Identifizierung von T-Zell-erkannten Nierenzellkarzinom-Antigenen

Eine Voraussetzung für die Entwicklung neuer immunmodulatorischer Therapieverfahren ist die Kenntnis immunogener Tumorantigene, die von tumorreaktiven T-Zellen erkannt werden. In der vorliegenden Arbeit wurden tumorreaktive CD8+ zytotoxische T-Lymphozyten (CTL, cytotoxic T-lymphocytes) aus dem Blut eines HLA (human leukocyte antigen)-kompatiblen Fremdspenders generiert. Methodisch wurden hierzu CD8-selektionierte periphere Blutlymphozyten repetitiv mit der klarzelligen Nierenzellkarzinomlinie MZ1851-RCC (RCC, renal cell carcinoma) in einer allogenen gemischten Lymphozyten-Tumorzell Kultur (MLTC, mixed lymphocyte tumor cell culture) stimuliert. Aus den Responderlymphozyten wurden mit Hilfe des Grenzverdünnungsverfahrens klonale zytotoxische T-Zellen generiert und expandiert. Die CTL-Klone wurden anschließend phänotypisch mittels Durchflußzytometrie sowie funktionell mittels HLA-Antikörper-Blockadeexperimenten und Kreuzreaktivitätstests detailliert charakterisiert. Dabei konnte gezeigt werden, daß aus dem Blut eines allogenen gesunden Spenders CD8+ T-Zellen isoliert werden können, welche Reaktivität gegen Nierenzellkarzinome (NZK) aufweisen und über verschiedene HLA-Klasse-I-Allele restringiert sind. Die von den einzelnen CTL-Klonen erkannten Zielstrukturen zeigten entweder ubiquitäre (z.B. HLA-Cw*0704-reaktiver CTL-Klon E77) oder eine tumorspezifische (z.B. HLA-B*0702-restringierter CTL-Klon A4) Gewebeexpression. Zur Identifizierung der natürlich prozessierten Peptidliganden wurden die HLA-B/C-Allele unter Verwendung des monoklonalen Antikörpers B123.2 aus einem zuvor hergestellten Detergenslysat der Nierenzellkarzinomlinie MZ1851-RCC immunchromatographisch aufgereinigt. Aus den so isolierten HLA-Peptid-Komplexen wurden die tumorassoziierten Peptidliganden nach Säureeluation und Filtration abgespalten und über eine „reverse phase“-HPLC (high performance liquid chromatography) fraktioniert. Die Überprüfung der einzelnen HPLC-Fraktionen auf Bioaktivität erfolgte mit den korrespondierenden CTL-Klonen in 51Cr-Zytotoxizitätstests. Dabei wurde eine HPLC-Fraktion identifiziert, die die lytische Funktion des HLA-B*0702-restringierten CTL-Klons A4 auslösen konnte. Die bioaktive HPLC-Fraktion wurde dazu durch eine zweite (second dimension) Kapillar-Flüssigkeitschromatographie (Cap-LC, capillar liquid chromatography) in Subfraktionen geringerer Komplexität aufgetrennt und die darin enthaltenen Peptidepitope durch das MALDI-TOF/TOF (matrix assisted laser desorption/ionization- time of flight/time of flight)-Analyseverfahren sequenziert. Innerhalb dieser HPLC-Fraktion wurden eine Vielzahl von HLA-B/C-assoziierten Peptidliganden erfolgreich sequenziert, was die Effektivität dieser Verfahrenstechnik zur Identifizierung natürlich prozessierter HLA-Klasse-I-bindender Peptide unter Beweis stellt. Leider war es mit dieser Methode bisher nicht möglich, das von CTL-Klon A4 detektierte Peptidepitop zu sequenzieren. Dies liegt möglicherweise in der unzureichenden Konzentration des Peptidepitops in der bioaktiven HPLC-Fraktion begründet. In Folgearbeiten soll nun mit erhöhter Probenmenge beziehungsweise verbesserter Analytik der erneute Versuch unternommen werden, das Zielantigen des CTL-Klons A4 zu identifizieren. Die Kenntnis von Antigenen, die tumorspezifisch exprimiert und von CD8+ CTL aus gesunden Spendern erkannt werden, eröffnet neue therapeutische Möglichkeiten, das spezifische Immunsystem des Stammzellspenders nach allogener Blutstammzelltransplantation gezielt zur Steigerung von Tumorabstoßungsreaktionen (z.B. durch Vakzinierung oder adoptivem T-Zelltransfer) zu nutzen.

Carcinoma polmonare non a piccole cellule T1aN0M0: Ruolo prognostico della Microvessel Density

Obiettivi. Valutare l’angiogenesi tumorale mediante la Microvessel density (MVD) come fattore predittivo di mortalità per tumore polmonare non a piccole cellule (NSCLC) pT1aN0M0 trattato chirurgicamente. Metodi. I dati demografici, clinici e istopatologici sono stati registrati per 82 pazienti (60 maschi, 22 femmine) sottoposti a resezione chirurgica in due diverse Chirurgie Toraciche tra gennaio 2002 e dicembre 2007 per tumori polmonari non a piccole cellule pT1AN0M0. La MVD è stata valutata mediante il conteggio visivo dei microvasi positivi alla colorazione immunoistochimica con anticorpo monoclonale anti-CD31 e definita come il numero medio di microvasi per 1 mm2 di campo ottico. Risultati. Sono state eseguite 59 lobectomie (72%) e 23 resezioni sublobari (28%). Reperti istopatologici: 43 adenocarcinomi (52%) e 39 neoplasie non- adenocarcinoma (48%) pT1aN0M0; MVD media: 161 (CD31/mm2); mediana: 148; range 50-365, cut-off=150. Una MVD elevata (> 150 CD31/mm2) è stata osservata in 40 pazienti (49%), una MVD ridotta ( ≤ 150 CD31/mm2 ) in 42 pazienti (51%). Sopravvivenze a 5 anni: 70 % e 95%, rispettivamente per il gruppo ad elevata MVD vs il gruppo a ridotta MVD con una p = 0,0041, statisticamente significativa. Il tipo di resezione chirurgica, il diametro del tumore, le principali comorbidità e l’istotipo nono sono stati fattori predittivi significativi di mortalità correlata alla malattia. La MVD è risultata essere superiore nel gruppo “Adenocarcinoma” (MVD mediana=180) rispetto al gruppo “Non-Adenocarcinoma (MVD mediana=125), con un test di Mann-Whitney statisticamente significativo (p < 0,0001). Nel gruppo “Adenocarcinoma” la sopravvivenza a 5 anni è stata del 66% e 93 %, rispettivamente per i pazienti con MVD elevata e ridotta (p = 0.043. Conclusioni. Il nostro studio ha mostrato che la Microvessel density valutata con la colorazione immunoistochimica per CD31 ha un valore prognostico rilevante nel carcinoma polmonare in stadio precoce pT1aN0M0.

Molekulare Mechanismen der Knochenmetastasierung des Nierenzellkarzinoms

Die schlechte Prognose des Nierenzellkarzinoms (NZK) kommt nicht durch den Primärtumor an sich zustande, sondern durch das Vorhandensein von Fernmetastasen. Obwohl bereits vieles über die Mechanismen der Metastasierung bekannt ist, sind die Hintergründe der Organspezifität metastasierender Tumorzellen weitgehend ungeklärt. In 30% der Fälle kommt es zur Entstehung von Knochenmetastasen. Diese hohe Frequenz deutet darauf hin, dass NZK-Zellen bevorzugt in dieses Organ metastasieren, da die Knochenmatrix ein günstiges Mikromilieu für ihr Wachstum bietet. Hierbei könnte extrazellulärem Calcium und dem für die Detektion zuständigen Calcium-sensitiven Rezeptor (CaSR) eine entscheidende Rolle zukommen, da sich Knochen durch ihren hohen Gehalt an Calcium auszeichnen und von anderen Organen unterscheiden. Das Ziel der vorliegenden Dissertation lag in der Aufklärung der Mechanismen, die zu einer Knochenmetastasierung des NZK führen.rnrnIn ersten Analysen konnte gezeigt werden, dass sich bereits der Primärtumor durch eine von Calcium unabhängige charakteristische Expression bestimmter Signalmediatoren auszeichnet, die Metastasierungspotenzial und –ort bestimmen. So wurden in Gewebeproben und primären Tumorzellen von NZK-Patienten, die innerhalb von fünf Jahren nach Nephrektomie Knochenmetastasen entwickelten, in Westernblot-Analysen eine sehr hohe Expression der α5-Integrine, eine starke Aktivität von Akt, FAK und eine Reduktion der PTEN-Expression detektiert. Diese Veränderungen begünstigten die chemotaktische Migration in Richtung Fibronektin (bestimmt in einer Boyden-Kammer) und die Adhäsion dieser NZK-Zellen an Komponenten der Extrazellularmatrix (Fibronektin und Kollagen I – beides ist Bestandteil der Knochenmatrix). Migration und Adhäsion sind essentielle Schritte beim Austreten der Tumorzellen aus dem Primärtumor und Infiltration des Knochens. In NZK-Zellen von Patienten, die keine Metastasen oder Lungenmetastasen entwickelten, waren diese Charakteristika nicht oder deutlich schwächer ausgeprägt. Bestimmte Primärtumore sind somit prädestiniert Knochenmetastasen auszubilden.rnrnUm die Bedeutung von extrazellulärem Calcium und dem CaSR darzustellen, wurde die Expression des CaSR mittels Real-Time PCR, Westernblot-Analysen und durchflusszytometrisch in NZK-Gewebeproben und –Zellen von Patienten untersucht, die innerhalb von fünf Jahren nach Nephrektomie keine bzw. Lungen- oder Knochenmetastasen ausbildeten. Proben von Patienten mit Knochenmetastasen zeigten die stärkste Expression von CaSR-mRNA und CaSR-Protein. Durch eine Behandlung der NZK-Zellen mit Calcium in physiologischen Konzentrationen, konnte Calcium als möglicher Regulator der CaSR-Expression ausgeschlossen werden. Der Einfluss von Calcium auf die Metastasierungsfähigkeit der primären NZK-Zellen wurde anhand eines weiteren chemotaktischen Migrationsversuchs mit Calcium als Chemotaxin analysiert. Die Zellproliferationsrate konnte nach Behandlung der Zellen mit Calcium mittels BrdU-Inkorporation gemessen werden. NZK-Zellen, die aus dem Primärtumor von Patienten mit Knochenmetastasen kultiviert wurden, konnten durch eine erhöhte extrazelluläre Calcium-Konzentration verstärkt zu Migration und Proliferation (Konzentrations-abhängige Steigerung) angeregt werden. Diese stellen weitere essentielle Schritte bei der Infiltration und Vermehrung der NZK-Zellen in den Knochen dar. Die Effekte traten bei NZK-Zellen aus Patienten, die keine oder Lungenmetastasen ausbildeten, nicht auf. Die Identifizierung der beteiligten Signalwege erfolgte in Westernblot-Analysen und einem Phospho-Kinase Array. Hierdurch konnten eine verstärkte Aktivierung des Akt-, JNK-, p38α- und PLCγ-1-Signalwegs und eine beinahe vollständige Reduktion der PTEN-Expression nach Calcium-Behandlung in Knochen-metastasierenden NZK-Zellen aufgedeckt werden. Durch Blockierung des CaSR mittels des Inhibitors NPS 2143 konnte bestätigt werden, dass die metastasierungs-fördernde Wirkung von Calcium über den CaSR zustande kommt. rnrnNZK-Zellen zeichnen sich somit bereits im Primärtumor durch eine charakteristische Expression verschiedener Signalmediatoren aus, die ihr Metastasierungspotenzial und die mögliche Lokalisation der Metastase bestimmen. Gelangen metastasierende NZK-Zellen auf ihrem Weg durch den Blutkreislauf in das Knochenmilieu, verhilft ihnen hier eine hohe Expression des CaSR zu einem wichtigen Überlebensvorteil. Extrazelluläres Calcium wirkt über den CaSR, verstärkt ihre metastatischen Eigenschaften und fördert schließlich die Ausbildung einer Knochenmetastase. Aus diesem Grund kommt dem CaSR eine Rolle als möglicher prognostischer Marker hinsichtlich der Knochenmetastasierung beim NZK zu. Die Charakteristika des Primärtumors sollten daher die Auswahl des adjuvanten Therapeutikums und die Nachsorgeuntersuchungen beeinflussen. um die Medizin dem Ziel einer individualisierten Therapie näher zu bringen.rn

Perdite aeree prolungate dopo resezione polmonare

Il tumore del polmone e una delle neoplasie più diagnosticate dal 1985 e rimane ancora oggi la causa più frequente di morte cancro-correlata nel mondo. Una resezione polmonare anatomica completa continua ad essere il cardine della terapia per il tumore non a piccole cellule. Perdite aeree prolungate (PAL) sono la più comune complicanza dopo una chirurgia polmonare e sono state riportate con un’incidenza compresa tra il 3-26%, simile sia nelle resezioni polmonari per via toracotomica sia in quelle per via toracoscopica. Fattori di rischio descritti sono scissure interlobari incomplete, patologie polmonari sottostanti (come enfisema, fibrosi, tubercolosi o neoplasie), aderenze pleuriche, pazienti anziani (>75 anni) e bassa capacita di diffusione. Lo sviluppo di strumentazione all’avanguardia e di nuove tecniche chirurgiche ha contribuito a ridurre l’incidenza di queste complicanze. Considerando l’alto impatto clinico e socio-economico di queste problematiche, e stata inoltre sviluppata una varietà di complementari naturali e materiali sintetici molti utili nella gestione delle perdite aeree.

Einfluss des Calcium-sensitiven Rezeptors auf knochenspezifische Metastasierungsprozesse des Nierenzellkarzinoms

Der Grund für die schlechte Prognose beim Nierenzellkarzinom (NZK) stellt nicht der Primärtumor dar sondern ist vielmehr der häufigen Ausbildung von Fernmetastasen geschuldet. Etwa 30 % aller Patienten mit fortgeschrittenem NZK bilden dabei Metastasen in den Knochen aus. Das Knochenmilieu scheint, aufgrund der hohen Frequenz der knochenspezifischen Metastasierung, einen idealen Wachstumslokus für die Nierenkarzinomzellen dazustellen und rückte in der jüngsten Vergangenheit in den Fokus der Forschung. Dabei konnte der Calcium-sensitive Rezeptor (CaSR), der im gesunden Gewebe die Konzentration der extrazellulären Calcium-Ionen reguliert und besonders in der Niere von Bedeutung ist, mit der Metastasierung in die Knochen in Zusammenhang gebracht werden. Die Knochen stellen im Körper das Organ mit der höchsten Calcium-Konzentration dar. Durch ständigen Knochenmetabolismus werden Calcium-Ionen freigesetzt, welche CaSR-exprimierende Zellen aktivieren können. Aus diesem Grund wurden im Zusammenhang mit dieser Arbeit Nierenkarzinomzellen (786 O) sowie gesunde Nierenzellen (HEK 293) mit dem Gen des CaSR transfiziert und anschließend unter dem Einfluss von Calcium (10 mM – 30 Min.), einem CaSR-Aktivator (Cinacalcet (10 µM – 1 Std.)), sowie einem CaSR-Inhibitor (NPS2143 (10 µM – 1 Std.)) auf Unterschiede im zellulären Verhalten hin untersucht.rnBereits ohne Calcium-Behandlung zeigten die CaSR-transfizierten 786 O-Zellen ein gesteigertes Migrationsverhalten (durchgeführt in einer Boyden Kammer, Fibronektin als Chemotaxin) und ein erhöhtes Adhäsionspotential (zum einen an Kompo¬nenten der EZM (Fibronektin und Kollagen I) und zum anderen an HUVEC). Bei den CaSR-transfizierten HEK 293-Zellen wurde nur die Migration positiv beeinflusst. Nach einer 30-minütigen Behandlung mit Calcium zeigten die CaSR-transfizierten 786 O-Zellen eine starke Zunahme des Adhäsions- und Proli¬ferations-verhaltens, sowie eine verstärkte Migration bei Verwendung von Calcium als Chemotaxin. CaSR-transfizierte HEK 293-Zellen hingegen zeigten keine Migration und nach Calcium-Behandlung nur geringfügige Änderungen in Adhäsion und Proliferation. Konsistent mit diesen Ergebnissen war die Auswertung der intrazellulären Signalwege mit Hilfe von Western Blot-Analysen. In CaSR-expri-mierenden 786 O-Zellen waren die Signalwege AKT, ERK, JNK und p38α nach Calcium-Behandlung deutlich erhöht. In den HEK 293-Zellen kam es zu einer Zunahme der Proteinmenge aktivierter ERK-, JNK-, Paxillin- und SHC-Moleküle. Mit Hilfe einer Kombinationsbehandlung aus NPS2143 und Calcium konnte der Calcium-bedingte Effekt in durchweg allen Untersuchungen wieder bis auf das Kontrollniveau gesenkt werden. Die Verwendung von Cinacalcet und Calcium führte zwar erneut zu deutlichen Steigerungen der zellulären Vorgänge, lag aber immer unter dem Calcium-abhängigen Maximum.rnDurch die Simulation der Vorgänge, die während einer Metastasierung ablaufen, konnte gezeigt werden, dass der CaSR in Nierenkarzinomzellen die Knochen-metastasierung induziert. Sollten sich diese Zusammenhänge in vivo im Mausmodell bestätigen, könnte der CaSR zukünftig als Marker für eine Früherkennung von Knochenmetastasen fungieren. Zudem könnten indivi¬dual¬isierte Therapieansätze entwickelt werden, die knochenmetastasierende Zellen bereits vor Metastasierung effizient bekämpfen können.rn

Reversal of established lupus nephritis and prolonged survival of New Zealand black x New Zealand white mice treated with the topoisomerase I inhibitor irinotecan

Systemic lupus erythematosus is a chronic autoimmune disorder that predominantly affects women of childbearing age. Lupus-associated glomerulonephritis is a major cause of mortality in these patients. Current treatment protocols for systemic lupus erythematosus include cyclophosphamide, prednisolone, azathioprine, and mycophenolate mofetil. However, in mice none of these agents alone or in combination were shown to reverse established proteinuria. Using New Zealand Black x New Zealand White F1 mice, we report that administration of the topoisomerase I inhibitor irinotecan from week 13 completely prevented the onset of proteinuria and prolonged survival up to at least 90 wk without detectable side effects. Furthermore, application of irinotecan to mice with established lupus nephritis, as indicated by grade 3+ (> or =300 mg/dl) and grade 4+ (> or =2000 mg/dl) proteinuria and, according to a median age of 35 wk, resulted in remission rates of 75% and 55%, respectively. Survival was significantly prolonged with 73 wk (grade 3+ and 4+ combined) versus 40 wk for control animals. Although total IgG and anti-dsDNA Abs in the serum and mesangial IgG deposits in the kidneys were not reduced in irinotecan-treated mice, subendothelial immune deposits were considerably diminished, suggesting a prevention of glomerular basement membrane disruption. This effect was accompanied by increased rates of ssDNA breaks and inhibition of renal cell apoptosis being different to what is known about irinotecan in anticancer therapy. In conclusion, our data provide evidence that irinotecan might represent an entirely new strategy for the treatment of systemic lupus erythematosus.

Acute visual loss after preoperative embolization of an ethmoidal metastasis

An unintentional embolization of retinal arteries is rare and has been documented as a complication after embolization of arteries supplying head and neck tumors. However, occlusion of the central retinal artery with severe loss of vision has never been reported to be a complication from embolization of tumor-supplying ethmoidal branches of the ophthalmic artery. A 40 year-old male patient with a history of right nephrectomy for renal cell carcinoma underwent preoperative radiological embolization of an ethmoidal metastasis after having experienced a life-threatening sinus bleeding. Repeated probing of the ophthalmic artery with an endovascular microcatheter for particle embolization of the tumor-supplying arteries was performed under anticoagulation with heparin. Postoperatively, a standard ophthalmological examination including extended vascular evaluation by angiography was performed. After extended probing of the ophthalmic artery a marked reduction in its blood flow occurred. Despite post-interventional imaging showing persisting perfusion of the central retinal and ciliary arteries, the patient developed complete loss of vision on this side four days later. At this time fundoscopy and fluorescein angiography revealed a recanalized central artery occlusion, while indocyanin angiography showed infarctions of the choroid. Radiological intervention via the ophthalmic artery can result in complete loss of vision, even after limited and transient obstruction of the vessel.

Selective in vitro targeting of GRP and NMB receptors in human tumours with the new bombesin tracer 177Lu-AMBA

PURPOSE: To investigate the in vitro binding properties of a novel radiolabelled bombesin analogue, (177)Lu-AMBA, in human neoplastic and non-neoplastic tissues selected for their expression of the bombesin receptor subtypes GRP-R, NMB-R and BRS-3. METHODS: In vitro receptor autoradiography was performed in cancers expressing the various bombesin receptor subtypes. The novel radioligand (177)Lu-AMBA was used and compared with established bombesin radioligands such as (125)I-Tyr(4)-bombesin and (125)I-[D: -Tyr(6),beta-Ala(11),Phe(13),Nle(14)]-bombesin(6-14). In vitro incidence of detection of each of the three bombesin receptor subtypes was evaluated in each tumour. RESULTS: (177)Lu-AMBA identified all GRP-R-expressing tumours, such as prostatic, mammary and renal cell carcinomas as well as gastrointestinal stromal tumours. (177)Lu-AMBA also identified all NMB-expressing tumours, but did not detect BRS-3-expressing tumours or BRS-3-expressing pancreatic islets. GRP-R-expressing peritumoural vessels were heavily labelled with (177)Lu-AMBA. In contrast to the strongly GRP-R-positive mouse pancreas, the human pancreas was not labelled with (177)Lu-AMBA unless chronic pancreatitis was diagnosed. In general, the sensitivity was slightly better with (177)Lu-AMBA than with the conventional bombesin radioligands. CONCLUSION: The present in vitro study suggests that (177)Lu-AMBA may be a very useful in vivo targeting agent for GRP-R-expressing tumours, NMB-R-expressing tumours and GRP-R-expressing neoangiogenic vessels.

High expression of gastrin-releasing peptide receptors in the vascular bed of urinary tract cancers: promising candidates for vascular targeting applications

Tumoral gastrin-releasing peptide (GRP) receptors are potential targets for diagnosis and therapy using radiolabeled or cytotoxic GRP analogs. GRP-receptor overexpression has been detected in endocrine-related cancer cells and, more recently, also in the vascular bed of selected tumors. More information on vascular GRP-receptors in cancer is required to asses their potential for vascular targeting applications. Therefore, frequent human cancers (n = 368) were analyzed using in vitro GRP-receptor autoradiography on tissue sections with the (125)I-[Tyr(4)]-bombesin radioligand and/or the universal radioligand (125)I-[d-Tyr(6), beta-Ala(11), Phe(13), Nle(14)]-bombesin(6-14). GRP-receptor expressing vessels were evaluated in each tumor group for prevalence, quantity (vascular score), and GRP-receptor density. Prevalence of vascular GRP-receptors was variable, ranging from 12% (prostate cancer) to 92% (urinary tract cancer). Different tumor types within a given site had divergent prevalence of vascular GRP-receptors (e.g. lung: small cell cancer: 0%; adenocarcinoma: 59%; squamous carcinoma: 83%). Also the vascular score varied widely, with the highest score in urinary tract cancer (1.69), moderate scores in lung (0.91), colon (0.88), kidney (0.84), and biliary tract (0.69) cancers and low scores in breast (0.39) and prostate (0.14) cancers. Vascular GRP-receptors were expressed in the muscular vessel wall in moderate to high densities. Normal non-neoplastic control tissues from these organs lacked vascular GRP-receptors. In conclusion, tumoral vessels in all evaluated sites express GRP-receptors, suggesting a major biological function of GRP-receptors in neovasculature. Vascular GRP-receptor expression varies between the tumor types indicating tumor-specific mechanisms in their regulation. Urinary tract cancers express vascular GRP-receptors so abundantly, that they are promising candidates for vascular targeting applications.

Targeting GRPR in urological cancers--from basic research to clinical application

Gastrin releasing peptide (GRP) is a regulatory peptide that acts through its receptor (GRPR) to regulate physiological functions in various organs. GRPR is overexpressed in neoplastic cells of most prostate cancers and some renal cell cancers and in the tumoral vessels of urinary tract cancers. Thus, targeting these tumours with specifically designed GRP analogues has potential clinical application. Potent and specific radioactive, cytotoxic or nonradioactive GRP analogues have been designed and tested in various animal tumour models with the aim of receptor targeting for tumour diagnosis or therapy. All three categories of compound were found suitable for tumour targeting in animal models. The cytotoxic and nonradioactive GRP analogues have not yet shown convincing tumour-reducing effects in human trials; however, the first clinical studies of radioactive GRP analogues--both agonists and antagonists--suggest promising opportunities for both diagnostic tumour imaging and radiotherapy of prostate and other GRPR-expressing cancers.

The inhibition of lipid transfer protein by negatively charged liposomes modifies the therapeutic index of amphotericin B

We have shown that liposomal amphotericin B (L-AmpB) decreased renal toxicity and maintains the antifungal activity of amphotericin B (AmpB). We have also observed that L-AmpB is predominantly associated with high density lipoproteins (HDL) as compared to Fungizone (AmpB + deoxycholate). The present experiments were designed to assess the biological relevance of transferring AmpB to HDL. We observed that AmpB was less toxic to kidney cells when associated with HDL, however AmpB toxicity was maintained when associated with LDL. To further understand how HDL-associated AmpB reduces renal cell toxicity the presence of HDL and LDL receptors in this cell line was determined. We observed that these cells expressed high and low affinity LDL receptors, but only low affinity HDL receptors. The reduced renal cell toxicity of HDL-associated AmpB may be due to its lack of interaction with renal cells because of the absence of HDL receptors. Since AmpB interacts with cholesteryl esters whose transfer among lipoproteins is regulated by Lipid transfer Protein (LTP), the role of LTP on the distribution of AmpB to HDL and LDL was next examined. We found that negatively charged liposomes significantly reduced LTP-mediated transfer of CE between HDL and LDL, independent of the presence of AmpB, while Fungizone only significantly inhibited CE transfer at one concentration tested (20$\mu$g/ml). Therefore, we believe that the decreased renal toxicity of L-AmpB is related to its predominant distribution to HDL which is regulated by the inhibition of LTP activity. ^

Evidence for the involvement of proximal chromosome 3P loci in the progression of Von Hippel-Lindau related tumors

Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder characterized by the development of retinal and central nervous system hemangioblastoma, renal cell carcinoma (RCC), pheochromocytoma and pancreatic islet cell tumors (PICT). The VHL gene maps to chromosome 3p25 and has been shown to be mutated in 57% of sporadic cases of RCC, implicating VHL in the genesis of RCC. We report a multigeneration VHL kindred in which four affected female siblings developed PICT at early ages. Analysis of the three coding exons of the VHL gene in this family revealed a single, missense mutation in codon 238. Inheritance of the 238 mutation has been reported to correlate with a 62% risk of pheochromocytoma development. In this kindred, all affected individuals carried the mutation as well as one additional sibling who showed no evidence of disease. Clinical screening of this individual indicated small ($<$1 cm) pancreatic and kidney tumors. Results suggest that inheritance of the codon 238 mutation does not correlate with early onset pheochromocytoma. Rather, the only individual in the pedigree with pheochromocytoma was the proband's mother who developed bilateral pheochromocytoma at the age of 62. Thus, the VHL codon 238 mutation may predispose to late onset pheochromocytoma in this family; however, it does not explain the preponderance of PICT in the third generation since this mutation has not been reported to increase the risk of developing pancreatic lesions. This suggests that inheritance of the codon 238 mutation and subsequent somatic inactivation of the wild type allele of the VHL gene may not be sufficient to explain the initiation and subsequent progression to malignancy in VHL-associated neoplasms. Since the two tumor types that most frequently progress to malignancy are RCC and PICT, we asked whether loss of heterozygosity (LOH) could be detected proximal to the VHL gene on chromosome 3 in distinct regions of 3p previously implicated by LOH and cytogenetic studies to contain tumor suppressor loci for RCC. LOH was performed on high molecular weight DNA isolated from peripheral blood and frozen tumor tissue of family members using microsatellite markers spanning 3p. Results indicated LOH for all informative 3p loci in tumor tissue from affected individuals with PICT. LOH was detected along the entire length of the chromosome arm and included the proximal region of 3p13-14.2 implicated in the hereditary form of renal cell carcinoma.^ If 3p LOH were a critical event in pancreatic islet cell tumorigenesis, then it should be expected that LOH in sporadic islet cell tumors would also be observed. We expanded LOH studies to include sporadic cases of PICT. Consistent LOH was observed on 3p with a highest frequency LOH in the region 3p21.2. This is the first evidence for an association between chromosome 3 loci and pancreatic islet cell tumorigenesis. (Abstract shortened by UMI.) ^

Towards the identification of a tumor suppressor gene on chromosome 3p12: Physical mapping and candidate gene screening

Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney. Characterization of RCC tumors indicates that the most frequent genetic event associated with the initiation of tumor formation involves a loss of heterozygosity or cytogenetic aberration on the short arm of human chromosome 3. A tumor suppressor locus Nonpapillary Renal Carcinoma-1 (NRC-1, OMIM ID 604442) has been previously mapped to a 5–7 cM region on chromosome 3p12 and shown to induce rapid tumor cell death in vivo, as demonstrated by functional complementation experiments. ^ To identify the gene that accounts for the tumor suppressor activities of NRC-1, fine-scale physical mapping was conducted with a novel real-time quantitative PCR based method developed in this study. As a result, NRC-1 was mapped within a 4.6-Mb region defined by two unique sequences within UniGene clusters Hs.41407 and Hs.371835 (78,545Kb–83,172Kb in the NCBI build 31 physical map). The involvement of a putative tumor suppressor gene Robo1/Dutt1 was excluded as a candidate for NRC-1. Furthermore, a transcript map containing eleven candidate genes was established for the 4.6-Mb region. Analyses of gene expression patterns with real-time quantitative RT-PCR assays showed that one of the eleven candidate genes in the interval (TSGc28) is down-regulated in 15 out of 20 tumor samples compared with matched normal samples. Three exons of this gene have been identified by RACE experiments, although additional exon(s) seem to exist. Further gene characterization and functional studies are required to confirm the gene as a true tumor suppressor gene. ^ To study the cellular functions of NRC-1, gene expression profiles of three tumor suppressive microcell hybrids, each containing a functional copy of NRC-1, were compared with those of the corresponding parental tumor cell lines using 16K oligonucleotide microarrays. Differentially expressed genes were identified. Analyses based on the Gene Ontology showed that introduction of NRC-1 into tumor cell lines activates genes in multiple cellular pathways, including cell cycle, signal transduction, cytokines and stress response. NRC-1 is likely to induce cell growth arrest indirectly through WEE1. ^

RNA polymerase II large subunit degradation induced by ecteinascidin 743: Molecular characterization and subsequent rational investigation of antitumor mechanisms in cancers with clinical response

Ecteinascidin 743 (Et-743), which is a novel DNA minor groove alkylator with a unique spectrum of antitumor activity, is currently being evaluated in phase II/III clinical trials. Although the precise molecular mechanisms responsible for the observed antitumor activity are poorly understood, recent data suggests that post-translational modifications of RNA polymerase II Large Subunit (RNAPII LS) may play a central role in the cellular response to this promising anticancer agent. The stalling of an actively transcribing RNAPII LS at Et-743-DNA adducts is the initial cellular signal for transcription-coupled nucleotide excision repair (TC-NER). In this manner, Et-743 poisons TC-NER and produces DNA single strand breaks. Et-743 also inhibits the transcription and RNAPII LS-mediated expression of selected genes. Because the poisoning of TC-NER and transcription inhibition are critical components of the molecular response to Et-743 treatment, we have investigated if changes in RNAPII LS contribute to the disruption of these two cellular pathways. In addition, we have studied changes in RNAPII LS in two tumors for which clinical responses were reported in phase I/II clinical trials: renal cell carcinoma and Ewing's sarcoma. Our results demonstrate that Et-743 induces degradation of the RNAPII LS that is dependent on active transcription, a functional 26S proteasome, and requires functional TC-NER, but not global genome repair. Additionally, we have provided the first experimental data indicating that degradation of RNAPII LS might lead to the inhibition of activated gene transcription. A set of studies performed in isogenic renal carcinoma cells deficient in von Hippel-Lindau protein, which is a ubiquitin-E3-ligase for RNAPII LS, confirmed the central role of RNAPII LS degradation in the sensitivity to Et-743. Finally, we have shown that RNAPII LS is also degraded in Ewing's sarcoma tumors following Et-743 treatment and provide data to suggest that this event plays a role in decreased expression of the Ewing's sarcoma oncoprotein, EWS-Fli1. Altogether, these data implicate degradation of RNAPII LS as a critical event following Et-743 exposure and suggest that the clinical activity observed in renal carcinoma and Ewing's sarcoma may be mediated by disruption of molecular pathways requiring a fully functional RNAPII LS. ^

Identification and characterization of cellular genes differentially expressed in a subset of tumors with non -functional WT1

Wilms tumor (WT) or nephroblastoma is a genetically heterogeneous pediatric renal tumor that accounts for 6–7% of all childhood cancers in the U.S. WT1, located at 11p13, is the sole WT gene cloned to date. Additional genomic regions containing genes that play a role in the development of Wilms tumor include 11p15, 7p, 16q, 1p, 17q and 19q. This heterogeneity has made it extremely difficult to develop an understanding of the pathways involved in the development of WT, even in the 5–20% of tumors that show mutations at the WT1 locus. My research addresses this gap in our current comprehension of the development of WT. ^ I have used two complementary approaches to extend the current understanding of molecular changes involved in the development of WT. In order to minimize complexities due to genetic heterogeneity, I confined my analysis to the WT1 pathway by assessing those genetically defined tumors that carry WT1 mutations. WT1 encodes a zinc finger transcription factor, and in vitro studies have identified many genes that are potentially regulated in vivo by WT1. However, there is very little in vivo data that suggests that they are transcriptionally regulated endogenously by WT1. In one approach I assessed the role of WT1 in the in vivo regulation of PDGFA and IGF2, two genes that are strong contenders for endogenous regulation by WT1. Using primary tissue samples, I found no correlation between the level of RNA expression of WT1 with either PDGFA or IGF2, suggesting that WT1 does not play a critical role in their expression in either normal kidney or WT. ^ In a parallel strategy, using differential display analysis I compared global gene expression in a subset of tumors with known homozygous inactivating WT1 mutations (WT1-tumors) to the gene expression in a panel of appropriate control tissues (fetal kidney, normal kidney, rhabdoid tumor and pediatric renal cell carcinoma). Transcripts that are aberrantly expressed in this subset of Wilms tumors are candidates for endogenous transcriptional regulation by WT1 as well as for potentially functioning in the development of WT. By this approach I identified several differentially expressed transcripts. I further characterized two of these transcripts, identifying a candidate WT gene in the process. I then performed a detailed analysis of this WT candidate gene, which maps to 7p. Future studies will shed more light on the role of these differentially expressed genes in WT. ^