Recent advances in the synthetic thymidine phosphorylase inhibitors for cancer therapy.

Thymidine phosphorylase (TP) is an important enzyme for the synthesis and decomposition of pyrimidine, which can specifically catalyze the reversible phosphorolysis of thymidine to thymine and 2-deoxy-α-D-ribose-1-phosphate in the body. TP is highly expressed in many solid tumor tissues and can induce angiogenesis and anti-apoptotic effect, as well as tumor growth and metastasis. Therefore, TP inhibitors play a major role in the treatment. In recent years, a large number of synthetic TP inhibitors have been widely reported. In this article, the research progress of synthetic TP inhibitors was reviewed, including inhibitory activity, cytotoxicity, structure-activity relationship (SAR), inhibitory kinetics, mechanism of interaction and molecular docking. In our reviewed inhibitors, pyrimidine derivatives account for about a half, but it is a lack for research on other biological activities of pyrimidine derivatives and further exploration of the inhibitory mechanism of excellent inhibitors. Meanwhile, application of radiolabeled inhibitors to assess TP expression in tumors and prognosis of cancer chemotherapy in vivo is rarely reported. In addition, the study on the synergistic anticancer activity of TP inhibitors in combination with other anticancer drugs is less. Therefore, it is valuable to look forward to developing more and more potent TP inhibitors and applying them in the clinical treatment of cancer in the future.

Thymidine phosphorylase promotes malignant progression in hepatocellular carcinoma through pentose Warburg effect.

Tumor progression is dependent on metabolic reprogramming. Metastasis and vasculogenic mimicry (VM) are typical characteristics of tumor progression. The relationship among metastasis, VM, and metabolic reprogramming remains unclear. In this study, we identified the novel role of Twist1, a VM regulator, in the transcriptional regulation of thymidine phosphorylase (TP) expression. TP promoted the extracellular metabolism of thymidine into ATP and amino acids through the pentose Warburg effect by coupling the pentose phosphate pathway and glycolysis. Moreover, Twist1 relied on TP-induced metabolic reprogramming to promote hepatocellular carcinoma (HCC) metastasis and VM formation mediated by VE-Cad, VEGFR1, and VEGFR2 in vitro and in vivo. The TP inhibitor tipiracil reduced the effect of TP on promoting HCC VM formation and metastasis. Hence, TP, when transcriptionally activated by Twist1, promotes HCC VM formation and metastasis through the pentose Warburg effect and contributes to tumor progression.

Efficacy of trifluridine and tipiracil (TAS-102) versus placebo, with supportive care, in a randomized, controlled trial of patients with metastatic colorectal cancer from Spain: results of a subgroup analysis of the phase 3 RECOURSE trial

Purpose. TAS-102 is a combination of the thymidine-based nucleoside analog trifluridine and the thymidine phosphorylase inhibitor tipiracil. Efficacy and safety of TAS-102 in patients with metastatic colorectal cancer (mCRC) refractory or intolerant to standard therapies were evaluated in the phase 3 RECOURSE trial. Results of RECOURSE demonstrated significant improvement in overall survival (OS) and progression-free survival (PFS) with TAS-102 versus placebo [hazard ratio (HR) = 0.68 and 0.48 for OS and PFS, respectively; both P < 0.001]. The current analysis evaluates efficacy and safety of TAS-102 in the RECOURSE Spanish subgroup. Methods. Primary and key secondary endpoints were evaluated in a post hoc analysis of the RECOURSE Spanish subgroup, using univariate and multivariate analyses. Safety and tolerability were reported with descriptive statistics. Results. The RECOURSE Spanish subgroup included 112 patients (mean age 61 years, 62 % male). Median OS was 6.8 months in the TAS-102 group (n = 80) versus 4.6 months in the placebo group (n = 32) [HR = 0.47; 95 % confidence interval (CI): 0.28-0.78; P = 0.0032). Median PFS was 2.0 months in the TAS-102 group and 1.7 months in the placebo group (HR = 0.47; 95 % CI: 0.30-0.74; P = 0.001). Eighty (100 %) TAS-102 versus 31 (96.9 %) placebo patients had adverse events (AEs). The most common drug-related ≥Grade 3 AE was neutropenia (40 % TAS-102 versus 0 % placebo). There was 1 (1.3 %) case of febrile neutropenia in the TAS-102 group versus none in the placebo group. Conclusions. In the RECOURSE Spanish subgroup, TAS-102 was associated with significantly improved OS and PFS versus placebo, consistent with the overall RECOURSE population. No new safety signals were identified (AU)

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Current options in the treatment of mitochondrial diseases.

Mitochondrial diseases (MD) are disorders caused by an impairment of the mitochondrial respiratory chain function. They are usually progressive, isolated or multi-system diseases and have variable times of onset. Because mitochondria have their own DNA (mtDNA), MD can be caused by mutations in both mtDNA and nuclear DNA (nDNA). The complexity of genetic control of mitochondrial function is in part responsible for the intra- and inter-familiar clinical heterogeneity of this class of diseases. Despite the remarkable progress in understanding of the molecular bases of these disorders, therapy of MD is quite inadequate. Present options of treatment mainly include physical, pharmacological and gene therapy approaches. Aerobic exercise and physical therapy is useful to prevent or correct deconditioning and may improve exercise tolerance. Pharmacological approach is based on removing noxious metabolites, using reactive oxygen species scavengers and administrating vitamins and cofactors which is especially important in case of primary deficiencies of specific compounds such as Coenzyme Q10. Gene therapy is fascinating but it is difficult to apply because of polyplasmy and heteroplasmy. Experimental methods include gene shifting, allotopic expression, mitochondrial transfection or correcting mtDNA mutations with specific restriction endonucleases. Here, we discussed some recent patents. Progresses in each of these fields may open interesting perspectives for the future.

Onicolisis con exudado del hiponiquio secundaria a quimioterapia con paclitaxel y capecitabina / Onycholysis with hyponychium exudate secondary to chemotherapy with paclitaxel and capecitabine

Se presenta el caso de una paciente de 39 años que consultó por onicolisis, hiperqueratosis subungueal y presencia de exudado en el primer dedo del pie derecho. Las lesiones aparecieron durante el tratamiento oncológico de un cáncer mamario bilateral con metástasis linfáticas con paclitaxel cada tres semanas y capecitabina diaria. Las manifestaciones clínicas se deben a la afectación del lecho ungueal por la quimioterapia y deben conocerse y ser tenidas en cuenta debido al aumento del uso de este tipo de citotóxicos

A 39-year-old female patient who consulted due to onycholysis, subungual hyperkeratosis and presence of exudate in the big toe of the right foot. The lesions appeared during oncology treatment of bilateral breast cancer with lymphatic metastases with paclitaxel every three weeks and capecitabine daily. Clinical manifestations are due to the involvement of the nail bed caused by the chemotherapy. These should be known and taken into account due to the increased use of this type of cytotoxic agents

Potential of the FES-hERL PET reporter gene system -- basic evaluation for gene therapy monitoring.

PURPOSE: In vivo reporter genes can be powerful tools in supporting and ensuring the success of gene therapy. A careful and rational design of a reporter system is essential to realize a noninvasive in vivo reporter gene imaging system applicable for humans. We designed a new in vivo reporter gene imaging system that uses F-18-labeled estradiol (FES) and human estrogen receptor ligand (hERL) binding domain, taking advantage that FES is a radiopharmaceutical already being used for human studies with access to a wide range of tissues, including the brain, and that hERL lacking DNA binding domain can no longer work as a transcription factor, and carried out basic studies to evaluate its potential for gene therapy monitoring. METHODS: We constructed a plasmid (pTIER) to coexpress a model therapeutic gene and the reporter gene hERL and transfected Cos7 cells and examined their uptake of [(3)H]estradiol and FES in culture media. The uptake of FES by mouse calf muscle electroporated with pTIER was also tested. RESULTS: The cells transfected with pTIER took up the radioligands efficiently and specifically in culture media. Also, the mouse calf muscle electroporated with pTIER accumulated a higher amount of FES than did the control. CONCLUSION: The data indicate that our new reporter gene system seems promising for in vivo imaging of gene expression and gene therapy monitoring.

Platelet-derived endothelial cell growth factor.

Platelet-derived endothelial cell growth factor (PD-ECGF) is a 45 kDa single chain polypeptide, which stimulates the DNA synthesis and chemotaxis of endothelial cells in vitro and angiogenesis in vivo. Purification from human platelets and cDNA cloning from a human placental cDNA library, revealed that PD-ECGF is a novel type of peptide without sequence similarity to hitherto known proteins. PD-ECGF is present in human platelets and placenta, and is produced by certain normal and transformed cultured cells; it lacks a hydrophobic leader sequence and most of the protein remains inside the producer cells. Analysis of PD-ECGF produced by cultured cells, revealed that it contains nucleotide(s) covalently bound to serine residues. The in vivo function of PD-ECGF is not known; its target cell specificity and tissue distribution suggest roles in angiogenesis of the placenta and in the maintenance of the integrity of the endothelial cell layer of blood vessels. PD-ECGF may have a clinical utility in the stimulation of wound healing and re-endothelialization of vessels.