Sorafenib combined with dasatinib therapy inhibits cell viability, migration, and angiogenesis synergistically in hepatocellular carcinoma.

PURPOSE: Sorafenib is a multikinase inhibitor used for treatment of advanced hepatocellular carcinoma. Sorafenib resistance may be related to Src-induced cell migration and angiogenesis, which are regulated by cancer stem cell activation and release of vascular endothelial growth factor. Dasatinib is a Src inhibitor that inhibits Src phosphorylation and suppresses Src-associated cell migration and angiogenesis. This study investigated whether combined treatment with dasatinib can overcome sorafenib resistance. METHODS: Hepatoma cell lines were used for sorafenib and/or dasatinib treatment. Cell viability, cell migration, molecular expressions, and release of vascular endothelial growth factor by hepatoma cells were evaluated. Hepatoma cell culture medium was applied on human umbilical vein endothelial cells to monitor angiogenesis promoted by the hepatoma cells. RESULTS: Sorafenib and dasatinib combined therapy suppressed cell viability of hepatoma cells synergistically. Dasatinib suppressed sorafenib-induced cell migration via inhibiting sorafenib-induced Src/FAK phosphorylation, cell-to-cell contact and cancer stem cell activation. Culture medium from Chang liver and PLC/PRF/5 cells suppressed angiogenesis of human umbilical vein endothelial cells with any treatment, whereas sorafenib-treated medium of HepG2 cells induced angiogenesis. This sorafenib-induced angiogenesis was then suppressed by dasatinib. Vascular endothelial growth factor released from hepatoma cells was also inhibited by combined treatment. CONCLUSION: Src/FAK phosphorylation and cancer stem cell activation inducing cell migration and angiogenesis may be the key factors of sorafenib resistance. Sorafenib and dasatinib combined treatment suppresses cell migration and angiogenesis by inhibiting the Src/FAK phosphorylation, cell-to-cell contact, cancer stem cell activation, and release of vascular endothelial growth factor.

The curative effects of the traditional Chinese herbal medicine "Jinchuang ointment" on excisional wounds.

BACKGROUND: "Jinchuang ointment" is a traditional Chinese herbal medicine for external incised wounds. This herbal medicine has been successfully used to treat patients with diabetic foot ulcers and pressure sores in Taiwan for several decades. We previously examined its biological activities on cell-based in vitro assay platforms. Because some patients refused to use animal-derived ingredients ointment during our clinical practice, the efficacy of plant oil-based reconstituted "Jinchuang ointment" was also investigated. METHODS: A porcine excisional wound model was established and used to evaluate its efficacy in vivo in this study. Besides, an unusual clinical case is also present. RESULTS: As judged from the wound appearance of animal studies on day 14 and the results of blood flow flux at the wound sites on day 28, "Jinchuang ointment" accelerated wound closure significantly better than the control group. CONCLUSIONS: The results from clinical treatment, histopathological evaluation, and the animal study showed that "Jinchung ointment" promotes wound healing significantly better than the control group. Also, sesame oil-reconstituted ointment can be a choice for patients who refuse to use lard-containing ointment.

Plectin deficiency in liver cancer cells promotes cell migration and sensitivity to sorafenib treatment.

Plectin involved in activation of kinases in cell signaling pathway and plays important role in cell morphology and migration. Plectin knockdown promotes cell migration by activating focal adhesion kinase and Rac1-GTPase activity in liver cells. Sorafenib is a multi-targeting tyrosine kinase inhibitor that improves patient survival on hepatocellular carcinoma. The aim of this study is to investigate the correlation between the expression of plectin and cell migration as well as the sensitivity of hepatoma cell lines exposing to sorafenib. Hepatoma cell lines PLC/PRF/5 and HepG2 were used to examine the level of plectin expression and cell migration in comparison with Chang liver cell line. In addition, sensitivity of the 3 cell lines to sorafenib treatment was also measured. Expression of plectin was lower in PLC/PRF/5 and HepG2 hepatoma cells than that of Chang liver cells whereas HepG2 and PLC/PRF/5 cells exhibit higher rate of cell migration in trans-well migration assay. Immunohistofluorecent staining on E-cadherin revealed the highest rate of collective cell migration in HepG2 cells and the lowest was found in Chang liver cells. Likewise, HepG2 cell line was most sensitive to sorafenib treatment and Chang liver cells exhibited the least sensitivity. The drug sensitivity to sorafenib treatment showed inverse correlation with the expression of plectin. We suggest that plectin deficiency and increased E-cadherin in hepatoma cells were associated with higher rates of cell motility, collective cell migration as well as higher drug sensitivity to sorafenib treatment.

Oxidative and nitrosative mediators in hepatic injury caused by whole body hyperthermia in rats.

The involvement of oxidative and nitrosative mediators in liver injury caused by heat stress remains unclear. This study aimed to elucidate the role of endothelial nitric oxide synthase (eNOS), and inducible NOS (iNOS)-derived NO and nitrotyrosine in the whole-body hyperthermia (WBH)-induced liver injury. Rats were anesthetized with intraperitoneal pentobarbital, and were exposed to a heating lamp for 60 min to raise the core temperature to 42.5 degrees C. The rats were maintained at the hyperthermic state for an additional 50 min. Blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, lactic dehydrogenase, creatine phosphokinase, amylase, lipase, nitrate/nitrite, methyl guanidine, and proinflammatory cytokines (tumor necrosis factoralpha, interleukin-1beta and interleukin-10) were measured before and 14 h after hyperthermia. Immunohistochemical staining was employed to detect the eNOS, iNOS and nitrotyrosine levels. Western blotting was used to examine the expression of heatshock protein 70 (HSP 70). Histopathological examination of the liver tissue was performed. WBH caused liver injury accompanied with significant increases in biochemical factors, nitrate/nitrite, methyl guanidine, and proinflammatory cytokines. In addition, WBH enhanced the eNOS, iNOS, nitrotyrosine and HSP 70 levels. WBH caused hepatic injury. The pathogenetic mechanism is likely mediated through the NOS-derived NO, free radical, proinflammatory cytokines and nitrotyrosine. The enhanced expression of HSP 70 may play a protective role.

Acute respiratory distress syndrome associated with hypercalcemia without parathyroid disorders.

Acute lung injury (ALI) can be induced by various causes. The occurrence of ALI associated with hypercalcemia has rarely been reported and the mechanisms are unknown. In the present study, we reported the clinical manifestation and pathological findings in patients with hypercalcemia and metastatic calcification. In addition, we addressed the possible mechanism and the preventive strategy for the acute episode of ALI due to hypercalcemic crisis. We encountered five patients with long-term malignancy of various origins. They displayed hypercalcemia and metastatic calcification in the kidney and stomach. One case with transitional cell carcinoma of the urinary bladder developed acute episode of acute respiratory distress syndrome (ARDS). The plasma calcium was elevated to above 5 mM. Simultaneously, He manifested ARDS followed by ALI. The pathological examination revealed severe alveolar edema with multiple calcification. In the other three cases, the plasma calcium level ranged from 3.1 to 4.4 mM and ARDS or ALI did not occur. One patient with esophageal squamous cell carcinoma experienced an acute hypercalcemia (plasma calcium 4.8-5.1 mM) accompanied by ARDS. Corticosteroid and calcitonin were prescribed to reduce the plasma calcium. The symptoms of ARDS also subsided and ALI did not occur. Chronic hypercalcemia results in severe metastatic calcification. The kidney and stomach are the most vulnerable organs. An increase in plasma calcium above 5 mM is a risk factor for developing ARDS and ALI. Our recent experiment in conscious rats and isolated rat's lungs supported this contention. In addition, corticosteroid and calcitonin were able to reduce the plasma calcium and to prevent the occurrence of ARDS and ALI.

Photoradiation could influence the cytoskeleton organization and inhibit the survival of human hepatoma cells in vitro.

Low-power laser therapy has become popular in clinical applications including promoting wound healing and pain relief. However, effects of this photoradiation on human hepatoma cells are rarely studied. Previously, we found 808 nm gallium aluminum arsenide (GaAlAs) continuous wave laser had an inhibitory effect on the proliferation of human hepatoma cell lines HepG2 and J-5 at the energy density of 5.85 and 11.7 J/cm(2), respectively. The aim of the present study was to evaluate the possible mechanism of action of this photoradiation on HepG2 and J-5 cells. HepG2 and J-5 cells were cultured in 24-well plates for 24 h. After photoradiation by 130 mW 808 nm GaAlAs continuous wave laser for different time intervals (0, 30, 60, 90, 120, 150, and 180 s), Western blot and immunofluorescent staining were used to examine the expression and distribution of histone and cytoskeletal proteins. The cell counts as well as histone and synemin expression of HepG2 and J-5 cells were reduced by photoradiation at the energy density of 5.85 and 11.7 J/cm(2), respectively. Furthermore, the architecture of cytoskeletons and the distribution of intermediate filament-associated proteins (plectin and synemin) were disorganized by photoradiation. Photoradiation by 808 nm GaAlAs continuous wave laser at the energy density of 5.85 and 7.8 J/cm(2) inhibited the survival of human hepatoma cell lines. The mechanism might reduce synthesis of histone and synemin. Reduced histone synthesis might further reduce the proliferation rate of these cells. Reduced synemin synthesis might result in the destruction of the cytoskeleton. Therefore, the net effects by this photoradiation were reduced cell survival.