Increased FOXM1 expression can stimulate DNA repair in normal hepatocytes in vivo but also increases nuclear foci associated with senescence.

OBJECTIVES: FOXM1 is a transcription factor that has been shown to promote cell proliferation in many tissues during early development and high cell turnover tissues in adults. In a number of tumour cell lines, enrichment of FOXM1 has been shown to reduce the DNA damage response (DDR) and induction of senescence by a range of DNA-damaging agents, suggesting a role for the protein in DNA repair. Endogenous FOXM1 is expressed at detectable levels in hepatocytes of mice up to 2 weeks of age, but not in older mice. The aim of this investigation has been to better understand the role of the protein in DDR in normal cells in vivo. MATERIALS AND METHODS: Mice with artificially prolonged elevated FOXM1 expression in hepatocytes, were exposed to alkylating diethylnitrosamine. RESULTS: FOXM1-enriched mice had dampened DDR after treatment with this alkylating agent, which was consistent with observed increase in expression of genes involved in DNA repair. Paradoxically, mice with FOXM1 expression, within weeks after exposure to the DNA-damaging agent, had increased levels of potentially senescent hepatocytes with large nuclear foci, containing 53BP1. Similarly, spontaneous accumulation of these cells seen with normal ageing in mice was increased with FOXM1 enrichment. CONCLUSION: Despite its known abilities to promote proliferation and DNA repair, and to reduce ROS, enrichment of FOXM1, as with other oncoproteins, may cause increased persistent DNA lesions and/or senescence in normal murine hepatocytes.

Foxm1 transcription factor is required for the initiation of lung tumorigenesis by oncogenic Kras(G12D.).

Lung cancer is the leading cause of deaths in cancer patients in the United States. Identification of new molecular targets is clearly needed to improve therapeutic outcomes of this devastating human disease. Activating mutations in K-Ras oncogene and increased expression of FOXM1 protein are associated with poor prognosis in patients with non-small-cell lung cancer. Transgenic expression of activated Kras(G12D) in mouse respiratory epithelium is sufficient to induce lung adenocarcinomas; however, transcriptional mechanisms regulated by K-Ras during the initiation of lung cancer remain poorly understood. Foxm1 transcription factor, a downstream target of K-Ras, stimulates cellular proliferation during embryogenesis, organ repair and tumor growth, but its role in tumor initiation is unknown. In the present study, we used transgenic mice expressing Kras(G12D) under control of Sftpc promoter to demonstrate that Foxm1 was induced in type II epithelial cells before the formation of lung tumors. Conditional deletion of Foxm1 from Kras(G12D)-expressing respiratory epithelium prevented the initiation of lung tumors in vivo. The loss of Foxm1 inhibited expression of K-Ras target genes critical for the nuclear factor-κB (NF-κB) and c-Jun N-terminal kinase (JNK) pathways, including Ikbkb, Nfkb1, Nfkb2, Rela, Jnk1, N-Myc, Pttg1 and Cdkn2a. Transgenic overexpression of activated FOXM1 mutant was sufficient to induce expression of these genes in alveolar type II cells. FOXM1 directly bound to promoter regions of Ikbkb, Nfkb2, N-Myc, Pttg1 and Cdkn2a, indicating that these genes are direct FOXM1 targets. FOXM1 is required for K-Ras-mediated lung tumorigenesis by activating genes critical for the NF-κB and JNK pathways.

Foxm1 transcription factor is required for macrophage migration during lung inflammation and tumor formation.

Macrophages have a key role in tumor-associated pulmonary inflammation that supports the proliferation of tumor cells and promotes lung tumor growth. Although increased numbers of tumor-associated macrophages are linked to poor prognosis in lung cancer patients, little is known regarding the transcriptional mechanisms controlling recruitment of macrophages during lung tumorigenesis. Forkhead Box m1 (Foxm1) transcription factor is induced in multiple cell types within tumor lesions and its increased expression is associated with poor prognosis in patients with lung adenocarcinomas. To determine the role of Foxm1 in recruitment of tumor-associated macrophages, a mouse line with macrophage-specific Foxm1 deletion was generated (macFoxm1(-/-)). Lung tumorigenesis was induced using a 3-methylcholanthrene/butylated hydroxytoluene (BHT; 3,5-di-t-butyl-4-hydroxytoluene) tumor initiation/promotion protocol. Ablation of Foxm1 in macrophages reduced the number and size of lung tumors in macFoxm1(-/-) mice. Decreased tumorigenesis was associated with diminished proliferation of tumor cells and decreased recruitment of macrophages during the early stages of tumor formation. The expression levels of the pro-inflammatory genes iNOS, Cox-2, interleukin-1b (IL-1b) and IL-6, as well as the migration-related genes macrophage inflammatory protein-1 (MIP-1α), MIP-2 and MMP-12, were decreased in macrophages isolated from macFoxm1(-/-) mice. Migration of Foxm1-deficient macrophages was reduced in vitro. The chemokine receptors responsible for monocyte recruitment to the lung, CX(3)CR1 and CXCR4, were decreased in Foxm1-deficient monocytes. In co-transfection experiments, Foxm1 directly bound to and transcriptionally activated the CX(3)CR1 promoter. Adoptive transfer of wild-type monocytes to macFoxm1(-/-) mice restored BHT-induced pulmonary inflammation to the levels observed in control mice. Expression of Foxm1 in macrophages is required for pulmonary inflammation, recruitment of macrophages into tumor sites and lung tumor growth.

Transgenic expression of the forkhead box M1 transcription factor induces formation of lung tumors.

The forkhead box m1 (Foxm1 or Foxm1b) protein (previously called HFH-11B, Trident, Win or MPP2) is abundantly expressed in human non-small cell lung cancers where it transcriptionally induces expression of genes essential for proliferation of tumor cells. In this study, we used Rosa26-Foxm1 transgenic mice, in which the Rosa26 promoter drives ubiquitous expression of Foxm1 transgene, to identify new signaling pathways regulated by Foxm1. Lung tumors were induced in Rosa26-Foxm1 mice using the 3-methylcholanthrene (MCA)/butylated hydroxytoluene (BHT) lung tumor initiation/promotion protocol. Tumors from MCA/BHT-treated Rosa26-Foxm1 mice displayed a significant increase in the number, size and DNA replication compared to wild-type mice. Elevated tumor formation in Rosa26-Foxm1 transgenic lungs was associated with persistent pulmonary inflammation, macrophage infiltration and increased expression of cyclooxygenase-2 (Cox-2), Cdc25C phosphatase, cyclin E2, chemokine ligands CXCL5, CXCL1 and CCL3, cathepsins and matrix metalloprotease-12. Cell culture experiments with A549 human lung adenocarcinoma cells demonstrated that depletion of Foxm1 by either short interfering RNA transfection or treatment with Foxm1-inhibiting ARF 26-44 peptide significantly reduced Cox-2 expression. In co-transfection experiments, Foxm1 protein-induced Cox-2 promoter activity and directly bound to the -2566/-2580 bp region of human Cox-2 promoter.

Defects in pulmonary vasculature and perinatal lung hemorrhage in mice heterozygous null for the Forkhead Box f1 transcription factor.

Decreased pulmonary expression of Forkhead Box f1 (Foxf1) transcription factor was associated with lethal alveolar hemorrhage in 55% of the Foxf1 +/- newborn mice. The severity of the pulmonary abnormalities correlates with the levels of Foxf1 mRNA. Defects in alveolarization and vasculogenesis were observed in subsets of the Foxf1 +/- mice with relatively low levels of expression from the normal Foxf1 allele. Lung hemorrhage was coincident with disruption of the mesenchymal-epithelial cell interfaces in the alveolar and bronchiolar regions of the lung parenchyma and was associated with increased apoptosis and reduced surfactant protein B (SP-B) expression. Finally, the lung defect associated with the Foxf1 +/- mutation was accompanied by reduced expression of vascular endothelial growth factor (VEGF), the VEGF receptor 2 (Flk-1), bone morphogenetic protein 4 (Bmp-4), and the transcription factors of the Brachyury T-Box family (Tbx2-Tbx5) and Lung Kruppel-like Factor. Reduction in the level of Foxf1 caused neonatal pulmonary hemorrhage and abnormalities in alveologenesis, implicating this transcription factor in the regulation of mesenchyme-epithelial interaction critical for lung morphogenesis.

Transcription factors in mouse lung development and function.

Development of the mouse lung initiates on day 9.5 postcoitum from the laryngotracheal groove and involves mesenchymal-epithelial interactions, in particular, those between the splanchnic mesoderm and epithelial cells (derived from foregut endoderm) that induce cellular proliferation, migration, and differentiation, resulting in branching morphogenesis. This developmental process mediates formation of the pulmonary bronchiole tree and integrates a terminal alveolar region with an extensive endothelial capillary bed, which facilitates efficient gas exchange with the circulatory system. The major function of the mesenchymal-epithelial signaling is to potentiate the activity or expression of cell type-specific transcription factors in the developing lung, which, in turn, cooperatively bind to distinct promoter regions and activate target gene expression. In this review, we focus on the role of transcription factors in lung morphogenesis and the maintenance of differentiated gene expression. These lung transcription factors include forkhead box A2 [also known as hepatocyte nuclear factor (HNF)-3beta], HNF-3/forkhead homolog (HFH)-8 [also known as FoxF1 or forkhead-related activator-1], HNF-3/forkhead homolog-4 (also known as FoxJ1), thyroid transcription factor-1 (Nkx2.1), and homeodomain box A5 transcription factors, the zinc finger Gli (mouse homologs of the Drosophila cubitus interruptus) and GATA transcription factors, and the basic helix-loop-helix Pod1 transcription factor. We summarize the phenotypes of transgenic and knockout mouse models, which define important functions of these transcription factors in cellular differentiation and lung branching morphogenesis.

Differential expression of forkhead box transcription factors following butylated hydroxytoluene lung injury.

The forkhead box (Fox) proteins are a growing family of transcription factors that have important roles in cellular proliferation and differentiation and in organ morphogenesis. The Fox family members hepatocyte nuclear factor (HNF)-3beta (Foxa2) and HNF-3/forkhead homolog (HFH)-8 (FREAC-1, Foxf1) are expressed in adult pulmonary epithelial and mesenchymal cells, respectively, but these cells display only low expression levels of the proliferation-specific HFH-11B gene (Trident, Foxm1b). The regulation of these Fox transcription factors in response to acute lung injury, however, has yet to be determined. We report here on the use of butylated hydroxytoluene (BHT)-mediated lung injury to demonstrate that HFH-11 protein and RNA levels were markedly increased throughout the period of lung repair. The maximum levels of HFH-11 were observed by day 2 following BHT injury when both bronchiolar and alveolar epithelial cells were undergoing extensive proliferation. Although BHT lung injury did not alter epithelial cell expression of HNF-3beta, a 65% reduction in HFH-8 mRNA levels was observed during the period of mesenchymal cell proliferation. HFH-8-expressing cells were colocalized with platelet endothelial cell adhesion molecule-1-positive alveolar endothelial cells and with alpha-smooth muscle actin-positive peribronchiolar smooth muscle cells.

Norepinephrine-mediated inhibition of antitumor cytotoxic T lymphocyte generation involves a beta-adrenergic receptor mechanism and decreased TNF-alpha gene expression.

We have previously shown that norepinephrine (NE) inhibits the in vitro generation of anti-MOPC-315 CTL activity by spleen cells from BALB/c mice rejecting a large MOPC-315 tumor as a consequence of low-dose melphalan (l -phenylalanine mustard (l -PAM)) treatment (l -PAM TuB spleen cells). Since TNF-alpha plays a key role in the generation of antitumor CTL activity in this system, we determined whether NE mediates this inhibition through inhibition of TNF-alpha production. Here, we show that NE inhibits the production of TNF-alpha protein and mRNA by l -PAM TuB spleen cells stimulated in vitro with mitomycin C-treated tumor cells. Flow cytometric analysis of intracellular expression of TNF-alpha revealed substantial NE-mediated decreases in the percentages of TNF-alpha+ cells among CD4+ and CD8+ T cells and F4/80+ activated macrophages. NE inhibition of CTL generation was largely overcome by addition of TNF-alpha to the stimulation cultures. When the beta-adrenergic antagonist propranolol was added to the stimulation cultures of l -PAM TuB spleen cells at a concentration that prevented NE-induced cAMP elevation, the NE-mediated decrease in TNF-alpha mRNA and NE-mediated inhibition of CTL generation were reversed. Collectively, these results suggest that NE inhibits antitumor CTL generation, at least in part, by inhibiting TNF-alpha synthesis through a mechanism(s) involving beta-adrenergic receptor signaling.

[Expert assessment of the therapeutic-diagnostic process in the evaluation of health care quality]. / Ekspertiza lechebno-diagnosticheskogo protsessa v otsenke kachestva meditsinskoi pomoshchi.

Introduction of automated system of screening expert evaluation of the quality of treatment and diagnostic process provides universal approaches to internal and external regulation of medical care and helps develop (at the level of a public health monitoring organ) an automated system for regulation of the quality of medical care at a territorial level. This, in turn, will help define the optimal criteria (standards) of medical care quality for medical institutions, control the adherence to these standards, detect the causes of neglect thereof, and adopt optimal managing decisions aimed at improvement of public health activities in general.

Antagonistic interactions among T cell subsets of old mice revealed by limiting dilution analysis.

When CD4 spleen cells from old (but not young) mice are tested for Con A-induced proliferation in limiting dilution assays, the dose response curve shows a nonlinear relationship. We interpret these observations using a two-cell model, in which proliferation of one cell type (LPC1) can be blocked by a second cell type (LPC2), which can itself generate detectable proliferation only at high multiplicities. The two-cell model accounts for several observations: 1) the variation in curve shape as a function of incubation time; 2) the skewed distribution of wells scored as "negative" in cultures of old splenocytes; and 3) the initially antagonistic effects of old splenocytes titrated into cultures containing fixed numbers of young responders. To provide a further test of the two-cell model, ionomycin-resistant (CaR) and ionomycin-sensitive (CaS) cells were separated using a Percoll/ionomycin gradient. The CaR preparation, shown previously to consist largely of memory T cells, showed the dose curve predicted for the LPC2 cell type, whereas the CaS (naive) cells showed the single-hit kinetics postulated for LPC1 cells. Furthermore, mixtures of CaR and CaS cells from young mice reproduced the zigzag dose curve characteristically produced by unseparated cells from old mice. These data suggest that the spleens of both young and old mice contain two kinds of Con A-responsive CD4 cell: one that proliferates vigorously, and a second, calcium ionophore-resistant type that proliferates less well, that can interfere with proliferation of the first cell type, and whose frequency increases with age.

Regulatory cellular interactions in the primary mixed lymphocyte reaction.

Limiting dilution analysis (LDA) of allogeneic and syngeneic murine mixed lymphocyte reactions was used to study the heterogeneity both of the responding spleen cells and of the stimulating antigen-presenting dendritic cells (DC). In contrast with traditional LDA of single-hit processes, a non-linear dependence of the proportion of negative microcultures on responding spleen cell concentration was obtained. The non-linearity of this LDA plot was interpreted as being the result of a competitive interaction between two types of limiting precursor cells. The regulatory and stimulatory functions of DC were investigated in the same LDA systems by testing various levels of DC from spleen or thymus as limiting cells in the presence of a constant quantity of syngeneic splenic responder T cells. This revealed a functional heterogeneity amongst DC, which were found to suppress proliferation of responder cells at low DC levels but to stimulate proliferation at higher levels. At levels where splenic DC became stimulatory, thymic DC remained suppressive.

About the great importance of venous blood circulation in the pathogenesis of spaceman state disturbances in weightlessness.

CVP increasing observed in OS "Mir" flights lets to consider it as one of the chief factors in stateman state disturbance. It is necessary to use prophylactic means to prevent pathological changes in long flights. The received data confirm physical training and clamping cuffs application efficiency as a blood volume decentring and CVP decreasing.

[Postural reactions in cosmonauts after long flights aboard Salyut-6]. / Postural'nye reaktsii u kosmonautov posle dlitel'nykh poletov na orbital'noi stantsii "Saliut-6".

Tilt tests were used to study changes in cardiovascular responses to ortho- and antiorthostasis of four cosmonauts after their 96- and 140-day flights onboard Salyut-6. Preflight the cosmonauts were exposed to head-up and head-down tests in order to facilitate their readaptation to weightlessness. Postflight all cosmonauts exhibited a better cardiovascular capability to counteract cranial blood redistribution during antiorthostatic tilt tests. This can be considered as a result of their adaptation to weightlessness. After flight every crewmember showed a significant decrease of orthostatic tolerance. One of the factors responsible for the lower orthostatic tolerance is assumed to be inactivity of the vascular tone mechanisms. It is suggested that their better stimulation before reentry may improve the efficacy of countermeasures against postflight orthostatic disorders.

[Changes in cardiac output and orthostatic tolerance of astronauts]. / Izmeneniia minutnogo ob'ema krovoobrashcheniia i ortostaticheskaia ustoichivost' kosmonautov.

Examinations of 14 cosmonauts who performed orbital flights of 14 to 175 days were used to correlate cardiac output (CO) inflight with orthostatic tolerance and LBNP reactions postflight. In 3 crewmembers CO was lower than or close to the preflight level. In 4 cosmonauts CO was higher thant preflight. The remaining 7 crewmembers showed lower orthostatic tolerance and stronger LBNP reactions. The difference between mean CO values before and during flight was in negative correlation with orthostatic tolerance (r = -0.6) and in positive correlation with LBNP reactions (r = 0.7). The correlation coefficients were derived from small samples but an identical relationship between the two different tests with inflight CO variations gives evidence that such a relationship actually exists.

[Results of vectorelectrocardiographic examinations during and after long space flights aboard the orbital complex "Sal'iut-6"--"Soiuz"]. / Rezul'taty vektorélekrokardiograficheskogo obsledovaniia vo vremia i posle dlitel'nykh kosmicheskikh poletov na orbital'nom komplekse "Sal'iut-6"-"Soiuz".

In long-term space flights cardiac bioelectric activity was measured by vector-electrocardiography using ECG in 12 standard leads. Most marked changes in the form of a decrease in the integral spatial repolarization vector were seen postflight. This parameter did not return to normal during one month postflight. Depolarization vector and vector orientation remained essentially unchanged.

Preliminary results of medical investigations during piloted flights in the Salyut-6 program.

The changes observed during flight on the whole corresponded with the preflight prognosis and reflected the phase nature of the processes of adaptation. They were shown by blood redistribution symptoms, fluctuations in the main indices of hemodynamics at rest not going beyond the limits of the physiological norm, an increase in the pulse-filling of the head with blood, and a decrease in that of the shank. The reaction of the blood circulation to a physical load and the application of negative pressure varied, and in a number of investigations during flight it was more pronounced than on Earth. The changes observed after the flight appeared regular for the period of readaptation of the reactions of the organism. These reactions bore a functional nature and qualitatively did not differ from reactions observed after other flights, and after the 140-day flight they were, on the whole, less pronounced than after the 96-day flight. In the postflight period to accelerate the process of adaptation a complex of restorative-healing measures was carried out, including mainly a regulation of motor activity, restorative massage of the muscles, remedial physical culture and aquatic procedures. The flight lasting 140 days revealed no contraindications to a further regular increase in the time of cosmic flights and demonstrates once again the possibility of the planned control of the state of a healthy subject in flight and the readiness of the organism for a return to the terrestrial force of gravity.