Detection of pancreatic cancer tumours and precursor lesions by cathepsin E activity in mouse models.

ABSTRACT Background and Aims Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in the USA. Surgical resection is the only effective treatment; however, only 20% of patients are candidates for surgery. The ability to detect early PDAC would increase the availability of surgery and improve patient survival. This study assessed the feasibility of using the enzymatic activity of cathepsin E (Cath E), a protease highly and specifically expressed in PDAC, as a novel biomarker for the detection of pancreas-bearing pancreatic intraepithelial neoplasia (PanIN) lesions and PDAC. Methods Pancreas from normal, chronic pancreatitis and PDAC patients was assessed for Cath E expression by quantitative real-time PCR and immunohistochemistry. Human PDAC xenografts and genetically engineered mouse models (GEMM) of PDAC were injected with a Cath E activity selective fluorescent probe and imaged using an optical imaging system. Results The specificity of Cath E expression in PDAC patients and GEMM of pancreatic cancer was confirmed by quantitative real-time PCR and immunohistochemistry. The novel probe for Cath E activity specifically detected PDAC in both human xenografts and GEMM in vivo. The Cath E sensitive probe was also able to detect pancreas with PanIN lesions in GEMM before tumour formation. Conclusions The elevated Cath E expression in PanIN and pancreatic tumours allowed in-vivo detection of human PDAC xenografts and imaging of pancreas with PanIN and PDAC tumours in GEMM. Our results support the usefulness of Cath E activity as a potential molecular target for PDAC and early detection imaging. Despite great efforts to help patients with pancreatic ductal adenocarcinoma (PDAC) in the past few years, this disease remains devastating with the worst outcome of all major cancers. In the USA, PDAC ranks 10th in terms of incidence, but for both men and women, it is fourth in terms of cancer deaths. Although many molecular biomarker candidates of PDAC have been identified, 3 biomarkers with the necessary sensitivity and specificity for early detection are still lacking. 4e6 The most widely utilised blood-based biomarker is CA 19-9, which is not expressed in all patients, is not highly specific as it is elevated in other gastrointestinal cancers, and is not useful for the detection of early disease. 7 8 Furthermore, CA 19-9 levels do not provide information about the localisation of the disease nor the existence of metastases. The most sensitive diagnosis of PDAC currently requires invasive imaging procedures such as endoscopic ultrasonography, which Significance of this study What is already known about this subject? < No highly specific and sensitive biomarkers are clinically available for the detection of PDAC at an early stage. < Cath E is highly overexpressed in many cancers including PDAC. < A Cath E selective peptide was recently identified that specifically detects its enzymatic activity. What are the new findings? < We demonstrate that the elevated levels of Cath E expression in early pancreatic cancer lesions and pancreatic tumours could be exploited for PDAC detection. < We illustrate that the detection and localisation of PDAC in mouse xenografts and GEMM was possible utilising the outstanding specificity of a novel Cath E-activatable imaging probe. How might it impact on clinical practice in the foreseeable future? < The ability to detect and visualise pancreatic tumours and PanIN in PDAC by virtue of Cath E activity sensitive probes in preclinical mouse models suggests that modifications of this approach will be useful for the early detection and management of this deadly cancer in patients. < The specificity of Cath E activity for PDAC suggests that this enzymatic activity will be useful in the future for the development of novel therapeutics or theranostics. Cruz-Monserrate Z, Abd-Elgaliel WR, Grote T, et al. Gut (2011)

Assessment of Cardiovascular Fibrosis Using Novel Fluorescent Probes

Cardiovascular fibrosis resulted from pressure overload or ischemia could alter myocardial stiffness and lead to ventricular dysfunction. Fluorescently labeled collagen-binding protein CNA 35, derived from the surface component of Staphylococcus aureus, and a novel synthetic biphenylalanine containing peptide are applied to stain fibrosis associated collagen and myocytes, respectively. Detailed pathological characteristics of cardiovascular fibrosis could be identified clearly in 2 hours. This staining pair requires only simple staining and brief washing, generating less than 10 ml of waste. The image information collected by this novel fluorescent staining pair is compatible with it collected by the traditional Masson's Trichrome and Picrosirius Red staining which are widely used to stain cardiovascular fibrosis and isolated cells

Perivascular fibrosis staining.

<p>A: Masson's Trichrome staining. B: CNA35 mono staining for collagen fibers. C: MTP mono staining for myocyte. D: Double staining for collagen (CNA35-Cy3, red) and myocyte (MTP-FITC, green).</p

Chemical structure of MTP.

<p>Chemical structure of MTP.</p

Interstitial fibrosis in hypertrophic hearts.

<p>A. normal control heart and B. hypertrophic heart with Masson's Trichrome stain. Blue  =  fibrous collagen, red  =  myocytes, black  =  nuclei, C: Picrosirius Red stain on hypertrophic heart, red  =  fibrous collagen, pale yellow  =  myocytes, black  =  nuclei. D: CNA35-Cy3 (red) and MTP-FITC (green) double stain on hypertrophic heart.</p

Staining of fibrosis in infarcted area.

<p>A and B: Masson's Trichrome, C: Picrosirius Red staining. D: Double staining for collagen (CNA35-Cy3, red) and myocyte (MTP-FITC, green).</p

Staining of neointima in coronary arteries in Ab+I/R+DeAb heart in rats.

<p>A: Picrosirius Red staining. B: Masson's Trichrome. C: CNA35 mono staining. D: Double staining for collagen (CNA35-Cy3, red) and myocyte (MTP-FITC, green).</p