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1.
Breast Cancer Res Treat ; 167(2): 515, 2018 01.
Article in English | MEDLINE | ID: mdl-29127589

ABSTRACT

In the original publication of the article, under the heading Discussion, 1st paragraph, the sentence that reads as, "Nonetheless, our observed improvements of over 50% for OS and over 30% for DFS (HRs: 0.45 and 0.66, respectively) are consistent with results from other available studies" should read as "Nonetheless, our observed improvements of over 50% for OS and DFS (HRs: 0.45 and 0.66, respectively) are consistent with results from other available studies." Under the heading Discussion, 3rd paragraph, the sentence that reads as "We cannot discount the possibility …such as education, income and access to care [1, 7]" should read as "We cannot discount the possibility…such as education, income and access to care, which ultimately have on survival outcomes [1, 7]."

2.
Breast Cancer Res Treat ; 167(2): 505-514, 2018 01.
Article in English | MEDLINE | ID: mdl-29063309

ABSTRACT

PURPOSE: The Exercise for Health trials were randomised, controlled trials designed to evaluate an 8-month pragmatic exercise intervention, commencing 6 weeks post-surgery for women with newly diagnosed breast cancer residing in urban or rural/regional Australia. For these exploratory analyses, the primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. METHODS: Consenting urban- (n = 194) and rural/regional-residing women (n = 143) were randomised to exercise (intervention delivered face-to-face or by telephone) or usual care. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for survival outcomes (exercise group, n = 207, 65% urban women; usual care group, n = 130, 46% urban women). RESULTS: After a median follow-up of 8.3 years, there were 11 (5.3%) deaths in the exercise group compared with 15 (11.5%) deaths in the usual care group (OS HR for the exercise group: 0.45, 95% CI 0.20-0.96; p = 0.04). DFS events for the exercise versus usual care group were 25 (12.1%) and 23 (17.7%), respectively (HR: 0.66, 95% CI 0.38-1.17; p = 0.16). HRs for OS favoured exercise irrespective of age, body mass index, stage of disease, intervention compliance, and physical activity levels at 12 months post-diagnosis, although were stronger (p < 0.05) for younger women, women with stage II + disease, women with 1 + comorbidity at time of diagnosis, higher intervention compliance and for those who met national physical activity guidelines at 12 months post-diagnosis. CONCLUSION: An exercise intervention delivered during and beyond treatment for breast cancer, and that was designed to cater for all women irrespective of place of residence and access to health services, has clear potential to benefit survival. Trial numbers: ACT RN: 012606000233527; ACT RN: 12609000809235.


Subject(s)
Breast Neoplasms/therapy , Exercise Therapy , Exercise/physiology , Adult , Australia/epidemiology , Breast Neoplasms/epidemiology , Breast Neoplasms/physiopathology , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Middle Aged , Neoplasm Staging , Quality of Life
3.
Breast ; 22(6): 1220-5, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24128741

ABSTRACT

PURPOSE: To investigate person, cancer and treatment determinants of immediate breast reconstruction (IBR) in Australia. METHODS: Bi-variable and multi-variable analyses of the Quality Audit database. RESULTS: Of 12,707 invasive cancers treated by mastectomy circa 1998-2010, 8% had IBR. This proportion increased over time and reduced from 29% in women below 30 years to approximately 1% in those aged 70 years or more. Multiple regression indicated that other IBR predictors included: high socio-economic status; private health insurance; being asymptomatic; a metropolitan rather than inner regional treatment centre; higher surgeon case load; small tumour size; negative nodal status, positive progesterone receptor status; more cancer foci; multiple affected breast quadrants; synchronous bilateral cancer; not having neo-adjuvant chemotherapy, adjuvant radiotherapy or adjuvant hormone therapy; and receiving ovarian ablation. CONCLUSIONS: Variations in access to specialty services and other possible causes of variations in IBR rates need further investigation.


Subject(s)
Breast Neoplasms/pathology , Breast Neoplasms/surgery , Mammaplasty/statistics & numerical data , Neoplasms, Multiple Primary/surgery , Adult , Age Factors , Aged , Aged, 80 and over , Asymptomatic Diseases , Australia , Breast Neoplasms/therapy , Female , Humans , Insurance, Health , Mastectomy , Middle Aged , Receptors, Progesterone , Social Class , Time Factors , Tumor Burden , Urban Health Services
5.
Br J Cancer ; 97(9): 1251-9, 2007 Nov 05.
Article in English | MEDLINE | ID: mdl-17923873

ABSTRACT

The generation of antitumour immunity depends on the nature of dendritic cell (DC)-tumour interactions. These have been studied mostly by using in vitro-derived DC which may not reflect the natural biology of DC in vivo. In breast cancer, only one report has compared blood DC at different stages and no longitudinal evaluation has been performed. Here we conducted three cross-sectional and one one-year longitudinal assessments of blood DC in patients with early (stage I/II, n=137) and advanced (stage IV, n=36) disease compared to healthy controls (n=66). Patients with advanced disease exhibit markedly reduced blood DC counts at diagnosis. Patients with early disease show minimally reduced counts at diagnosis but a prolonged period (1 year) of marked DC suppression after tumour resection. While differing in frequency, DC from both patients with early and advanced disease exhibit reduced expression of CD86 and HLA-DR and decreased immunostimulatory capacities. Finally, by comparing a range of clinically available maturation stimuli, we demonstrate that conditioning with soluble CD40L induces the highest level of maturation and improved T-cell priming. We conclude that although circulating DC are compromised by loco-regional and systemic breast cancer, they respond vigorously to ex vivo conditioning, thus enhancing their immunostimulatory capacity and potential for immunotherapy.


Subject(s)
Adenocarcinoma/blood , Apoptosis , Breast Neoplasms/blood , Dendritic Cells/immunology , Neoplasm Recurrence, Local/blood , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Blood Cells , Breast Neoplasms/pathology , CD40 Ligand/physiology , Case-Control Studies , Cell Count , Cross-Sectional Studies , Culture Media, Conditioned , Female , Flow Cytometry , Humans , Immunophenotyping , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Phenotype
6.
Diabet Med ; 22(1): 74-80, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15606695

ABSTRACT

AIMS: Recently, a novel human G protein-coupled receptor 40 (GPR40), which is predominantly expressed in pancreatic islets, was shown to mediate an amplifying effect of long-chain fatty acids on glucose-induced insulin secretion. The present aim was to examine the coding region of GPR40 for variation and to assess whether identified variants confer an increased risk of Type 2 diabetes or altered insulin release. METHODS: Mutation analysis was performed in 43 patients with Type 2 diabetes, 18 normal glucose-tolerant subjects, and 3 maturity-onset of diabetes in the young (MODY) X patients using direct sequencing. Genotyping was performed using polymerase chain reaction (PCR)-generated primer extension products analysis by high throughput chip-based mass spectrometry (MALDI-TOF). The potential impact of GPR40 mutations on [(3)H]-myo-inositol turnover was estimated in COS-7 cells after stimulation with various concentrations of 5,8,11-eicosatriynoic acid. RESULTS: Two nucleotide substitutions, an Arg211His polymorphism and a rare Asp175Asn mutation, were identified. Both variants showed EC(50) values similar to the wild type. However, the maximal efficacy of the rare Asp175Asn was 39% lower compared with the wild type (P = 0.01). The Arg211His polymorphism had a similar allele frequency among 1384 Type 2 diabetic patients [MAF%; 23.4 (95% CI: 21.8-25.0)] and 4424 middle-aged glucose-tolerant subjects [24.1% (23.2-25.0)]. A genotype-quantitative trait study of 5597 non-diabetic, middle-aged subjects from the Inter99 cohort showed no significant differences in oral glucose tolerance test (OGTT)-derived estimates of insulin release between carriers of various GPR40 genotypes. CONCLUSIONS: Variations in the coding region of GPR40 do not appear to be associated with Type 2 diabetes or insulin release alterations.


Subject(s)
Diabetes Mellitus, Type 2/genetics , Insulin/metabolism , Mutation/genetics , Polymorphism, Single Nucleotide/genetics , Receptors, G-Protein-Coupled/genetics , Case-Control Studies , Diabetes Mellitus, Type 2/metabolism , Humans , Middle Aged , Pedigree
7.
Cytotherapy ; 6(2): 154-63, 2004.
Article in English | MEDLINE | ID: mdl-15203992

ABSTRACT

The long-held belief that breast cancer is a weakly immunogenic tumor and a poor candidate for immunotherapy should be reappraised. There is ample evidence for the existence of an immune response, which is, however, attenuated by multiple inhibitory factors. Many tumor-associated antigens (TAA) have been identified in breast cancer, some of which appear to play a critical role in tumorigenesis and may be attractive targets for immunotherapy. There is evidence for DC recruitment and activation within breast cancers, and the presence of intratumoral activated DCs impacts favorably upon survival. Furthermore, there is a striking paucity of activated DCs within the primary draining or sentinel lymph nodes of breast cancers. Tumor infiltrating lymphocytes (TIL) are often documented, however, their function is impaired by inhibitory cytokines, increased regulatory T lymphocyte activity, tumor cell MHC molecule alterations, and aberrant Fas ligand expression, amongst others. DCs are recognized as one of the critical interfaces between a cancer and the immune system, and have emerged as a promising platform for cancer vaccination via ex vivo immunomodulation. Clinical evaluation of DC vaccination in breast cancer is still relatively limited, although evolving. This article details evidence for the immune response in breast cancer and its many failings, and reviews the clinical trials and significant preclinical data which, taken together, validate the concept of DC vaccination in breast cancer.


Subject(s)
Breast Neoplasms/immunology , Breast Neoplasms/therapy , Cancer Vaccines/therapeutic use , Dendritic Cells/immunology , Dendritic Cells/transplantation , Immunotherapy, Adoptive , Adenoviridae/genetics , Adenoviridae/immunology , Animals , Antigens, Neoplasm/immunology , Cancer Vaccines/immunology , DNA, Neoplasm/genetics , DNA, Neoplasm/immunology , Female , Humans , Immunologic Memory , Mice , Peptides/immunology , Proteins/immunology , RNA, Neoplasm/genetics , RNA, Neoplasm/immunology , T-Lymphocytes/immunology
8.
J Immunol Methods ; 284(1-2): 73-87, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14736418

ABSTRACT

Dendritic cells (DC) from distinct DC subsets are essential contributors to normal human immune responses. Despite this, reliable assays that enable DC to be counted precisely have been slow to evolve. We have now developed a new single-platform flow cytometric assay based on TruCOUNT beads and the whole blood "Lyse/No-Wash" protocol that allows precise counting of the CD14(-) blood DC subsets: CD11c(+)CD16(-) DC, CD11c(+)CD16(+) DC, CD123(hi) DC, CD1c(+) DC and BDCA-3(+) DC. This assay requires 50 microl of whole blood; does not rely on a hematology blood analyser for the absolute DC counts; allows DC counting in EDTA samples 24 h after collection; and is suitable for cord blood and peripheral blood. The data is highly reproducible with intra-assay and inter-assay coefficients of variation less than 3% and 11%, respectively. This assay does not produce the DC-T lymphocyte conjugates that result in DC counting abnormalities in conventional gradient-density separation procedures. Using the TruCOUNT assay, we established that absolute blood DC counts reduce with age in healthy individuals. In preliminary studies, we found a significantly lower absolute blood CD11c(+)CD16(+) DC count in stage III/IV versus stage I/II breast carcinoma patients and a lower absolute blood CD123(hi) DC count in multiple myeloma patients, compared to age-matched controls. These data indicate that scientific progress in DC counting technology will lead to the global standardization of DC counting and allow clinically meaningful data to be obtained.


Subject(s)
Dendritic Cells/immunology , Flow Cytometry/methods , Adult , Aged , Blood Cell Count/methods , Breast Neoplasms/blood , Centrifugation, Density Gradient , Dendritic Cells/cytology , Female , Humans , Immunophenotyping , Male , Microspheres , Middle Aged , Multiple Myeloma/blood , Reproducibility of Results
9.
Blood ; 98(1): 140-5, 2001 Jul 01.
Article in English | MEDLINE | ID: mdl-11418473

ABSTRACT

Dendritic cells (DCs) are specialized antigen-presenting cells that have the unique ability to initiate a primary immune response. The effect of physiologic stress on circulating blood DCs has thus far not been studied. In this study, we applied a recently developed method of counting blood DCs to test the hypothesis that significant stress to the body such as surgery and exercise might induce measurable changes in the DC numbers, subsets, phenotype, and function. Twenty-six patients scheduled for elective laparoscopic cholecystectomy, 4 for elective hysterectomy, 56 controls, and 5 volunteers who underwent a stress exercise test were enrolled in the study. Absolute DC counts increased acutely (71.7% +/- 11% [SEM], P =.0001) in response to the stress of surgery and dropped below preoperative levels (-25% +/- 14% [SEM], P =.05) on days 2-3. The perioperative DC subset balance remained constant. Interestingly, DC counts changed independently of monocyte counts. Exercise also induced a rise in DC counts but coincidentally with monocyte counts. Surprisingly, no phenotypic or functional activation of DCs was seen in either stress situations in vivo. DCs are rapidly mobilized into the circulation in response to surgical and exercise stress, which may serve to prepare the host's immune defenses against trauma. The independent regulation of the DC and monocyte counts reinforces the distinction between these 2 cell populations.


Subject(s)
Dendritic Cells/cytology , Monocytes/cytology , Stress, Physiological/blood , Adult , Aged , Blood Cell Count , Blood Circulation , Case-Control Studies , Elective Surgical Procedures/adverse effects , Elective Surgical Procedures/psychology , Exercise/physiology , Female , Humans , Hydrocortisone/blood , Male , Middle Aged
10.
Blood ; 97(6): 1712-20, 2001 Mar 15.
Article in English | MEDLINE | ID: mdl-11238112

ABSTRACT

Endocytosis and recycling of coagulation factor VIIa (VIIa) bound to tissue factor (TF) was investigated in baby hamster kidney (BHK) cells stably transfected with TF or TF derivatives. Cell surface expression of TF on BHK cells was required for VIIa internalization and degradation. Approximately 50% of cell surface-bound VIIa was internalized in one hour, and a majority of the internalized VIIa was degraded soon thereafter. Similar rates of VIIa internalization and degradation were obtained with BHK cells transfected with a cytoplasmic domain-deleted TF variant or with a substitution of serine for cysteine at amino acid residue 245 (C245S). Endocytosis of VIIa bound to TF was an active process. Acidification of the cytosol, known to inhibit the internalization via clathrin-coated pits, did not affect the internalization of VIIa. Furthermore, receptor-associated protein, known to block binding of all established ligands to members of the low-density lipoprotein receptor family, was without an effect on the internalization of VIIa. Addition of tissue factor pathway inhibitor/factor Xa complex did not affect the internalization rate significantly. A substantial portion (20% to 25%) of internalized VIIa was recycled back to the cell surface as an intact and functional protein. Although the recycled VIIa constitutes to only approximately 10% of available cell surface TF/VIIa sites, it accounts for 65% of the maximal activation of factor X by the cell surface TF/VIIa. In summary, the present data provide evidence that TF-dependent internalization of VIIa in kidney cells occurs through a clathrin-independent mechanism and does not require the cytoplasmic domain of TF.


Subject(s)
Endocytosis/drug effects , Factor VIIa/physiology , Thromboplastin/pharmacology , Animals , Cell Line , Clathrin , Cricetinae , Endocytosis/physiology , Factor VIIa/drug effects , Factor VIIa/pharmacokinetics , Factor Xa/pharmacology , Iodine Radioisotopes , Lipoproteins/pharmacology , Microscopy, Fluorescence , Protein Binding , Thromboplastin/genetics , Thromboplastin/metabolism , Transfection
11.
J Invest Dermatol ; 116(3): 353-8, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11231307

ABSTRACT

In this study we have used in situ hybridization with radiolabeled antisense RNA probes to examine the expression of mRNA for urokinase-type plasminogen activator and its receptor in histologic samples of squamous cell (n = 7) and basal cell (n = 7) carcinomas of the skin. Messenger RNA for both urokinase-type plasminogen activator and its receptor were expressed in all of the squamous cell carcinomas, but could not be detected in the basal cell carcinomas. In all of the seven squamous cell carcinomas a signal for urokinase-type plasminogen activator receptor mRNA was detected focally in well-differentiated cancer cells surrounding keratinized pearls, and in four specimens urokinase-type plasminogen activator receptor mRNA was in addition expressed by cancer cells at the edge of invasively growing strands of tumor. Urokinase-type plasminogen activator mRNA expression was found in virtually all the cancer cells of the squamous cell carcinomas, and importantly we found, by hybridizations for urokinase-type plasminogen activator and its receptor mRNA on adjacent sections of squamous cell carcinomas, that it was exactly the invading cancer cells that simultaneously expressed both these components required for plasmin-mediated proteolysis at the cell surface. We have previously shown that both urokinase-type plasminogen activator and its receptor mRNA are expressed by the leading-edge keratinocytes in regenerating epidermis during mouse skin wound healing, and that wound healing is impaired in mice made deficient in plasminogen by targeted gene disruption. We propose that there are similarities between the mechanisms of generation and regulation of extracellular proteolysis during skin re-epithelialization and squamous cell carcinoma invasion. The ability of the squamous carcinoma cells to mimic the "invasive" phenotype of re-epithelializing keratinocytes may be one of the factors that make squamous cell carcinomas more aggressive tumors than basal cell carcinomas.


Subject(s)
Carcinoma, Squamous Cell/metabolism , RNA, Messenger/metabolism , Skin Neoplasms/metabolism , Urokinase-Type Plasminogen Activator/genetics , Carcinoma, Basal Cell/metabolism , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/pathology , Humans , Neoplasm Invasiveness , Receptors, Cell Surface/genetics , Receptors, Urokinase Plasminogen Activator , Skin Neoplasms/pathology
12.
Am J Transplant ; 1(1): 29-37, 2001 May.
Article in English | MEDLINE | ID: mdl-12095034

ABSTRACT

Vascular changes are considered the major histopathological indicator of chronic allograft dysfunction. These changes are characterized by intimal thickening caused by accumulation of primarily smooth muscle cells. Contributing factors may be of both immunological and nonimmunological origin. Cold ischemia has been shown to trigger intimal proliferation in the absence of alloantigen in an isogenic rat aortic transplant model. We have used this model to investigate the impact of inhibition of tissue factor (TF) signalling on the progression of intimal thickening. Group 1 was treated with recombinant FVIIa inhibited in its active site (rFVIIai), and group 2 served as untreated controls. At 8 weeks the intimal area was measured with image analysis. Medial areas and the proportion of medial necrosis were determined. Animals treated with rFVIIai showed significantly less intimal thickening compared with controls: median 0.147 vs. 0.256 mm2, respectively (p = 0.008). A positive correlation between intimal hyperplasia and medial necrosis (r(s) = 0.79, p = 0.01), as well as adventitial inflammation (r(s) = 0.83, p = 0.009), was found. TF mRNA was not detected in the neointima at 8 weeks, as determined by in situ hybridization. We conclude that active site inhibited FVIIa (rFVIIai) given prior to and directly after implantation of aortic transplants significantly reduces intimal hyperplasia caused by nonimmunological factors in this model.


Subject(s)
Aorta, Abdominal/transplantation , Signal Transduction/physiology , Thromboplastin/physiology , Transplantation, Isogeneic/pathology , Animals , Aorta, Abdominal/pathology , Factor VIIa/pharmacology , Necrosis , Rats , Recombinant Proteins/pharmacology , Thromboplastin/antagonists & inhibitors , Thromboplastin/genetics , Transplantation, Isogeneic/immunology , Tunica Intima/pathology
13.
Am J Pathol ; 156(6): 2077-89, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10854229

ABSTRACT

Angiopoietins are ligands for the endothelial cell tyrosine kinase receptor Tie-2. Ang-1, the major physiological activator of Tie-2, promotes blood vessel maturation and stability. Ang-2 counteracts this effect by competitively inhibiting the binding of Ang-1 to Tie-2. Using a combined RNase protection/semiquantitative reverse transcriptase-polymerase chain reaction approach, we demonstrate that hypoxia up-regulates Ang-2 mRNA levels by up to 3.3-fold in two human endothelial cell lines. In bovine microvascular endothelial (BME) cells, the flavoprotein oxidoreductase inhibitor diphenylene iodonium (DPI) and the related compound iodonium diphenyl mimic induction of Ang-2 but not vascular endothelial growth factor (VEGF) by hypoxia; in combination with hypoxia, DPI further increases Ang-2 expression but has no effect on the induction of VEGF by hypoxia. Neither Ang-2 or VEGF was increased by cyanide or rotenone, suggesting that failure in mitochondrial electron transport is not involved in the oxygen-sensing system that controls their expression. In ischemic rat dorsal skin flaps or in the brain of rats maintained for 12 hours under conditions of hypoxia, Ang-2 mRNA was up-regulated 7.5- or 17.6- fold, respectively. VEGF was concomitantly increased, whereas expression of Ang-1, Tie-2, and the related receptor Tie-1 was unaltered. In situ hybridization localized Ang-2 mRNA to endothelial cells in hypoxic skin. These findings 1) show that up-regulation of Ang-2 by hypoxia occurs widely in endothelial cells in vitro and in vivo; 2) suggest that induction of Ang-2, but not VEGF, by hypoxia in BME cells is controlled by a flavoprotein oxidoreductase that is sensitive to iodonium compounds; and 3) point to Ang-2 and VEGF as independently regulated and selective effectors of hypoxia-induced vascular sprouting.


Subject(s)
Brain/metabolism , Hypoxia/metabolism , Ischemia/metabolism , Proteins/metabolism , Skin/metabolism , Angiopoietin-2 , Animals , Biphenyl Compounds/pharmacology , Cattle , Cell Line , Endothelial Growth Factors/metabolism , Humans , Lymphokines/metabolism , Male , Onium Compounds/pharmacology , RNA, Messenger/metabolism , Rats , Rats, Sprague-Dawley , Rats, Wistar , Skin/blood supply , Up-Regulation , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors
14.
Placenta ; 21(2-3): 170-6, 2000.
Article in English | MEDLINE | ID: mdl-10736239

ABSTRACT

An intimately regulated cell surface activation of matrix metalloproteinases (MMPs) is believed to be of critical importance for the control of trophoblast invasion. A histological investigation of the expression and localization of three different MMPs, the membrane-type matrix metalloproteinases 1 and 2 (MT1-MMP, MT2-MMP) and matrix metalloproteinase 2 (MMP-2/gelatinase A) was performed by in situ hybridization on consecutive sections from human placentae of first trimester pregnancies. Cytokeratin immunostaining identified trophoblast cells. Both normal and tubal implantation sites were studied. We observed a high degree of coexpression of MT2-MMP, MT1-MMP and MMP-2 mRNAs in single extravillous cytotrophoblasts that had invaded the endometrium and tubal wall. Furthermore, mRNAs for all three genes were also seen in cytotrophoblasts of cell islands. In contrast to this coexpression pattern, MT2-MMP expression was absent from cell columns and decidual cells, in which signals for MT1-MMP and MMP-2 mRNAs were seen. The present data on the cellular expression of MT2-MMP mRNA in placenta extend our knowledge of the proteolytic events that take place during early pregnancy. The data suggest that MT2-MMP, capable of activating MMP-2 in vitro, is involved in the invasion of extravillous cytotrophoblast, possibly related to the physiological activation of MMP-2.


Subject(s)
Metalloendopeptidases/genetics , Placenta/enzymology , RNA, Messenger/genetics , Enzyme Activation , Female , Gene Expression , Humans , In Situ Hybridization , Matrix Metalloproteinase 15 , Matrix Metalloproteinase 2/genetics , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinases, Membrane-Associated , Metalloendopeptidases/metabolism , Pregnancy , Pregnancy Trimester, First , Pregnancy, Tubal/enzymology , Pregnancy, Tubal/genetics , RNA, Messenger/metabolism , Trophoblasts/enzymology
15.
APMIS ; 107(1): 120-7, 1999 Jan.
Article in English | MEDLINE | ID: mdl-10190288

ABSTRACT

Proteolytic degradation of the extracellular matrix plays a crucial role in both cancer invasion and non-neoplastic tissue remodeling processes. In human cancers the components of matrix degrading protease systems (uPA, uPAR, PAI-1 and MMPs) can be expressed by either the non-neoplastic stromal cells, the cancer cells or both. Studies of the prognostic impact of these components in human cancer and the effect of targeted gene inactivation on cancer metastasis in mice support the assumption that proteases promote cancer progression, independent of whether they are expressed by cancer cells or stromal cells. The pattern of expression of components of protease systems is usually very similar in different cases of the same type of cancer, while it varies between different types of cancer. There are intriguing similarities between the cellular expression pattern of components of protease systems seen in cancer invasion and in certain types of non-neoplastic tissue remodeling. We propose that cancer invasion can be viewed as tissue remodeling gone out of control. The stromal cell involvement in cancer invasion represents a new paradigm with important implications for cancer pathophysiology and cancer therapy.


Subject(s)
Endopeptidases/physiology , Extracellular Matrix/metabolism , Neoplasm Invasiveness , Animals , Humans , Mice , Plasminogen Activator Inhibitor 1/physiology , Receptors, Cell Surface/physiology , Receptors, Urokinase Plasminogen Activator , Stromal Cells/physiology , Wound Healing
17.
Mol Hum Reprod ; 3(8): 713-23, 1997 Aug.
Article in English | MEDLINE | ID: mdl-9294857

ABSTRACT

The spatial expression of mRNA for matrix metalloproteinase 2 (MMP-2), its putative activator, the membrane-type 1 matrix metalloproteinase (MT1-MMP), and the MMP-2 substrate type IV collagen was investigated in human placentas of both normal and tubal ectopic pregnancies and in cyclic endometrium using in-situ hybridization. Cytokeratin staining applied to adjacent sections was used to identify epithelial and trophoblast cells. In both normal and tubal pregnancies MT1-MMP, MMP-2 and type IV collagen mRNA were highly expressed and co-localized in the extravillous cytotrophoblasts of anchoring villi, in cytotrophoblasts that had penatrated into the placental bed and in cytotrophoblastic cell islands. In addition, the decidual cells of normal pregnancies in some areas co-expressed MT1-MMP and MMP-2 mRNA, with moderate signals for both components. Fibroblast-like stromal cells in tubal pregnancies were positive for MMP-2 mRNA but generally negative for MT1-MMP mRNA. The consistent co-localization of MT1-MMP with MMP-2 and type IV collagen in the same subset of cytotrophoblasts strongly suggests that all three components co-operate in the tightly regulated fetal invasion process. The co-expression of MT1-MMP and MMP-2 mRNA in some of the decidual cells indicates that these cells are also actively involved in the placentation process.


Subject(s)
Endometrium/enzymology , Gelatinases/biosynthesis , Metalloendopeptidases/biosynthesis , Placenta/enzymology , Placentation , Pregnancy, Tubal/enzymology , Transcription, Genetic , Chorionic Villi/enzymology , Chorionic Villi/pathology , Chorionic Villi/ultrastructure , Endometrium/cytology , Endometrium/pathology , Female , Gene Expression Regulation, Enzymologic , Humans , Keratins/analysis , Matrix Metalloproteinase 2 , Matrix Metalloproteinases, Membrane-Associated , Menstrual Cycle , Pregnancy , Pregnancy Trimester, First , RNA, Messenger/biosynthesis , Reference Values , Trophoblasts/cytology , Trophoblasts/pathology
18.
Lung Cancer ; 17(2-3): 197-209, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9237155

ABSTRACT

The components of the plasminogen activation system have been reported to have prognostic impact in several cancer types, e.g. breast-, colon-, gastric- and lung cancer. Most of these studies have used quantification by enzyme-linked immunosorbent assay (ELISA) on tumour tissue extracts. However, results in non-small cell lung cancer (NSCLC) studies obtained by quantitative ELISA and semiquantitative immunohistochemistry differ. If the prognostic value of the components of the plasminogen activation system is to be exploited clinically in the future, it is important to choose an easy and valid methodology. In the present study we investigated levels of plasminogen activator inhibitor type 1 (PAI-1) and urokinase plasminogen activator receptor (uPAR), as quantitated by ELISA in tumour extracts from 64 NSCLC patients (38 squamous cell carcinomas, 26 adenocarcinomas), and compared them to staining intensity as semiquantitated by immunohistochemistry for PAI-1 and uPAR on corresponding cryostat sections. A significant association (r = 0.49, P < 0.0001) was found between the PAI-1 levels measured by ELISA and semiquantitated by immunohistochemistry. No association was found for uPAR. When correlating levels of PAI-1 and uPAR determined by ELISA and immunohistochemistry, respectively, to survival status, no significant correlation was found for any of the subgroups. At present neither of the methods examined in the present study can be recommended as superior for quantitating PAI-1 and uPAR with the aim of predicting prognosis. In conclusion, a larger comparative study is needed to clarify the relationship between ELISA and immunohistochemical results, before a methodology for clinical use can be chosen in non-small cell lung cancer.


Subject(s)
Carcinoma, Non-Small-Cell Lung/chemistry , Enzyme-Linked Immunosorbent Assay , Lung Neoplasms/chemistry , Plasminogen Activator Inhibitor 1/analysis , Plasminogen Activators/analysis , Receptors, Cell Surface/analysis , Serine Proteinase Inhibitors/analysis , Adenocarcinoma/chemistry , Adenocarcinoma/mortality , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Squamous Cell/chemistry , Carcinoma, Squamous Cell/mortality , Female , Humans , Immunohistochemistry , Lung Neoplasms/mortality , Male , Middle Aged , Receptors, Urokinase Plasminogen Activator , Survival Rate
19.
Aust N Z J Surg ; 67(5): 256-9, 1997 May.
Article in English | MEDLINE | ID: mdl-9152154

ABSTRACT

BACKGROUND: To compare already used serum markers in advanced breast cancer, namely erythrocyte sedimentation rate (ESR), carcino-embryonic antigen (CEA), and polymorphic epithelial mucins (e.g. CA15-3) with a newer potential marker: parathyroid hormone related protein (PTHrP). METHODS: A study group of 33 patients of proven advanced breast cancer was compared with 11 patients with benign breast lumps who were undergoing surgery, and eight patients with humoral hypercalcaemia of malignancy of non-breast origin. ESR, CA15-3, CEA, PTHrP, parathormone (PTH), liver and renal function were measured using commercially available kits. Using given reference ranges, results were classified into normal versus abnormal, and univariate statistical comparisons were made using Fisher's exact test. For multivariate analysis, absolute serum levels were used, and multivariate logistic regression models were employed. RESULTS: By univariate analysis, only CA15-3 (P = 0.007), and CEA (P = 0.004), were significant markers of metastatic disease. By multivariate analysis the only independently significant serum marker was CA15-3 (P = 0.043). PTHrP was neither a sensitive (22%) nor specific (90.1%) serum marker when compared to CEA or CA15-3. ESR was the most sensitive single serum marker (93%). An incidental finding of elevations of serum parathormone was found in as many patients as in the study group as there were elevations of PTHrP. CONCLUSIONS: PTHrP would not have revealed any patients with metastatic disease that would not have been predicted by any existing tumour markers including CA15-3, CEA and ESR. The finding of elevated PTH in as many patients as PTHrP indicates the possible need for a study inclusive of other polypeptide hormones as markers in advanced breast cancer.


Subject(s)
Biomarkers, Tumor/blood , Breast Neoplasms/diagnosis , Neoplasm Proteins/analysis , Proteins/analysis , Adult , Aged , Aged, 80 and over , Blood Sedimentation , Bone Neoplasms/secondary , Breast Neoplasms/pathology , Carcinoembryonic Antigen/blood , Female , Humans , Hypercalcemia/blood , Lung Neoplasms/secondary , Middle Aged , Mucin-1/blood , Parathyroid Hormone/blood , Parathyroid Hormone-Related Protein , Sensitivity and Specificity
20.
Nephron ; 77(4): 461-70, 1997.
Article in English | MEDLINE | ID: mdl-9434070

ABSTRACT

Proteoglycans constitute a heterogenous group of complex macromolecules, consisting of a backbone core protein and a variable number of sulfated polysaccharide side chains covalently linked to the core. A dual function for these polyanionic glycosaminoglycans in kidney physiology has been proposed: to maintain a fixed negative charge in the glomerular filtration barrier, and to bind and sequester cytokines essential for renal development and function. With the aim of identifying proteoglycan genes expressed in kidney glomeruli, we have performed in situ hybridization for selected proteoglycan core proteins in the normal rat kidney. Syndecan-4, glypican-1 and biglycan were all expressed in normal glomeruli, whereas syndecan-1, perlecan and versican mRNAs were confined to the papillary area. Decorin mRNA was detected in interstitial cells found between tubuli and surrounding larger vessels. No signal for betaglycan mRNA could be detected. By hybridizing adjacent sections with a probe for the podocyte-specific PTPase GLEPP-1, the glomerular cells containing mRNA for syndecan-4 and glypican-1 could be identified as podocytes, whereas the cells expressing biglycan were identified as mesangial cells. These results demonstrate that seven out of the eight proteoglycans investigated are expressed in the normal kidney in detectable amounts and, importantly, that each proteoglycan gene shows a unique pattern of expression. The constitutive expression of syndecan-4, glypican-1 and biglycan in glomerular cells points to a role for these polyanionic molecules in maintaining the integrity of the glomerular filtration barrier.


Subject(s)
Kidney/metabolism , Proteoglycans/biosynthesis , Amino Acid Sequence , Animals , Immunohistochemistry , In Situ Hybridization , Kidney Glomerulus/metabolism , Male , Mice , Molecular Sequence Data , Polymerase Chain Reaction , Rats , Rats, Sprague-Dawley , Reference Values
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