Präklinische Studien zur Behandlung des Nierenzellkarzinoms durch den Histondeacetylase-Inhibitor Valproat und Interferon-alpha

Das Nierenzellkarzinom (NZK) ist der häufigste maligne Tumor der Niere. In vielen Fällen sind bereits bei der Erstdiagnose Metastasen vorhanden oder entstehen im Verlauf der Therapie. Die Behandlungsmöglichkeiten für diese NZK-Patienten sind äußerst limitiert. Nahezu 2/3 der Betroffenen versterben an ihrer Erkrankung. Die Etablierung neuer Therapieansätze zur Behandlung des NZK ist dringend gefordert. Es wird postuliert, dass ein Therapiekonzept basierend auf dem Histondeacetylase (HDAC)-Inhibitor Valproat (VPA) kombiniert mit niedrig dosiertem Interferon (IFN)-alpha eine innovative und effiziente Behandlungsoption für austherapierte NZK-Patienten eröffnen könnte. In der vorliegenden Studie wurde der Einfluss einer VPA-Mono- versus VPA/IFN-alpha-Kombinationstherapie auf die malignen Eigenschaften verschiedener NZK-Zelllinien evaluiert. Mittels funktioneller Untersuchungen wurden Proliferations- und Adhäsionsphänomene unter den entsprechenden Therapien näher betrachtet. Fluorimetrische und molekularbiologische Studien dienten der detaillierten Aufklärung der den Veränderungen zugrunde liegenden Wirkmechanismen. Zur translationalen Gestaltung wurden zusätzlich tierexperimentelle Untersuchungen durchgeführt. VPA induzierte eine signifikante Reduktion der Proliferation von NZK-Zellen, die durch die additive Gabe von IFN-alpha weiter verstärkt wurde. Die anti-proliferativen Effekte korrelierten mit einer Zunahme der Zellen in der G0/G1-Phase und einer damit einhergehenden verminderten Anzahl an Zellen in der S-Phase. Die Verschiebung der Zellzyklusphasen war mit einer deutlichen Modulation relevanter regulatorischer Zellzyklusproteine assoziiert. Des Weiteren resultierte VPA und die korrespondierende Kombination mit IFN-alpha in einer signifikanten Inhibition der Adhäsion an Endothel und die extrazellulären Matrixproteine. VPA und die VPA/IFN-alpha-Kombination übten ihren Einfluss dabei offensichtlich über eine Modulation von Adhäsionsrezeptoren, implizit Integrine und CD44-Varianten, aus. Die antiproliferative und –adhäsive Wirkung war in der Regel nach längerer Inkubationszeit von 5 Tagen deutlich stärker als nach 3 Tagen. In analog behandelten normalen Nierenzellen zeigten sich im Vergleich keine solchen Effekte. Die Behandlung mit VPA und IFN-alpha scheint somit spezifisch maligne Zellen zu beeinflussen. VPA induzierte in den NZK-Zellen ferner die Reduktion von Protoonkogenen und MAP-Kinasen sowie die Zunahme von Tumorsuppressoren. Die zusätzliche Gabe von IFN-alpha resultierte in einer weiteren Wirkungsverstärkung gegenüber VPA allein. VPA und die Kombination mit IFN-alpha inhibierten zudem signifikant die HDAC6-Aktivität und -Proteinexpression der NZK-Zellen. Diese Hemmung ging mit einer Hyperacetylierung der Histone einher. Die epigenetische Modulation führte zur veränderten Genregulation und Transkription. So nahmen VPA und die korrespondierende Kombination neben den genannten funktionellen und molekularbiologischen Veränderungen maßgeblich Einfluss auf das Genexpressionsprofil der Tumorzellen. Die Expression negativer Regulatoren der Proliferation, Migration und Adhäsion sowie von Genen involviert in Differenzierung und Immunantwort wurden erhöht, wohingegen die Anzahl der Transkripte von Genen mitverantwortlich für die Ausbildung von Resistenzen und die Nährstoffversorgung der Tumoren reduziert wurde. Translationale tierexperimentelle Studien bestätigten die klinische Relevanz der VPA- und VPA/IFN-alpha-Behandlung, die in einer signifikanten Hemmung des Tumorwachstums resultierten. Die Wachstums-Inhibition war mit einer starken Modulation regulatorischer Proteine des Zellzyklus, der Apoptose und des HDAC-Systems assoziiert. Die vorliegenden Ergebnisse demonstrieren das viel versprechende Wirkungspotential von VPA und der korrespondierenden Kombination mit niedrig dosiertem IFN-alpha. VPAs anti-proliferative und -adhäsive Effekte in vitro und in vivo eröffnen die Perspektive für eine innovative Strategie in der Behandlung des NZK. Aufgrund der präsentierten Daten lässt sich postulieren, dass VPA und IFN-alpha die Grundlage für ein neues, effizientes Therapiekonzept bei austherapierten NZK-Patienten darstellen könnte

Publication of original research in urologic journals - a neglected orphan?

The pathophysiologic mechanisms behind urologic disease are increasingly being elucidated. The object of this investigation was to evaluate the publication policies of urologic journals during a period of progressively better understanding and management of urologic disease. Based on the ISI Web of Knowledge Journal Citation Reports and the PubMed database, the number and percentage of original experimental, original clinical, review or commentarial articles published between 2002–2010 in six leading urologic journals were analyzed. “British Journal of Urology International”, “European Urology”, “Urologic Oncology-Seminars and Original Investigations” (“Urologic Oncology”), “Urology”, “The Journal of Urology”, and “World Journal of Urology” were chosen, because these journals publish articles in all four categories. The publication policies of the six journals were very heterogeneous during the time period from 2002 to 2010. The percentage of original experimental and original clinical articles, related to all categories, remained the same in “British Journal of Urology International”, “Urologic Oncology”, “Urology” and “The Journal of Urology”. The percentage of experimental reports in “World Journal of Urology” between 2002–2010 significantly increased from 10 to 20%. A distinct elevation in the percentage of commentarial articles accompanied by a reduction of clinical articles became evident in “European Urology” which significantly correlated with a large increase in the journal’s impact factor. No clearly superior policy could be identified with regard to a general increase in the impact factors from all the journals. The publication policy of urologic journals does not expressly reflect the increase in scientific knowledge, which has occurred over the period 2002–2010. One way of increasing the exposure of urologists to research and expand the interface between experimental and clinical research, would be to enlarge the percentage of experimental articles published. There is no indication that such policy would be detrimental to a journal’s impact factor

Resistance after chronic application of the HDAC-inhibitor valproic acid is associated with elevated Akt activation in renal cell carcinoma in vivo

Targeted drugs have significantly improved the therapeutic options for advanced renal cell carcinoma (RCC). However, resistance often develops, negating the benefit of these agents. In the present study, the molecular mechanisms of acquired resistance towards the histone deacetylase (HDAC) inhibitor valproic acid (VPA) in a RCC in vivo model were investigated. NMRI:nu/nu mice were transplanted with Caki-1 RCC cells and then treated with VPA (200 mg/kg/day). Controls remained untreated. Based on tumor growth dynamics, the mice were divided into “responders” and “non-responders” to VPA. Histone H3 and H4 acetylation and expression of cell signaling and cell cycle regulating proteins in the RCC mouse tumors were evaluated by Western blotting. Tumor growth of VPA responders was significantly diminished, whereas that of VPA non-responders even exceeded control values. Cdk1, 2 and 4 proteins were strongly enhanced in the non-responders. Importantly, Akt expression and activity were massively up-regulated in the tumors of the VPA non-responders. Chronic application (12 weeks) of VPA to Caki-1 cells in vitro evoked a distinct elevation of Akt activity and cancer cells no longer responded with cell growth reduction, compared to the short 2 week treatment. We assume that chronic use of an HDAC-inhibitor is associated with (re)-activation of Akt, which may be involved in resistance development. Consequently, combined blockade of both HDAC and Akt may delay or prevent drug resistance in RCC

New histone deacetylase inhibitors as potential therapeutic tools for advanced prostate carcinoma

The anti-epileptic drug valproic acid is also under trial as an anti-cancer agent due to its histone deacetylase (HDAC) inhibitory properties. However, the effects of valproic acid (VPA) are limited and concentrations required for exerting anti-neoplastic effects in vitro may not be reached in tumour patients. In this study, we tested in vitro and in vivo effects of two VPA-derivatives (ACS2, ACS33) on pre-clinical prostate cancer models. PC3 and DU-145 prostate tumour cell lines were treated with various concentrations of ACS2 or ACS33 to perform in vitro cell proliferation 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays and to evaluate tumour cell adhesion to endothelial cell monolayers. Analysis of acetylated histones H3 and H4 protein expression was performed by western blotting. In vivo tumour growth was conducted in subcutaneous xenograft mouse models. Tumour sections were assessed by immunohistochemistry for histone H3 acetylation and proliferation. ACS2 and ACS33 significantly up-regulated histone H3 and H4 acetylation in prostate cancer cell lines. In micromolar concentrations both compounds exerted growth arrest in PC3 and DU-145 cells and prevented tumour cell attachment to endothelium. In vivo, ACS33 inhibited the growth of PC3 in subcutaneous xenografts. Immunohistochemistry and western blotting confirmed increased histone H3 acetylation and reduced proliferation. ACS2 and ACS33 represent novel VPA derivatives with superior anti-tumoural activities, compared to the mother compound. This investigation lends support to the clinical testing of ACS2 or ACS33 for the treatment of prostate cancer

Bladder cancer metastasis induced by chronic everolimus application can be counteracted by sulforaphane in vitro

Chronic treatment with the mTOR inhibitor, everolimus, fails long-term in preventing tumor growth and dissemination in cancer patients. Thus, patients experiencing treatment resistance seek complementary measures, hoping to improve therapeutic efficacy. This study investigated metastatic characteristics of bladder carcinoma cells exposed to everolimus combined with the isothiocyanate sulforaphane (SFN), which has been shown to exert cancer inhibiting properties. RT112, UMUC3, or TCCSUP bladder carcinoma cells were exposed short- (24 h) or long-term (8 weeks) to everolimus (0.5 nM) or SFN (2.5 µM), alone or in combination. Adhesion and chemotaxis along with profiling details of CD44 receptor variants (v) and integrin α and β subtypes were evaluated. The functional impact of CD44 and integrins was explored by blocking studies and siRNA knock-down. Long-term exposure to everolimus enhanced chemotactic activity, whereas long-term exposure to SFN or the SFN-everolimus combination diminished chemotaxis. CD44v4 and v7 increased on RT112 cells following exposure to SFN or SFN-everolimus. Up-regulation of the integrins α6, αV, and β1 and down-regulation of β4 that was present with everolimus alone could be prevented by combining SFN and everolimus. Down-regulation of αV, β1, and β4 reduced chemotactic activity, whereas knock-down of CD44 correlated with enhanced chemotaxis. SFN could, therefore, inhibit resistance-related tumor dissemination during everolimus-based bladder cancer treatment

Chronic sulforaphane administration inhibits resistance to the mTOR-inhibitor everolimus in bladder cancer cells

Progressive bladder cancer growth is associated with abnormal activation of the mammalian target of the rapamycin (mTOR) pathway, but treatment with an mTOR inhibitor has not been as effective as expected. Rather, resistance develops under chronic drug use, prompting many patients to lower their relapse risk by turning to natural, plant-derived products. The present study was designed to evaluate whether the natural compound, sulforaphane (SFN), combined with the mTOR inhibitor everolimus, could block the growth and proliferation of bladder cancer cells in the short- and long-term. The bladder cancer cell lines RT112, UMUC3, and TCCSUP were exposed short- (24 h) or long-term (8 weeks) to everolimus (0.5 nM) or SFN (2.5 µM) alone or in combination. Cell growth, proliferation, apoptosis, cell cycle progression, and cell cycle regulating proteins were evaluated. siRNA blockade was used to investigate the functional impact of the proteins. Short-term application of SFN and/or everolimus resulted in significant tumor growth suppression, with additive inhibition on clonogenic tumor growth. Long-term everolimus treatment resulted in resistance development characterized by continued growth, and was associated with elevated Akt-mTOR signaling and cyclin-dependent kinase (CDK)1 phosphorylation and down-regulation of p19 and p27. In contrast, SFN alone or SFN+everolimus reduced cell growth and proliferation. Akt and Rictor signaling remained low, and p19 and p27 expressions were high under combined drug treatment. Long-term exposure to SFN+everolimus also induced acetylation of the H3 and H4 histones. Phosphorylation of CDK1 was diminished, whereby down-regulation of CDK1 and its binding partner, Cyclin B, inhibited tumor growth. In conclusion, the addition of SFN to the long-term everolimus application inhibits resistance development in bladder cancer cells in vitro. Therefore, sulforaphane may hold potential for treating bladder carcinoma in patients with resistance to an mTOR inhibitor

Relevance of the natural HDAC inhibitor sulforaphane as a chemopreventive agent in urologic tumors

Due to an increased understanding of molecular biology and the genomics of cancer, new and potent agents have been approved by the Food and Drug Administration (FDA) to fight this disease. However, all of these drugs cause severe side effects and resistance inevitably develops, re-activating tumor growth and dissemination. For this reason, patients turn to natural compounds as alternative or complementary treatment options, since it has been found that natural plant products may block, inhibit, or reverse cancer development. The present review focusses on the role of the natural compound sulforaphane (SFN) as an anti-tumor agent in urologic cancer. SFN is a natural compound found in cruciferous vegetables from the Brassicaceae family such as broccoli, cauliflower and cabbage. Several epidemiologic and clinical studies have documented chemopreventive properties of SFN, making it an interesting candidate for additive cancer treatment. SFN shows remarkable anti-tumor effects in vitro and in vivo without exerting toxicity. The review summarizes the current understanding of SFN and provides insights into its molecular mode of action with particular emphasis on epigenetic tumor control

I publish in 1 edit? : Do editorial board members of urologic journals preferentially publish their own scientific work?

Scientists who are members of an editorial board have been accused of preferentially publishing their scientific work in the journal where they serve as editor. Reputation and academic standing do depend on an uninterrupted flow of published scientific work and the question does arise as to whether publication mainly occurs in the self-edited journal. This investigation was designed to determine whether editorial board members of five urological journals were more likely to publish their research reports in their own rather than in other journals. A retrospective analysis was conducted for all original reports published from 2001–2010 by 65 editorial board members nominated to the boards of five impact leading urologic journals in 2006. Publications before editorial board membership, 2001–2005, and publications within the period of time as an editorial board member, 2006–2010, were identified. The impact factors of the journals were also recorded over the time period 2001–2010 to see whether a change in impact factor correlated with publication locality. In the five journals as a whole, scientific work was not preferentially published in the journal in which the scientists served as editor. However, significant heterogeneity among the journals was evident. One journal showed a significant increase in the amount of published papers in the ‘own’ journal after assumption of editorship, three journals showed no change and one journal showed a highly significant decrease in publishing in the ‘own’ journal after assumption of editorship

PIAS1 is not suitable as a urothelial carcinoma biomarker protein and pharmacological target.

Urothelial cancer (UC) is one of the most common cancers in Europe and is also one of the costliest to treat. When first line therapies show initial success, around 50% of cancers relapse and proceed to metastasis. In this study we assessed the Protein inhibitor of activated signal transducers and activators of transcription (PIAS)1 as a potential therapeutic target in urothelial cancer. PIAS1 is a key regulator of STAT1 signalling and may be implicated in carcinogenesis. In contrast to other cancer types PIAS1 protein expression is not significantly different in malignant areas of UC specimens compared to non-malignant tissue. In addition, we found that down-regulation and overexpression of PIAS1 had no effect on the viability or colony forming ability of tested cell lines. Whilst other studies of PIAS1 suggest an important biological role in cancer, this study shows that PIAS1 has no influence on reducing the cytotoxic effects of Cisplatin or cell recovery after DNA damage induced by irradiation. Taken together, these in vitro data demonstrate that PIAS1 is not a promising therapeutic target in UC cancer as previously shown in different entities such as prostate cancer (PCa)