Nanomedicine for urologic cancers: diagnosis and management.

Urologic cancers accounted for more than two million new cases and around 0.8 million deaths in 2020. Although surgery, chemotherapy, and radiotherapy, as well as castration for prostate cancer, remain the cornerstones for managing urologic neoplasms, they can result in severe adverse effects, poor patient compliance, and unsatisfactory survival rates, thus, it is essential to develop novel options that enable the early detection of these malignancies, together with providing accurate diagnoses, and more efficient treatment strategies. Nanomedicine represents an emerging approach that can deliver formulations or drugs across traditional biological barriers in the body and be directed to specific cell types within target organs via active targeting or passive targeting, thus, showing potential to improve the management of urologic cancers. In this review, we discussed the most recent updates on the application of nanomedicines in the diagnosis and treatment of urologic cancers, with focus on prostate, bladder and kidney tumors. We also presented the anti-tumor molecular mechanisms of newly designed nanomedicine for treating urologic cancers, mainly including image-guided surgery, chemotherapy, radiotherapy, gene therapy, immunotherapy, and their synergetic therapy. Current studies have demonstrated the potential advantages of nanomedicine over conventional approaches. However, most developments and new findings in this area have not been validated in clinical trials yet, and therefore, efforts shall be made to translate these research insights into clinical practices for urologic cancers.

CircACTR2 in macrophages promotes renal fibrosis by activating macrophage inflammation and epithelial-mesenchymal transition of renal tubular epithelial cells.

The crosstalk between macrophages and tubular epithelial cells (TECs) actively regulates the progression of renal fibrosis. In the present study, we revealed the significance of circular RNA ACTR2 (circACTR2) in regulating macrophage inflammation, epithelial-mesenchymal transition (EMT) of TECs, and the development of renal fibrosis. Our results showed UUO-induced renal fibrosis was associated with increased inflammation and EMT, hypertrophy of contralateral kidney, up-regulations of circACTR2 and NLRP3, and the down-regulation of miR-561. CircACTR2 sufficiently and essentially promoted the activation of NLRP3 inflammasome, pyroptosis, and inflammation in macrophages, and through paracrine effect, stimulated EMT and fibrosis of TECs. Mechanistically, circACTR2 sponged miR-561 and up-regulated NLRP3 expression level to induce the secretion of IL-1ß. In TECs, IL-1ß induced renal fibrosis via up-regulating fascin-1. Knocking down circACTR2 or elevating miR-561 potently alleviated renal fibrosis in vivo. In summary, circACTR2, by sponging miR-561, activated NLRP3 inflammasome, promoted macrophage inflammation, and stimulated macrophage-induced EMT and fibrosis of TECs. Knocking down circACTR2 and overexpressing miR-561 may, thus, benefit the treatment of renal fibrosis.

Prediction of Proximal Junctional Kyphosis After Posterior Scoliosis Surgery With Machine Learning in the Lenke 5 Adolescent Idiopathic Scoliosis Patient.

OBJECTIVE: To build a model for proximal junctional kyphosis (PJK) prognostication in Lenke 5 adolescent idiopathic scoliosis (AIS) patients undergoing long posterior instrumentation and fusion surgery by machine learning and analyze the risk factors for PJK. MATERIALS AND METHODS: In total, 44 AIS patients (female/male: 34/10; PJK/non-PJK: 34/10) who met the inclusion criteria between January 2013 and December 2018 were retrospectively recruited from West China Hospital. Thirty-seven clinical and radiological features were acquired by two independent investigators. Univariate analyses between PJK and non-PJK groups were carried out. Twelve models were built by using four types of machine learning algorithms in conjunction with two oversampling methods [the synthetic minority technique (SMOTE) and random oversampling]. Area under the receiver operating characteristic curve (AUC) was used for model discrimination, and the clinical utility was evaluated by using F1 score and accuracy. The risk factors were simultaneously analyzed by a Cox regression and machine learning. RESULTS: Statistical differences between PJK and non-PJK groups were as follows: gender (p = 0.001), preoperative factors [thoracic kyphosis (p = 0.03), T1 slope angle (T1S, p = 0.078)], and postoperative factors [T1S (p = 0.097), proximal junctional angle (p = 0.003), upper instrumented vertebra (UIV) - UIV + 1 (p = 0.001)]. Random forest using SMOTE achieved the best prediction performance with AUC = 0.944, accuracy = 0.909, and F1 score = 0.667 on independent testing dataset. Cox model revealed that male gender and larger preoperative T1S were independent prognostic factors of PJK (odds ratio = 10.701 and 57.074, respectively). Gender was also at the first place in the importance ranking of the model with best performance. CONCLUSION: The random forest using SMOTE model has the great value for predicting the individual risk of developing PJK after long instrumentation and fusion surgery in Lenke 5 AIS patients. Moreover, the combination of the outcomes of a Cox model and the feature ranking extracted by machine learning is more valuable than any one alone, especially in the interpretation of risk factors.

MiR-200b/c family inhibits renal fibrosis through modulating epithelial-to-mesenchymal transition via targeting fascin-1/CD44 axis.

BACKGROUND: Renal fibrosis is the characteristic of all kinds of chronic kidney diseases (CKDs). Fascin-1 plays an important role in tumor development, but the roles of fascin-1 in renal fibrosis have not been studied. Here, we explored the role of fascin-1 in renal fibrosis and the potential mechanisms. METHODS: Kidney unilateral ureteral obstruction (UUO) mouse model was used as an in vivo model, and proximal tubule epithelial cell lines treated with TGF-ß1 were used as in vitro model of renal fibrosis. Cell transfection was performed to manipulate the expression of miR-200b/c, fascin-1 and CD44. Western blotting, qRT-PCR, immunohistochemistry or immunofluorescence assays were used to measure levels of miR-200b/c, fascin-1, CD44, and fibrosis and EMT-related markers. H&E and Masson stainings were used to examine the degree of injury and fibrosis in kidneys. Dual luciferase assay was used to examine the interaction between miR-200b/c family and fascin-1. RESULTS: Fascin-1 and CD44 levels were both significantly up-regulated while miR-200b/c family was reduced in models of renal fibrosis. Furthermore, overexpression of miR-200b/c family and inhibition of fascin-1 or CD44 ameliorated renal fibrosis through suppressing EMT process. Mechanistically, miR-200b/c family directly and negatively regulated the expression of fascin-1. Overexpression of fascin-1 could reverse the effects of miR-200b/c family on renal fibrosis, and fascin-1 regulated renal fibrosis by activating CD44. CONCLUSION: Our study is the first to show that fascin-1 plays a critical role in renal fibrosis. MiR-200b/c family could inhibit renal fibrosis through modulating EMT process by directly targeting fascin-1/CD44 axis.

A novel "AIE + ESIPT" near-infrared nanoprobe for the imaging of γ-glutamyl transpeptidase in living cells and the application in precision medicine.

γ-Glutamyl transpeptidase (GGT) has been reported as a biomarker of hepatocellular carcinoma (HCC), and its imaging is of great benefit for early detection in precise medicine as well as intraoperative navigation. Herein, we have designed and synthesized a novel near-infrared fluorescent probe coupled aggregation-induced emission (AIE) and excited-state intramolecular proton transfer (ESIPT) effect for the detection of GGT. Thanks to conjugated glutamate acid, this probe could be dispersed in aqueous solution and showed barely any fluorescence emission. Through a GGT-mediated enzymatic reaction, the aggregation state of the probe in aqueous solution was changed and an intramolecular hydrogen bond was formed, resulting in an enhanced fluorescence emission. An excellent linear relationship was observed and the concentration of GGT measured was in the range of 10-90 U L-1 with a limit of detection calculated at 2.9 U L-1. Its feasibility has been confirmed by detecting GGT in HepG2 cells with high specificity and long-term sustainability, satisfying clinical need. Moreover, this nanoprobe showed great potential for precise medicine guided surgery by realizing fluorescence imaging in human liver tumour tissue and distinguishing it from normal tissue. Thus, we supposed that our AIE coupled ESIPT fluorescent nanoprobe has great potential in the early detection of HCC, the selective fluorescence imaging of GGT positive cells during surgery and application in precision medicine.

Identification of hub genes with diagnostic values in pancreatic cancer by bioinformatics analyses and supervised learning methods.

BACKGROUND: Pancreatic cancer is one of the most lethal tumors with poor prognosis, and lacks of effective biomarkers in diagnosis and treatment. The aim of this investigation was to identify hub genes in pancreatic cancer, which would serve as potential biomarkers for cancer diagnosis and therapy in the future. METHODS: Combination of two expression profiles of GSE16515 and GSE22780 from Gene Expression Omnibus (GEO) database was served as training set. Differentially expressed genes (DEGs) with top 25% variance followed by protein-protein interaction (PPI) network were performed to find candidate genes. Then, hub genes were further screened by survival and cox analyses in The Cancer Genome Atlas (TCGA) database. Finally, hub genes were validated in GSE15471 dataset from GEO by supervised learning methods k-nearest neighbor (kNN) and random forest algorithms. RESULTS: After quality control and batch effect elimination of training set, 181 DEGs bearing top 25% variance were identified as candidate genes. Then, two hub genes, MMP7 and ITGA2, correlating with diagnosis and prognosis of pancreatic cancer were screened as hub genes according to above-mentioned bioinformatics methods. Finally, hub genes were demonstrated to successfully differ tumor samples from normal tissues with predictive accuracies reached to 93.59 and 81.31% by using kNN and random forest algorithms, respectively. CONCLUSIONS: All the hub genes were associated with the regulation of tumor microenvironment, which implicated in tumor proliferation, progression, migration, and metastasis. Our results provide a novel prospect for diagnosis and treatment of pancreatic cancer, which may have a further application in clinical.

Fascin1 promotes gastric cancer progression by facilitatingcell migrationand epithelial-mesenchymal transition.

BACKGROUND: Fascin1 regulates cell motility, migration and invasion. Abnormal fascin1 expression has been implicated in a variety of cancers. In this study, we measured fascin1 expression in gastric cancer tissues from 80 gastric cancer patients, and assessed the correlation of fascin1 expression with a series of clinicopathologic gastric cancer parameters.We also verified the results with 4 gastric cancer cell lines in subsequent in vitro studies. METHODS: We measured mRNA expression of fascin1 with RT-qPCR, and measured protein expressions of fascin1 and EMT markers with western blot in gastric cancer cells. Additionally, we used RT-qPCR to assess fascin1 expression in gastric cancer tissues and adjacent normal tissue.Transwell assay was used for cell migration. Xenograft was established by subcutaneous injection of Fascin1 knockdown gastric cancer cells. RESULTS: Fascin1 expression was greater in gastric cancer cell lines compared to normal cells and the expression increased with decreasing cell differentiation. In addition, fascin1 expression was significantly different between gastric cancer tissue and adjacent normal tissue. Fascin1 positivity was higher in poorly differentiated carcinomas compared to moderately and highly differentiated carcinomas. The fascin1 expression was associated with differentiation, tumor size, lymph node status, distant metastasis and TNM stage, but not patient age and sex. Fascin1 expression in gastric carcinoma cells and tissues is significantly higher than in normal gastric mucosa and adjacent tissue to cancerous tissues, and it increases as cancer cell differentiation decreases. Furthermore, fascin1 expression regulates gastric cancer cell migration, expressions of EMT markers and transcription factors as well as xenograft tumor formation. CONCLUSION: Fascin1 is related with clinicopathologic parameters of gastric cancer and overexpressed both in gastric cell lines and gastric tumor tissue. Knockdown of Fascin1 inhibited gastric cancer cell migration and EMT markers expression.

Effects and mechanisms of action of SARI on androgen-independent prostate cancer (DU145) cells.

This study aimed to characterize the role and mechanisms of action of suppressor of AP-1, regulated by IFN (SARI) in androgen-independent prostate cancer cells using the DU145 cell line. Prostate cancer cell lines were transfected to permit both the overexpression and inhibition of SARI. MTT assays and Transwell assays were performed to detect the effects of SARI overexpression and inhibition on the proliferation activity, invasiveness, and metastatic ability of DU145 cells. Expression of vascular endothelial growth factor (VEGF) and tyrosine-phosphorylated signal transducer and activator of transcription 3 (p-STAT3) was monitored in the experimental groups using a qPCR assay and western blot analysis. Additionally, DU145 cells were separately treated with 5, 50, and 100 µmol/L AG490 for 48 h and SARI expression was detected using the qPCR assay and western blot analysis. We also monitored the effects of AG490 treatment (100 µmol/L for 48 h) on both the SARI-SiRNA DU145 cells and empty vector DU145 (DU145-V) cells using the MTT assay and a Transwell migration assay. SARI overexpression and SARI-SiRNA DU145 prostate cancer cell lines were successfully established. The proliferation activity and the invasion and migration abilities of DU145-SARI cells were significantly lower compared with the DU145-V group (P < 0.05). Conversely, the proliferation activity and the invasion and migration abilities of SARI-SiRNA cells were significantly higher compared with the DU145-V group (P < 0.05). VEGF and p-STAT3 expression levels were lower in the SARI overexpression group compared with the DU145-V group and the control group (P < 0.05). In contrast, VEGF and p-STAT3 expression levels were higher in the SARI-SiRNA group compared with both the DU145-V group and the control group (P < 0.05). In comparison with the control group, SARI expression levels were higher in DU145 cells treated with 50 and 100 µmol/L AG490. Upon treatment with 100 µmol/L AG490 for 48 h, the proliferation activity and invasiveness and migration abilities of SARI-SiRNA cells were significantly higher compared with the DU145-V group (P < 0.05). SARI significantly affects the proliferation, invasion, and metastasis of DU145 cells. It is possible that SARI inhibits the proliferation, invasion, and migration of androgen-independent prostate cancer cells by regulating downstream genes through the SARI/STAT3/VEGF pathways.

Study of breakthrough cancer pain in an animal model induced by endothelin-1.

Cancer patients with bone metastases often suffer breakthrough pain. However, little progress has been made in the treatment of breakthrough pain and its associated mechanism(s) in the patient with cancer due to lacking of resembling and predictive animal models. We previously have demonstrated that endothelin-1 plays an important role in breakthrough cancer pain. In the present study, we have established an animal model of breakthrough cancer pain induced by endothelin-1. The animal model of breakthrough cancer pain is strictly followed the definition and meets the characteristics of breakthrough pain. The model is reliable, reproducible and easy to be produced. To our knowledge, this is the first report for establishing such an animal model. In addition, we also found that a selective ETA receptor antagonist BQ-123 could reverse endothelin-1 induced breakthrough pain. We further studied the characteristics of pain behaviors such as hind limb use score and voluntary wheel running as well as the electrophysiology of sciatic nerve fibers with the model. The murine model shows high resemblance compared to the breakthrough cancer pain in the patients with cancer clinically. It provides a platform for further study of the pathogenesis of breakthrough cancer pain and targeted intervention.

Expression and mechanism of action of the SARI tumor suppressor in prostate cancer.

The objective of this study was to assess the expression of SARI (Suppressor of AP-1, Regulated by IFN) in prostate cancer (Pca) and explore the effects and possible mechanism of action of SARI in the occurrence and development of Pca. In the current study, the expression of SARI was detected using PCR in 40 patients with prostate cancer, 20 patients with prostatic hyperplasia, and prostate cancer cells (LNCaP. and DU145). In addition, the effects of the pro-inflammatory cytokine interferon (IFN)-ß on the expression of SARI in DU145 prostate cancer cells and the possible potential signaling pathways activated by SARI were detected using RT-PCR. The expression of SARI protein was downregulated from 0.6957 ± 0.0104 to 0.1597 ± 0.0032 in prostate cancer cells compared with normal prostate tissues and cells. In addition, SARI gene expression increased from 0.0794 ± 0.0133 to 0.1232 ± 0.0162 significantly in a concentration- and time-dependent manner in DU145 cells treated with IFN-ß (P<0.05). Finally, MTT assays demonstrated that DU145 cells growth slowed down, flow cytometry demonstrated that IFN-ß induced apoptosis increased from 0.0343 ± 0.0039 to 0.0612 + 0.0025 in DU145 prostate cancer cells. In conclusion, the results of the current study suggest that SARI might play an important role in the occurrence and development of prostate cancer. In addition, IFN-ß might inhibit the growth of prostate cancer and promote cellular apoptosis by inducing the expression of SARI.