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M J Droller

Publications and source records attributed to M J Droller.

At least 19 recordsLinked to original sources

Abrogation of the invasion of human bladder tumor cells by using protease inhibitor(s).

It was shown previously that invasive human transitional cell carcinoma cell line EJ, but not the noninvasive RT4 cells, can degrade basement membrane laminin and that the degradation of basement membrane laminin was a result of a redistribution of activated cysteine proteinase cathepsin B to the plasma membrane of the invasive EJ cells. Using a modified Boyden chamber and an artificial basement membrane, it was found first that cysteine proteinase inhibitor E-64 can abolish the ability of the EJ cells to invade through the artificial basement membrane to the underside of the filter. Second, E-64 can prevent the degradation of purified human basement membrane laminin by the plasma membrane fraction of invasive EJ cells. Third, E-64 does not affect the ability of the EJ cells to attach to the extracellular matrix nor is the inhibitory dose toxic to the cells when assayed with trypan-blue dye exclusion. However, E-64 does affect the ability of the EJ cells to respond to autocrine motility factor-induced motility. Finally, in an in vivo model, E-64 was not toxic to the animals tested and may have limited the blood-borne metastatic ability of invasive EJ cells in the treated animals. It was concluded that proteinase cathepsin B may be involved in human bladder tumor invasion, in both extracellular matrix degradation and factor-induced cellular motility, and the authors suggested that the use of inhibitor(s) to cysteine proteinases may limit the invasive potential of human bladder cancer cells.

Animals

Bacillus Calmette-Guerin abrogates in vitro invasion and motility of human bladder tumor cells via fibronectin interaction.

Intravesical bacillus Calmette-Guerin (BCG) has been shown to be an effective treatment for superficial transitional cell carcinoma of the bladder (TCC). The mechanisms by which BCG limits tumor cell activity have thus far been unclear. We investigated the interaction between BCG and invasive human TCC cell line EJ in an in vitro invasion assay. We observed that BCG inhibited the invasion of EJ cells through an artificial basement membrane. In terms of the steps involved in tumor cell invasion, i.e. attachment, proteolysis, and motility, BCG was found to limit tumor cell motility. Attachment and proliferation of tumor cells were not affected by BCG. The effects of BCG on tumor cell migration were mediated by fibronectin (FN), a basement membrane glycoprotein component. Abrogation of BCG-FN-tumor cell interactions with anti-FN antibodies eliminated the ability of BCG to block tumor cell invasion. Fibronectin appears to link BCG and tumor cells via independent FN binding receptors to separate domains of the FN molecule. The molecular mechanism by which BCG may limit tumor cell motility may be its ability to protect against the formation of specific FN sequences as a result of protease cathepsin B digestion. A 31 kD and 27 kD FN band were absent from purified or tumor cell associated cathepsin B digestion when incubated in the presence of BCG, but present in the absence of BCG. Furthermore when purified from SDS polyacrylamide gel electrophoresis, the fragments were shown to have motility stimulating activity for the invasive EJ cells. These findings suggest that BCG functions as a potent inhibitor of tumor cell invasion. We conclude that BCG-fibronectin-tumor cell interactions may have a direct influence on the invasive mechanisms, such as motility, of tumor cells.

BCG Vaccine

Treatment of regionally advanced bladder cancer. An overview.

The finding of muscle-infiltrative bladder cancer is generally considered ominous, as 50% of patients who present with this condition are likely to develop distant metastases within 2 years. However, some types of infiltrative bladder cancer appear to have a less ominous prognosis. In order to assess the results of various therapies on regionally advanced bladder cancer, it is important to characterize the distinctions between the types with a poor prognosis (5-year survival rate 15% to 30%) and those with a better prognosis (5-year survival rate 50% to 85%). The former have a nodular architecture, infiltrate more deeply and in a tentacular pattern, and more often involve the bladder wall vasculature and lymphatics than does the latter type, which has papillary architecture and infiltrates on a broad front. These two types appear to respond differently to various treatments except systemic chemotherapy.

Antineoplastic Combined Chemotherapy Protocols

Type IV procollagen mRNA regulation: evidence for extracellular matrix/cytoskeleton/nuclear matrix interactions in human urothelium.

The absence of basement membrane components correlates with tumor stage and progression in human bladder cancers. We have previously shown that invasive tumors possess the ability to degrade basement membrane. However, the presence of basement membrane may be affected not only by its degradation, but by its synthesis and deposition as well. Our results in the present study suggest that while the invasive human transitional carcinoma cell line EJ has an increased amount of type IV procollagen mRNA when compared to the non-invasive RT4 cell line, type IV collagen staining is absent in the invasive EJ cells and intensely present in the non-invasive RT4 cells. Moreover, when EJ cells were grown on an artificial basement membrane (Matrigel), type IV procollagen mRNA expression was down-regulated to the levels seen with the non-invasive RT4 cells. We also discovered that the invasive cells, when grown on Matrigel, appeared morphologically different from the same cells grown on plastic tissue cultures. We conclude that a deficient basement membrane in invasive cancer cells may be due not only to active proteolytic activity but also to an abnormal production and deposition of extracellular matrix components. In addition, we also demonstrated that basement membrane components may have a significant effect on epithelial cell morphology and gene regulation, and that any alterations of the extracellular matrix-cytoskeleton-nuclear matrix interactions can lead to altered gene regulations and cell function.

Basement Membrane

Biochemistry of human bladder tumor invasion.

Bladder tumors comprise a spectrum of neoplastic diathesis. Some behave in a benign fashion, and others are highly aggressive and lead rapidly to metastatic disease and death. The metastasizing potential, often described as a sequence of interrelated steps, involve 1) tumor cell adhesion to basement membranes, 2) degradation of basement membranes and underlying connective tissue stroma, and 3) migration of tumor cells through the destroyed stroma into blood and lymphatic vessels. Each of these processes involves the expression of molecular and biochemical factors identified with tumor cells. With better understanding of the molecular basis of these factors, novel prognostic and potential therapeutic agents can be generated and applied to the clinical arena.

Cathepsins

Inhibition of invasion of invasive human bladder carcinoma cells by protein kinase C inhibitor staurosporine.

To study the effect of the protein kinase C (PKC) inhibitor staurosporine on invasion, we selected the invasive human bladder carcinoma cell line EJ. Total PKC activity was more than twofold higher in the EJ cells than in RT4 cells (superficial human bladder carcinoma cells), which do not pass through an artificial basement membrane. There was more PKC activity in the cytosol than in the membrane of EJ cells. Staurosporine, at nontoxic concentrations, inhibited the invasion of EJ cells through an artificial basement membrane in a dose-dependent manner. Staurosporine caused a dose-dependent inhibition of cell motility but did not inhibit cell attachment. Staurosporine represents a new agent for the inhibition of tumor cell invasion and may prove useful in studying the mechanisms responsible for this phenomenon.

Alkaloids

Anatomic considerations in extraperitoneal approach to radical nephrectomy.

The interrelationship between the lateral and posterior portions of the peritoneum and Gerota's fascia allows them to be separated from each other, permitting ready visualization of the major renal vessels. The posterior relationship between Gerota's fascia and the transversalis fascia overlying the more posterior psoas muscle can be used to advantage in exposing the renal vessels posteriorly. That the fascial layers defining the retroperitoneal spaces might therefore be used in dissecting the renal hilum and vessels in the performance of radical nephrectomy prompted the present investigation. Twenty patients underwent this approach for radical nephrectomy for varying stages of renal cell carcinoma involving either upper, mid, or lower portion of right or left kidney. Postoperative recovery appeared to be shortened because of the lesser interval of ileus than had previously been encountered using a transperitoneal approach. Despite the minimal manipulation of the kidney prior to ligation of the renal vessels, there was no apparent increased tumor dissemination as detected clinically, and experimentally there appeared to be no increase in tumor cells in the venous effluent. Operative time, blood loss, and postoperative complications were comparable to those reported for the transperitoneal approach. This means of performing radical nephrectomy, based on the relationship of fascial layers in the retroperitoneum thus appeared to lend itself to easier dissection as well as lesser postoperative ileus and corresponding shorter hospital stays.

Abdomen

Mechanisms of human bladder tumor invasion: role of protease cathepsin B.

To study the biochemical mechanisms of bladder tumor invasion, we analyzed specimens of invasive transitional cell carcinoma cell line EJ and non-invasive transitional cell carcinoma cell line RT4 which had been implanted into the bladders of nude mice. Using immunoprobes specific to basement membrane laminin, we observed that superficial but not invasive tumors were surrounded by intact laminin. With immunoprobes specific to cathepsin B, a cysteine proteinase which has the ability to degrade laminin, we demonstrated that cathepsin B is localized in discrete cytoplasmic granules in the non-invasive tumors, and in a more diffuse cytoplasmic pattern in the invasive tumors. Subcellular fractionation followed by immunoblot analysis and enzymatic analysis confirmed that the invasive EJ cells had active cathepsin B localized to its plasma membrane, while non-invasive RT4 cells had cathepsin B confined to lysosomes. Furthermore, immunoblot analysis revealed that invasive EJ cells had the mature form of cathepsin B with a molecular weight of 25 kD, while non-invasive RT4 cells had predominantly precursor forms with molecular weights between 30 and 35 kD. In vitro degradation assays with plasma membrane fractions isolated from invasive EJ cells and non-invasive RT4 cells demonstrated that the plasma membrane of EJ cells but not that of the RT4 cells had the ability to degrade purified laminin, and that the degradative products were similar to those obtained with purified cathepsin B. We conclude that invasive tumor cells have enhanced cathepsin B in their plasma membranes which may be used to degrade basement membrane components such as laminin and thereby facilitate tumor invasion.

Animals

Muscle-invasive bladder cancer: does it arise de novo or from pre-existing superficial disease?

This study examines the clinical and pathologic features of 20 consecutive patients with muscle-invasive bladder cancer diagnosed between January 1, 1983, and December 31, 1984, at The Mount Sinai Hospital. On retrospective analysis, 18 patients (90%) had muscle-invasive bladder cancer at their initial presentation. The interval between onset of symptoms and histologic documentation of cancer was less than two months in 14 cases (78%), and in the remaining 22 per cent, the intervals of six, six, twelve, and twenty-four months were attributable to delay in seeking medical attention or delay in biopsy. In contrast, in the 2 patients who had presented with superficial tumors, the intervals were thirteen and one hundred eighty months. It therefore appeared that most patients with invasive bladder cancer had no therapeutically significant prior clinical or symptomatic history of superficial disease, and that invasion either was already present when symptoms had begun, or occurred rapidly after symptoms had initially appeared. These findings confirm the broad applicability of this pattern of bladder cancer in the general population, thereby complementing similar findings reported in recent years by secondary referral centers.

Aged

Controversies in urologic oncology.

The persistent controversies that characterize urologic oncology reflect the significant advances that have been made in our understanding of genitourinary malignancy and the objective posture that has been taken both by those active in this area and by those whose interests are more indirect. Ultimately, the beneficiaries of these controversies are the patients and their physicians. As continued problems are recognized and investigations are designed to explore them, controversy and skepticism become a healthy concomitant so that true knowledge and understanding can be achieved and such issues ultimately resolved.

Carcinoma in Situ

Biologic response modifiers in genitourinary neoplasia.

With the exception of testis cancer, the variety of genitourinary cancers have not been found to be consistently responsive to chemotherapeutic agents or regimens for other than anecdotal short duration. This has generated keen interest in the possibility that biologic response modifiers might either directly or through manipulation of immune response mechanisms successfully prevent tumor progression in these systems. In recent years, those substances that have attracted the greatest attention have included interferon (and, more recently, recombinant gamma interferon), bacillus Calmette-Guerin (BCG), tumor necrosis factor, prostaglandin synthetase inhibitors, and interleukin-2. Results with each of these agents in the variety of genitourinary cancers have been both promising and disappointing. A number of mechanisms have been suggested to underlie the actions of each of these substances, and the successful or unsuccessful recruitment of these mechanisms, in the context of the particular intrinsic behavior of the cancers being treated, have been suggested as reasons for the treatment results that have been seen. Therapeutic efficacy has been described in the treatment of renal cell cancer by both systemic interferon and interleukin-2. Successful treatments have been reported in approximately 20% of patients treated with each substance, but generally, these results have been of short duration. Topical BCG has been used with great success to treat superficial transitional cell bladder cancer. In these instances, the generation of tumor necrosis factor has been suggested as possibly accounting for the 70% success rate both in therapy and prophylaxis that has been seen. Leukocyte-derived interferon and, more recently, recombinant gamma interferon, were found in initial trials to generate a 20% response rate in renal cell carcinoma patients. Enthusiasm for these agents, however, has been tempered more recently both by a failure to reproduce these results with any substantial duration as well as by the significant side effects that have been seen. Clearly, these agents continue to be intriguing both because of their intellectual appeal through the mechanisms by which they may be effective, as well as by the absence of any definitive therapy for the cancers they are being used to treat. An understanding of the complex host/tumor cell interaction that may ultimately determine therapeutic efficacy for each of these agents is undoubtedly critical if the role of these substances in the treatment of genitourinary cancer is to be successfully implemented, either alone or in combination with other treatment modalities.

Animals

Ureteral and renal pelvic metastases from renal cell carcinoma.

Six patients with ureteral or renal pelvic metastases from renal cell carcinoma (RCC) were studied radiologically. Correlation with surgical and histologic findings confirmed renal venous involvement in 5 and lymphatic invasion in 3 patients. The possible role of nephroureterectomy or secondary ureterectomy in patients with RCC is discussed in the background of our cases, as are prior reports of this finding.

Adult

Immunotherapy of metastatic renal cell carcinoma with polyinosinic-polycytidylic acid.

Polyinosinic-polycytidylic acid, a double-stranded ribonucleic acid that is a potent inducer of interferon production, was used in a stabilized form to treat 11 patients with metastatic renal cell carcinoma. Seven patients completed a full course of 8 infusions at maximum tolerated dosage. All patients experienced transient fever and marked fatigue. Anorexia was mild. Transient leukopenia occurred in 3 patients and reversible elevation in creatinine was observed in 1. All 4 patients with brain metastases became lethargic, and 3 died during or shortly after therapy. Only 2 patients demonstrated measurable total regression of isolated metastases (pleural/pulmonary in 1 and bone in 1) but in both metastases at other sites progressed. No partial regressions were seen. Metastases at all other sites (liver, brain and renal fossa) progressed during therapy. Patients who appeared to respond and who performed best during therapy generally demonstrated a higher performance status initially. Expression of natural cytotoxicity in in vitro testing did not correlate with a demonstrated response to treatment.

Bone Neoplasms