Targeting the Serotonin (5-HT) system to control seizures

Compelling animal and human evidence suggests that serotonin plays an important role in the pathophysiology of epilepsy as it is involved in iperexcitability, epileptogenesis, seizure generation, depression and psychiatric disorders comorbid with epilepsy. Serotonin involvement in epilepsy is complex; the reasons are twofold i) epilepsy is in reality a spectrum disorder, and ii) serotonin effects vary from one form of epilepsy to another, due also to the different serotonin receptors involved. Here, we will focus on the role of serotonin and its 5-HT2 receptors in absence epilepsy. Our recent pharmacological experimental evidence in GAERS will be reviewed together with our preliminary optogenetic results. 5-HT2C receptor agonists may represent a new approach to interfere with seizure generation and seizure management. Our optogenetic experiments also indicate that by modulating rhythmic cortical activity, optogenetic stimulation of the serotonergic system may provide seizure control without the adverse effects induced by pharmacological activation of 5-HT2C receptors. Thus, targeting the serotonergic system could provide novel insights into the pathophysiological mechanisms of seizure generation and lead to potentially novel treatments.peer-reviewe

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies

Representative sequencing: Unbiased sampling of solid tumor tissue

International audienceAlthough thousands of solid tumors have been sequenced to date, a fundamental under-sampling bias isinherent in current methodologies. This is caused by a tissue sample input of fixed dimensions (e.g., 6 mmbiopsy), which becomes grossly under-powered as tumor volume scales. Here, we demonstrate representative sequencing (Rep-Seq) as a new method to achieve unbiased tumor tissue sampling. Rep-Seq uses fixed residual tumor material, which is homogenized and subjected to next-generation sequencing. Analysis of intratumor tumor mutation burden (TMB) variability shows a high level of misclassification using current single-biopsy methods, with 20% of lung and 52% of bladder tumors having at least one biopsy with high TMB butlow clonal TMB overall. Misclassification rates by contrast are reduced to 2% (lung) and 4% (bladder) when a more representative sampling methodology is used. Rep-Seq offers an improved sampling protocol for tumor profiling, with significant potential for improved clinical utility and more accurate deconvolution of clonal structure