Implications of therapy interruption on monthly migraine days and modified migraine disability assessment in patients treated with erenumab for chronic and episodic migraine: SQUARE study interim results.

BACKGROUND There are limited real-world data in Switzerland examining the impact of erenumab, a fully human IgG2 monoclonal antibody targeting the calcitonin gene-related peptide (CGRP) receptor, on migraine-related quality of life. OBJECTIVE This 18-month interim analysis of 172 patients with episodic or chronic migraine from the SQUARE study provides first prospective insights on the impact of mandatory erenumab treatment interruption, following Swiss-reimbursement requirements, in a real-world clinical setting in Switzerland. FINDINGS Recruited patients receiving 70 or 140 mg erenumab underwent treatment interruption on average 11.2 months after therapy onset with a mean duration of 4 months. There were sustained improvements in mean monthly migraine days (MMD) and migraine disability (mMIDAS) during initial treatment with erenumab. Treatment interruption was associated with a temporary worsening of condition. Symptoms ameliorated upon therapy reuptake reaching improvements similar to pre-break within 3 months. CONCLUSIONS Treatment interruption was associated with a temporary worsening of condition, which improved again after therapy restart

Estrogen-induced chromatin decondensation and nuclear re-organization linked to regional epigenetic regulation in breast cancer

BACKGROUND: Epigenetic changes are being increasingly recognized as a prominent feature of cancer. This occurs not only at individual genes, but also over larger chromosomal domains. To investigate this, we set out to identify large chromosomal domains of epigenetic dysregulation in breast cancers. RESULTS: We identify large regions of coordinate down-regulation of gene expression, and other regions of coordinate activation, in breast cancers and show that these regions are linked to tumor subtype. In particular we show that a group of coordinately regulated regions are expressed in luminal, estrogen-receptor positive breast tumors and cell lines. For one of these regions of coordinate gene activation, we show that regional epigenetic regulation is accompanied by visible unfolding of large-scale chromatin structure and a repositioning of the region within the nucleus. In MCF7 cells, we show that this depends on the presence of estrogen. CONCLUSIONS: Our data suggest that the liganded estrogen receptor is linked to long-range changes in higher-order chromatin organization and epigenetic dysregulation in cancer. This may suggest that as well as drugs targeting histone modifications, it will be valuable to investigate the inhibition of protein complexes involved in chromatin folding in cancer cells. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13059-015-0719-9) contains supplementary material, which is available to authorized users

Investigation on the regulator proteins Geminin and Cdt1 in human cells

One major function of Geminin is to inhibit replication-licensing by sequestration of the initiator protein Cdt1. Geminin is a cell-cycle regulated protein that is expressed during S and G2 phase, rapidly degraded at the end of mitosis and absent in G1 phase.This work has shown that Geminin-mRNA is synthesized during the whole cell cycle in HeLa-cells with a slight increase at the beginning of S phase. Metabolic labelling experiments with synchronized HeLa-cells have shown that the protein Geminin is permanently synthesized during S phase. Furthermore, the fraction of Geminin that is synthesized in the first hours of S phase becomes then slowly degraded with a half-life of 3 to 4 hours.A knockdown of Geminin with specific siRNA-sequences does neither affect DNA replication, cell-cycle progression nor expression and chromatin binding of the initiator-protein Cdt1.Cell-cycle studies have further shown that Geminin and Cdt1 are only co-expressed in a short period of the cell cycle, bind together to chromatin at the G1-to-S transition and interact with each other during this period. Chromatin-immunoprecipitations have shown that this interaction takes place on chromatin and analysis of the MCM4-promtor region refers to the existence of Geminin and Cdt1 near the binding site of the origin recognition complex ORC. Geminin stays bound to chromatin during S phase, when Cdt1 is released and degraded. A stabilization of Cdt1 with the proteasome-inhibitor MG132 in S phase has led to an increase in the amount of chromatin-bound Geminin and an interaction of both proteins also during S phase.In vitro and in vivo studies gave evidence that Geminin is phosphorylated in a cell-cycle dependent manner during S phase. Specific inhibitors have shown that protein-kinase CK2 is the major responsible kinase for the phosphorylation of Geminin, but glycogen-synthase kinase does also contribute. The phosphorylation with CK2 takes place in the C-terminal part of Geminin whereas GSK3 most likely phosphorylates N-terminal, probably at serine-45. Treating HeLa-cells with kinase-specific inhibitors does not influence the behaviour of Geminin, namely its interaction with Cdt1 or its subcellular localisation

Protein kinase CK2 phosphorylates the cell cycle regulatory protein Geminin

Geminin contributes to cell cycle regulation by a timely inhibition of Cdt1p, the loading factor required for the assembly of pre-replication complexes. Geminin is expressed during S and G2 phase of the HeLa cell cycle and phosphorylated soon after its synthesis. We show here that Geminin is an excellent substrate for protein kinase CK2 in vitro; and that the highly specific CK2 inhibitor tetrabromobenzotriazole (TBB) blocks the phosphorylation of Geminin in HeLa protein extracts and HeLa cells in vivo. The sites of CK2 phosphorylation are located in the carboxyterminal region of Geminin, which carries several consensus sequence motifs for CK2. We also show that a minor phosphorylating activity in protein extracts can be attributed to glycogen synthase kinase 3 (GSK3), which most likely targets a central peptide in Geminin. Treatment of HeLa cells with TBB does not interfere with the ability of Geminin to interact with the loading factor Cdt1

Implications of therapy interruption on monthly migraine days and modified migraine disability assessment in patients treated with erenumab for chronic and episodic migraine: SQUARE study interim results.

There are limited real-world data in Switzerland examining the impact of erenumab, a fully human IgG2 monoclonal antibody targeting the calcitonin gene-related peptide (CGRP) receptor, on migraine-related quality of life. This 18-month interim analysis of 172 patients with episodic or chronic migraine from the SQUARE study provides first prospective insights on the impact of mandatory erenumab treatment interruption, following Swiss-reimbursement requirements, in a real-world clinical setting in Switzerland. Recruited patients receiving 70 or 140 mg erenumab underwent treatment interruption on average 11.2 months after therapy onset with a mean duration of 4 months. There were sustained improvements in mean monthly migraine days (MMD) and migraine disability (mMIDAS) during initial treatment with erenumab. Treatment interruption was associated with a temporary worsening of condition. Symptoms ameliorated upon therapy reuptake reaching improvements similar to pre-break within 3 months. Treatment interruption was associated with a temporary worsening of condition, which improved again after therapy restart