xenograft rejection. The role of human nucleoside diphosphate kinase A (hNME1), from the secretome of MPs involved in the neuronal differentiation of miniature pig adipose tissue-derived mesenchymal stem cells (mp AD-MSCs), was evaluated by proteomic analysis. Herein, we first demonstrate that hNME1 strongly binds to porcine ST8 alpha-N-acetyl-neuraminide alpha-2,8-sialyltransferase 1 (pST8SIA1), which is a ganglioside GD3 synthase. When hNME1 binds with pST8SIA1, it induces degradation of pST8SIA1 in mp AD-MSCs, thereby inhibiting the expression of ganglioside GD3 followed by decreased neuronal differentiation of mp AD-MSCs. Therefore, we produced nanobodies (NBs) named NB-hNME1 that bind to hNME1 specifically, and the inhibitory effect of NB-hNME1 was evaluated for blocking the binding between hNME1 and pST8SIA1. Consequently, NB-hNME1 effectively blocked the binding of hNME1 to pST8SIA1, thereby recovering the expression of ganglioside GD3 and neuronal differentiation of mp AD-MSCs. Our findings suggest that mp AD-MSCs could be a potential candidate for use as an additive, such as an immunosuppressant, in stem cell transplantation.

Growth Modulatory Role of Zinc in Prostate Cancer and Application to Cancer Therapeutics.

Zinc is a group IIB heavy metal. It is an important regulator of major cell signaling pathways in most mammalian cells, functions as an antioxidant and plays a role in maintaining genomic stability. Zinc deficiency leads to severe diseases in the brain, pancreas, liver, kidneys and reproductive organs. Zinc loss occurs during tumor development in a variety of cancers. The prostate normally contains abundant intracellular zinc and zinc loss is a hallmark of the development of prostate cancer development. The underlying mechanism of this loss is not clearly understood. The knowledge that excess zinc prevents the growth of prostate cancers suggests that zinc-mediated therapeutics could be an effective approach for cancer prevention and treatment, although challenges remain. This review summarizes the specific roles of zinc in several cancer types focusing on prostate cancer. The relationship between prostate cancer and the dysregulation of zinc homeostasis is examined in detail in an effort to understand the role of zinc in prostate cancer.

Synergistic alveolar bone resorption by diabetic advanced glycation end products and mechanical forces.

BACKGROUND: The association between diabetes mellitus (DM) and bone diseases is acknowledged. However, the mechanistic pathways leading to the alveolar bone (AB) destruction remain unclear. This study aims to elucidate the mechanical forces (MF)-induced AB destruction in DM and its underlying mechanism. METHODS: In vivo periodontal tissue responses to MF were evaluated in rats with diabetes. In vitro human periodontal ligament (PDL) cells were either treated with advanced glycation end products (AGEs) alone or with AGEs and MF. RESULTS: In vivo, the transcription of VEGF-A, colony stimulating factor-1 (CSF-1), and Ager was upregulated in diabetes, whereas changes in DDOST and Glo1 mRNAs were negligible. DM induced VEGF-A protein in the vascular cells of the PDL and subsequent angiogenesis, but DM itself did not induce osteoclastogenesis. MF-induced AB resorption was augmented in DM, and such augmentation was morphologically substantiated by the occasional undermining resorption as well as the frontal resorption of the AB by osteoclasts. The mRNA levels of CSF-1 and vascular endothelial growth factor (VEGF) during MF application were highly elevated in diabetes, compared with those of the normal counterparts. In vitro, AGEs treatment elevated Glut-1 and CSF-1 mRNA levels via the p38 and JNK pathways, whereas OGT and VEGF levels remained unchanged. Compressive MF especially caused upregulation of VEGF, CSF-1, and Glut-1 levels, and such upregulation was further enhanced by AGEs treatment. CONCLUSIONS: Overloaded MF and AGEs metabolites may synergistically aggravate AB destruction by upregulating CSF-1 and VEGF. Therefore, regulating the compressive overloading of teeth, as well as the levels of diabetic AGEs, may prove to be an effective therapeutic modality for managing DM-induced AB destruction.

Cone-beam computed tomography evaluation on the condylar displacement following sagittal split ramus osteotomy in asymmetric setback patients: Comparison between conventional approach and surgery-first approach.

OBJECTIVE: To compare the condylar displacement following sagittal split ramus osteotomy (SSRO) in asymmetric setback patients between the conventional approach and surgery-first approach and to determine whether the condylar displacement is affected by asymmetric setback in SSRO patients. MATERIALS AND METHODS: This was a retrospective study. The subjects consisted of patients with facial asymmetry who underwent SSRO and had cone-beam computed tomography taken before and 1 month after surgery. They were allocated into the conventional (n = 18) and surgery-first (SF) groups (n = 20). Descriptive, independent t-tests and Pearson correlation analysis were computed. RESULTS: The amount of condylar displacement in x-, y-, and z-directions and Euclidean distance showed no statistically significant differences between the conventional and SF groups. Comparing the postoperative condylar position with the preoperative position, the condylar displacement occurred in posterior (P < .05) and downward (P < .05) directions in both groups except on the deviated side in the conventional group. The condylar displacement occurred in a posterior (P < .05) direction on the deviated side of the conventional group. However, the condylar displacement in three dimensions showed no statistically significant differences between the two groups. In the correlation analysis, the condylar displacement in both the deviated and contralateral sides showed no significant correlation with asymmetric setback in either group. CONCLUSION: The condylar displacement in three dimensions and the distance of condylar displacement in SSRO patients with facial asymmetry showed no significant difference between conventional and SF groups. Condylar displacement was not associated with asymmetric setback.

Cone-beam computed tomography evaluation on the changes in condylar long axis according to asymmetric setback in sagittal split ramus osteotomy patients.

OBJECTIVE: To determine whether the condylar rotation is affected by asymmetric setback in patients undergoing sagittal split ramus osteotomy. MATERIALS AND METHODS: Thirty patients who underwent bilateral sagittal split ramus osteotomy setback surgery were divided into the two groups, symmetric setback and asymmetric setback, according to the right/left difference of setback amount (<2.0, ≥2.0 mm). Condylar long axis changes were evaluated using the three-dimensional superimposition of before and immediately after surgery cone-beam computed tomography volume images. Evaluations were performed separately in lesser setback and greater setback side in patients undergoing asymmetric setback, whereas both side condyles were evaluated together in patients undergoing symmetric setback. Condylar axis changes on axial view were correlated with setback amount or right/left setback difference using Pearson correlation analysis. RESULTS: In general, the condylar axis change occurred in a pattern of inward rotation. The condyles in patients undergoing symmetric setback showed 3.4° rotation in average. In case of asymmetric setback, the lesser setback side showed larger value (4.3°) than the greater setback side (2.3°) with a statistical significance. In the correlation analysis, setback amount showed no significant correlation with the condylar axis changes in both groups. However, correlation with right/left setback difference showed a positive correlation in lesser setback side of patients undergoing asymmetric setback. CONCLUSION: The findings of this study indicate that large amount of setback alone does not contribute to the change in condylar long axis, but asymmetric setback might cause a change in condylar long axis, particularly on the lesser setback side.

Antitumorigenic effect of atmospheric-pressure dielectric barrier discharge on human colorectal cancer cells via regulation of Sp1 transcription factor.

Human colorectal cancer cell lines (HT29 and HCT116) were exposed to dielectric barrier discharge (DBD) plasma at atmospheric pressure to investigate the anticancer capacity of the plasma. The dose- and time-dependent effects of DBDP on cell viability, regulation of transcription factor Sp1, cell-cycle analysis, and colony formation were investigated by means of MTS assay, DAPI staining, propidium iodide staining, annexin V-FITC staining, Western blot analysis, RT-PCR analysis, fluorescence microscopy, and anchorage-independent cell transformation assay. By increasing the duration of plasma dose times, significant reductions in the levels of both Sp1 protein and Sp1 mRNA were observed in both cell lines. Also, expression of negative regulators related to the cell cycle (such as p53, p21, and p27) was increased and of the positive regulator cyclin D1 was decreased, indicating that the plasma treatment led to apoptosis and cell-cycle arrest. In addition, the sizes and quantities of colony formation were significantly suppressed even though two cancer promoters, such as TPA and epidermal growth factor, accompanied the plasma treatment. Thus, plasma treatment inhibited cell viability and colony formation by suppressing Sp1, which induced apoptosis and cell-cycle arrest in these two human colorectal cancer cell lines.

Rhein exhibits antitumorigenic effects by interfering with the interaction between prolyl isomerase Pin1 and c-Jun.

The Pin1 protein (or peptidyl-prolyl cis/trans isomerase) specifically catalyzes the cis/trans isomerization of phosphorylated serine/threonine-proline (Ser/Thr-Pro) bonds and plays an important role in many cellular events through the effects of conformational change in the function of c-Jun, its biological substrate. Pin1 expression is involved in essential cellular pathways that mediate cell proliferation, cell cycle progression, tumorigenesis and apoptosis by altering their stability and function, and it is overexpressed in various types of tumors. Pin1 phosphorylation has been regarded as a marker of Pin1 isomerase activity, and the phosphorylation of Ser/Thr-Pro on protein substrates is prerequisite for its binding activity with Pin1 and subsequent isomerization. Since phosphorylation of proteins on Ser/Thr-Pro is a key regulatory mechanism in the control of cell proliferation and transformation, Pin1 has become an attractive molecule in cancer research. Many inhibitors of Pin1 have been discovered, including several classes of both designed inhibitors and natural products. Anthraquinone compounds possess antitumor properties and have therefore been applied in human and veterinary therapeutics as active substances in medicinal products. Among the anthraquinones, rhein (4,5-dihydroxy-9,10-dioxoanthracene-2-carboxylic acid) is a monomeric anthraquinone derivative found mainly in plants in the Polygonaceae family, such as rhubarb and Polygonum cuspidatum. Recent studies have shown that rhein has numerous pharmacological activities, including antitumor effects. Here, we demonstrated the antitumorigenic effect of rhein using cell proliferation assay, anchorage-independent cell transformation, pull-down assay, luciferase promoter activity, fluorescence-activated cell sorting and western blot analysis. The rhein/Pin1 association was found to play a regulatory role in cell proliferation and neoplastic cell transformation and the binding of phosphorylated c-Jun (Ser73) with Pin1 was markedly decreased and inhibited activator protein 1 or NF-κB reporter activity by rhein. Overall, our findings and the accompanying biochemical data demonstrated the antitumorigenic effect of rhein through its interference in Pin1/c-Jun interaction and suggest the possible use of rhein in suppressing the tumor-promoting effects of Pin1. Therefore, rhein may have practical implications for cancer prevention or therapy.

Effects of herbal Epimedium on the improvement of bone metabolic disorder through the induction of osteogenic differentiation from bone marrow-derived mesenchymal stem cells.

Herbal Epimedium (HE) has been commonly used as a tonic, antirheumatic agent and in the treatment of bone­associated diseases including osteoporosis. Treatment for osteoporosis is important to increase bone mass density and maintain to balance of bone remodeling. The present study was performed to investigate the effects of HE on mouse bone marrow mesenchymal stem cell (mBMMSC) proliferation and osteogenic differentiation, using MTT assays, proliferating cell nuclear antigen (PCNA) detection and apoptosis and differentiation assays. HE was demonstrated to inhibit the proliferation of mBMMSCs up to 45.43±3.33% and to decrease the level of PCNA expression compared with untreated cells. HE also induced late apoptosis at 24 and 48 h after treatment up to 71.93 and 67.03%, respectively, while only 14.93% of untreated cells exhibited apoptosis. By contrast, HE induced differentiation of mBMMSCs into an osteogenic lineage at the beginning of three weeks after commencement of treatment. This suggested that HE is a candidate as an inducer of osteogenesis from bone marrow mesenchymal stem cells, and additionally has potential for use in the treatment of bone metabolic disorders such as osteoporosis.

Kahweol induces apoptosis by suppressing BTF3 expression through the ERK signaling pathway in non-small cell lung cancer cells.

Kahweol, a diterpene molecule, has antiproliferative effects on several types of human cancer cells, but whether it has apoptotic effect in non-small cell lung cancer (NSCLC) is not known. To explore this possibility, we incubated cells from two NSCLC cell lines, NCI-H358 and NCI­H1299, with different concentrations of kahweol and used the MTS assay, DAPI staining, propidium iodide staining, Annexin V staining, immunocytochemical test, and western blot analysis to characterize this molecule and the signaling pathway underlying its effects. The kahweol-treated cells showed significantly decreased cell viability, increased nuclear condensation, and an increased number of Annexin V-positive NSCLC cells. Suppression of basic transcription factor 3 (BTF3) was followed by apoptosis induced by kahweol via the ERK-mediated signaling pathway in a dose- and time-dependent manner. In addition, kahweol modulated the protein expression of BTF3 genes involved in cell-cycle regulation and apoptosis-related proteins, resulting in apoptotic cell death. Our results collectively indicated that kahweol inhibited the proliferation of NSCLC cells through ERK-mediated signaling pathways and the downregulation of BTF3.

Manumycin A induces apoptosis in malignant pleural mesothelioma through regulation of Sp1 and activation of the mitochondria-related apoptotic pathway.

Manumycin A (Manu A) is a natural product isolated from Streptomyces parvulus and has been reported to have anti-carcinogenic and anti-biotic properties. However, neither its molecular mechanism nor its molecular targets are well understood. Thus, the aim of the present study was to explore the possibility that Manu A has cancer preventive and chemotherapeutic effects on malignant pleural mesothelioma (MPM) through regulation of Sp1 and induction of mitochondrial cell death pathway. Manu A inhibited the cell viability of MSTO-211H and H28 cells in a concentration­dependent manner as determined by MTS assay. IC50 values were calculated as 8.3 and 4.3 µM in the MSTO-311H and H28 cells following 48 h incubation, respectively. Manu A induced a significant increase in apoptotic indices as shown by DAPI staining, Annexin V assay, multi-caspase activity and mitochondrial membrane potential assay. The downregulation of Sp1 mRNA and protein expression by Manu A led to apoptosis by suppressing Sp1-regulated proteins (cyclin D1, Mcl-1 and survivin). Manu A decreased the protein levels of BID, Bcl-xL and PARP while it increased Bax levels. Manu A caused depolarization of the mitochondrial membrane with induction of CHOP, DR4 and DR5. Our results demonstrated that Manu A exerted anticancer effects by inducing apoptosis via inhibition of the Sp1-related signaling pathway in human MPM.

Licochalcone B induces apoptosis of human oral squamous cell carcinoma through the extrinsic- and intrinsic-signaling pathways.

Licochalcone B (Lico B), which belongs to the retrochalcone family, is isolated from the roots of Chinese licorice. Lico B has been reported to have several other useful pharmacological properties, such as anti-inflammatory, antibacterial, antioxidant, antiulcer, anticancer, and anti-metastasis activities. We elucidated the underlying mechanism by which Lico B can induce apoptosis in oral squamous cell carcinoma (OSCC). Our results showed that exposure of OSCC cells (HN22 and HSC4) to Lico B significantly inhibited cell proliferation in a time- and concentration-dependent manner. Lico B caused cell cycle arrest at G1 phase along with downregulation of cyclin D1 and upregulation of p21 and p27 proteins. Lico B also facilitated the diffusion of phospholipid phosphatidylserine (PS) from inner to outer leaflets of the plasma membrane with chromatin condensation, DNA fragmentation, accumulated sub-G1 population in a concentration-dependent manner. Moreover, Lico B promoted the generation of reactive oxygen species (ROS), which, in turn, can induce CHOP, death receptor (DR) 4 and DR5. Lico B treatment induced downregulation of anti-apoptotic proteins (Bid and Bcl-xl and Mcl-1), and up-regulation of pro-apoptotic protein (Bax). Lico B also led to the loss of mitochondrial membrane potential (MMP), resulting in cytochrome c release. As can be expected from the above results, the apoptotic protease activating factor-1 (Apaf-1) and survivin were oppositely expressed in favor of apoptotic cell death. This notion was supported by the fact that Lico B activated multi-caspases with cleavage of poly (ADP-ribose) polymerase (PARP) protein. Therefore, it is suggested that Lico B is a promising drug for the treatment of human oral cancer via the induction of apoptotic cell death.

ß-lapachone suppresses the proliferation of human malignant melanoma cells by targeting specificity protein 1.

ß-lapachone (ß-lap), a novel natural quinone derived from the bark of the Pink trumpet tree (Tabebuia avellanedae) has been demonstrated to have anticancer activity. In this study, we investigated whether ß-lap exhibits anti-proliferative effects on two human malignant melanoma (HMM) cell lines, G361 and SK-MEL-28. The effects of ß-lap on the HMM cell lines were investigated using 3-(4,5-dimethylthiazol-2-yl)­5-(3-carboxymethoxyphenyl)­2-(4-sulfophenyl-2H-tetrazolium (MTS) assay, 4',6-diamidino-2-phenylindole (DAPI) staining, Annexin V and Dead cell assay, mitochondrial membrane potential (MMP) assay and western blot analysis. We demonstrated that ß-lap significantly induced apoptosis and suppressed cell viability in the HMM cells. Intriguingly, the transcription factor specificity protein 1 (Sp1) was significantly downregulated by ß-lap in a dose- and time-dependent manner. Furthermore, ß-lap modulated the protein expression level of the Sp1 regulatory genes including cell cycle regulatory proteins and apoptosis-associated proteins. Taken together, our findings indicated that ß-lap modulates Sp1 transactivation and induces apoptotic cell death through the regulation of cell cycle- and apoptosis-associated proteins. Thus, ß-lap may be used as a promising anticancer drug for cancer prevention and may improve the clinical outcome of patients with cancer.