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Relationship of chromosome changes to neoplastic cell transformation.

Chromosomal abnormalities are a frequent concomitant of neoplasia, and although it is tempting to relate these mutations and alterations in chromatin (DNA) function to cancer, their relationship to the initiation or progression of carcinogenesis is unknown. Mammalian cells in culture, after interacting with chemical carcinogens, often exhibit chromosome damage consisting of breaks and exchanges of chromatid material. The pattern of damage of banded metaphases indicates that negative bands are especially vulnerable to the action of chemical carcinogens, probably because of differential chromatin condensation. Damage to individual chromosomes may be random or nonrandom, depending on the species. Cell death can be correlated with chromatid alterations that occur shortly after treatment with chemical carcinogens. There is also a correlation between mutagenic and carcinogenic activity of some chemical carcinogens and the frequency of sister chromatid exchanges. The question of whether specific chromosome changes are absolutely required for neoplastic transformation cannot be answered because of conflicting data and diverse results from studies even with known carcinogens. Cell transformation may occur without any visible chromosome changes. A universal specific numerical or visible structural chromosomal alteration is not necessarily associated with chemical or viral transformation. Chromosome changes are independent of the etiologic agents: different carcinogens may produce transformation associated with the same abnormal chromosomes, but not all transformed lines invariably exhibit the same abnormality, even with the same chemical. In some species, chromosome having nucleolar organizer regions may be more frequently involved in numerical or structural deviations. Progressively growing tumors also may occur as a result of the proliferation of transformed cells without detectable chromosome changes, indicating that tumorigenicity need not be related to an imbalance of chromosome number or structure. Our studies indicate that chromosome changes are not essential for establishment of neoplasms but that karyotypic instability may result in response to selective growth pressures.

9,10-Dimethyl-1,2-benzanthracene↗

Peripheral neuropathy and cancer.

Peripheral neuropathy has a major impact on quality of life and may limit the amount of treatment patients can receive. Neurotoxic agents are used increasingly in oncologic practice, yet clinicians are often unaware of the protean manifestations of neuropathy and find its management troubling. Recent knowledge about the mechanisms of neuropathic disease and new treatments may help to minimize the impact of neuropathy on this vulnerable patient population.

Antineoplastic Agents↗

Spatial proteogenomic profiling uncovers sensitization strategies for antibody-drug conjugate in HER2-positive breast cancer.

Antibody-drug conjugates (ADCs) have transformed the treatment of HER2-positive breast cancer, yet resistance remains poorly understood. Using imaging mass cytometry, we profiled 157 regions of interest comprising 912,360 single cells from 47 HER2-positive/hormone receptor-negative breast cancers treated with SHR-A1811 in the FASCINATE-N trial. Spatial proteomic analyses identified two determinants of ADC response: elevated tumor-cell H3K27ac expression was associated with improved ADC efficacy, whereas collagen-positive fibroblasts mediated resistance. Combining ADC with the histone deacetylase inhibitor chidamide or the collagen-modulating agent losartan produced synergistic antitumor effects in preclinical models. These biomarkers and therapeutic vulnerabilities were independently validated in patients with advanced HER2-positive disease receiving trastuzumab deruxtecan. Moreover, based on these spatial features, we developed a clinically applicable ADC barrier prediction model that can be implemented using multiplex immunofluorescence. Taken together, our findings reveal actionable spatial determinants of ADC efficacy and suggest potential combination therapeutic strategies.

Humans↗

Cancer chemotherapy - a new approach.

A considerable body of evidence indicates that interference with amino acid metabolism could be used as a basis for a concerted attack on tumor growth. Tumor cells are known to concentrate amino acids; the same transport mechanisms cause them to concentrate amino acid analogues as well. Furthermore, the growth of many tumors if affected by deficiences of certain amino acids. This apparent vulnerability of tumors points to a new approach to in vivo testing and clinical trials of amino acid analogues for efficacy against tumor growth. This approach consists of creating a dietary deficiency of an amino acid, replacing the amino acid by a toxic analogue which would be selectively concentrated by the tumor, followed at the appropriate time by restoration of the normal dietary level of the natural amino acid to allow growth of normal tissues.

Amino Acids↗

Marital and sexual satisfaction in testicular cancer survivors and their spouses.

GOAL: To compare marital and sexual satisfaction of men who survived testicular cancer (TC) and their spouses to a reference group, and to compare marital and sexual satisfaction of couples who had a relationship at time of diagnosis (couples during TC) to couples who developed a relationship after completion of treatment (couples after TC). PATIENTS AND METHODS: Two hundred and nineteen couples during TC and 40 couples after TC completed the Maudsley Marital Questionnaire, a validated instrument to measure marital and sexual satisfaction. RESULTS: Survivors and spouses of both couple groups reported similar marital satisfaction as men and women of the reference group. Survivors (t=2.9, p<0.01) and spouses (t=2.9, p<0.01) of couples during TC and survivors of couples after TC (t=1.9, p=0.05) reported less sexual satisfaction than the reference groups. Survivors of couples after TC reported less sexual satisfaction than survivors of couples during TC (F=4.0, p<0.05). Correlations between sexual satisfaction of survivors and spouses in couples during TC (r=0.76, p<0.001) and couples after TC (r=0.77, p<0.001) were high. CONCLUSION: Testicular cancer did not appear to have a negative effect on marital satisfaction in couples during TC, although TC survivors and their spouses reported less sexual satisfaction than men and women of the reference group. Survivors who developed a relationship after completion of treatment seemed to form a vulnerable group: their sexual satisfaction was lower than that of men in the reference group and of TC survivors with a longer relationship. Besides that, they more often reported marital problems than their spouses did.

Adult↗

The effect of the age of mice on the incidence of skin cancer.

The plausibilities of two hypotheses explaining the increased cancer incidence rate in old age caused by a constant dose of carcinogen were compared using a mouse skin painting experiment in which two groups of mice started treatment at different ages. It was shown that the hypothesis of the increased rate being caused simply by increased vulnerability of old animals was not as plausible as the alternative hypothesis of the carcinogen acting to some extent cumulatively.

Age Factors↗

Screening and cognitive impairment: ethics of forgoing mammography in older women.

Mammographic screening for breast cancer in cognitively impaired women poses significant ethical questions. Many woman with dementia should not be screened because of the greater harm than benefits and the difficulty in obtaining informed consent. This article reviews the current controversy about mammography and then suggests a risk/benefit analysis for this vulnerable population. Autonomy, decision-making capacity, and the roles of surrogates and physicians are considered, as are ageism and the risk of undertreatment. The harm of overdiagnosis and subsequent overtreatment for women who are cognitively impaired, have comorbidity and a limited life span are outlined. In these cases, the burdens of mammography outweigh the benefits. For women with early cognitive impairment and longer life expectancies, the potential benefits may outweigh the harms. A decision-making process by the patient, proxy, and practitioner that takes account of foreseeable risks and benefits, patient capacity and preferences, and the effect of this screening intervention on quality of life is outlined.

Adult↗

Machine learning and multi-omics clustering to map cellular rewiring and immune evasion in ccRCC.

Immune checkpoint blockade (ICB) efficacy in clear cell renal cell carcinoma (ccRCC) is limited by tumor microenvironment (TME) heterogeneity. Because traditional bulk-derived models lack spatial resolution, we developed an integrated framework connecting macroscopic survival risks to microscopic TME structures. We applied ten algorithms to establish multi-omics subtypes and evaluated 101 machine-learning combinations across three independent cohorts to generate a Consensus Machine Learning-driven Signature (CMLS). The signature's spatial and cellular origins were decoded using spatial transcriptomics (ST) and a 140,000-cell scRNA-seq atlas. Expression of key genes was experimentally validated via RT-qPCR in 17 paired ccRCC clinical tissues. We identified two molecular subtypes with distinct clinical and epigenetic profiles. SuperPC optimization yielded a 24-gene CMLS serving as an independent prognostic factor. scRNA-seq and ST deconvolution revealed these signals predominantly originate from cancer-associated fibroblasts (CAFs) and malignant epithelial cells, which collaborate to drive spatial immune exclusion. RT-qPCR confirmed significant overexpression of five core CMLS genes in ccRCC versus adjacent normal tissues. Low CMLS scores correlated with enhanced ICB responsiveness, whereas high-CMLS tumors demonstrated specific vulnerability to dasatinib and dabrafenib. The CMLS translates spatial immune-exclusion dynamics into a quantifiable metric, outperforming tumor mutational burden in predicting ICB benefits, providing a robust tool for patient stratification in ccRCC.

Humans↗

Pimecrolimus: new preparation. Me-too: too many risks, not beneficial enough in atopic dermatitis.

(1) Symptomatic treatment of atopic dermatitis is initially based on simple measures and moisturising creams. Topical corticosteroids are reserved for treatment of inflammatory exacerbations. (2) After topical tacrolimus, marketing authorisation has been granted in France for a second topical immunosuppressant, pimecrolimus, as a short-term symptomatic treatment for atopic dermatitis in children from the age of two years, and intermittently for long-term prevention of new exacerbations. (3) Short-term treatment with pimecrolimus has been tested in three trials in children with mild to moderate dermatitis (against the excipient), in one adult trial against the excipient, and in one dose-finding study in adults that included a group treated with topical corticosteroids. (4) Longer term treatment periods of 6 to 12 months have been tested in two trials versus excipient in children, and two adult trials, one versus moderately active topical corticosteroids. (5) These trials show that pimecrolimus works better than the excipient, but not nearly as well as moderately active topical corticosteroids. Pimecrolimus has not been compared with topical corticosteroids in children, the age group most vulnerable to atopic dermatitis. (6) The commonest adverse effects observed in clinical trials were local and included a burning sensation at the site of application and skin infections. Systemic adverse effects (mainly infections) were most marked in infants. Long-term risks, especially the risk of skin cancer, have not been assessed. (7) In practice, the reference treatment for exacerbations of atopic dermatitis is a topical corticosteroid; in children, it seems best to begin with a weak preparation. There is no reason to use pimecrolimus, which is less active than topical corticosteroids and whose potential long-term adverse effects, especially in children, are unknown.

Administration, Cutaneous↗

Mental and physical health consequences of alcohol use in women.

Chronic consumption of alcohol in levels typically consumed by alcoholic women clearly produces adverse health consequences, including a shorter life expectancy. The health consequences of alcohol use appear to depend on the characteristics of the person consuming the alcohol (genetic vulnerability to particular diseases, the particular point in the life span when the majority of the alcohol is consumed, and the pattern of consumption typical for that individual). For adolescence and young adulthood, emphasis is placed on increased rates of accidental and suicidal mortality. For middle age, breast cancer risk and risk for developing osteoporosis is discussed. Finally, use of alcohol alone and in combination with psychoactive drugs presents special problems for older women. Other specific adverse effects of alcohol are reviewed with respect to gender differences in cardiovascular, hepatological, and neuropathological outcome, as well as with respect to HIV/AIDS. Psychiatric comorbidity and domestic violence are also discussed with respect to gender differences.

Adolescent↗

Risk assessment of endocrine disrupters: the role of toxicological studies.

Endocrine disrupters (ED) represent a good challenge for experimental toxicology. In order to deal with several critical points relevant to risk assessment: (a) ED may induce long-term effects upon exposure in susceptible developmental phases, including postnatal life up to puberty; thus, efforts are required to refine testing strategies, for example, by supporting the two-generation rodent study with a comprehensive in vitro/in vivo screening battery; (b) due to the regulatory role of endocrine homeostasis, mechanisms of endocrine disruption may impact on immune, neurobehavioral, and reproductive development, as well as on susceptibility to cancer; (c) the potential multiple exposure to ED with common targets through diet and/or living environment calls for the development of models to understand mechanisms of interactions and effects of mixtures; and (d) last but not least, ED may interact with a number of factors related to differential vulnerability of individuals or population subgroups, including the intake of nutrients or bioactive food components. Besides reducing the chance for noxious chemicals to enter our life, toxicological research on mechanisms may also lead to the definition of possible biomarkers of exposure, effect, and susceptibility that may be further exploited in human health surveillance.

Endocrine Disruptors↗

Sex differences in marijuana use in the United States.

Marijuana and other cannabis preparations are the most widely used illicit drugs in the United States. A review of the literature reveals a number of sex differences in the epidemiology and adverse medical consequences of marijuana use. In 1995, 6.5% of females and 10.5% of males aged 12 and older reported marijuana use in the previous year. Although 4% more males than females used marijuana, the percentage of males using marijuana between 1994 and 1995 had decreased, whereas the percentage of females using marijuana during that same period had increased. Among females, the age of initiation of use is declining and the prevalence of problems with marijuana is on the rise. Both male and female marijuana users may experience adverse effects of cognitive dysfunction and airway inflammation. However, clinicians should be aware of sex-specific effects of marijuana use, including a possible increased risk of prostate cancer for male users and possible adverse effects on reproductive hormones in female users. Review of the available information on this topic indicates that we have much more to learn about the similarities and differences between males and females with respect to patterns of use, adverse consequences, and vulnerabilities to marijuana.

Cannabis↗

Par-4 is a mediator of neuronal degeneration associated with the pathogenesis of Alzheimer disease.

Prostate apoptosis response-4 (Par-4) is a protein containing both a leucine zipper and a death domain that was isolated by differential screening for genes upregulated in prostate cancer cells undergoing apoptosis. Par-4 is expressed in the nervous system, where its function is unknown. In Alzheimer disease (AD), neurons may die by apoptosis, and amyloid beta-protein (A beta) may play a role in this. We report here that Par-4 expression is increased in vulnerable neurons in AD brain and is induced in cultured neurons undergoing apoptosis. Blockade of Par-4 expression or function prevented neuronal apoptosis induced by Ab and trophic factor withdrawal. Par-4 expression was enhanced, and mitochondrial dysfunction and apoptosis exacerbated, in cells expressing presenilin-1 mutations associated with early-onset inherited AD.

Alzheimer Disease↗

Vascular ossification-calcification in metabolic syndrome, type 2 diabetes mellitus, chronic kidney disease, and calciphylaxis-calcific uremic arteriolopathy: the emerging role of sodium thiosulfate.

BACKGROUND: Vascular calcification is associated with metabolic syndrome, diabetes, hypertension, atherosclerosis, chronic kidney disease, and end stage renal disease. Each of the above contributes to an accelerated and premature demise primarily due to cardiovascular disease. The above conditions are associated with multiple metabolic toxicities resulting in an increase in reactive oxygen species to the arterial vessel wall, which results in a response to injury wound healing (remodeling). The endothelium seems to be at the very center of these disease processes, acting as the first line of defense against these multiple metabolic toxicities and the first to encounter their damaging effects to the arterial vessel wall. RESULTS: The pathobiomolecular mechanisms of vascular calcification are presented in order to provide the clinician-researcher a database of knowledge to assist in the clinical management of these high-risk patients and examine newer therapies. Calciphylaxis is associated with medial arteriolar vascular calcification and results in ischemic subcutaneous necrosis with vulnerable skin ulcerations and high mortality. Recently, this clinical syndrome (once thought to be rare) is presenting with increasing frequency. Consequently, newer therapeutic modalities need to be explored. Intravenous sodium thiosulfate is currently used as an antidote for the treatment of cyanide poisoning and prevention of toxicities of cisplatin cancer therapies. It is used as a food and medicinal preservative and topically used as an antifungal medication. CONCLUSION: A discussion of sodium thiosulfate's dual role as a potent antioxidant and chelator of calcium is presented in order to better understand its role as an emerging novel therapy for the clinical syndrome of calciphylaxis and its complications.

Animals↗

The Dutch famine and its long-term consequences for adult health.

Small size at birth is linked with an increased risk of chronic diseases in later life. Poor maternal nutrition during gestation may contribute to restricted fetal growth, leading to increased disease susceptibility in later life. Animal studies have shown that undernutrition during gestation is associated with reduced life span and increased disease susceptibility. The Dutch famine is a unique counterpart for animal models that study the effects of restricted maternal nutrition during different stages of gestation. This paper describes the findings from a cohort study of 2414 people born around the time of the Dutch famine. Exposure to famine during any stage of gestation was associated with glucose intolerance. We found more coronary heart disease, a more atherogenic lipid profile, disturbed blood coagulation, increased stress responsiveness and more obesity among those exposed to famine in early gestation. Women exposed to famine in early gestation also had an increased risk of breast cancer. People exposed to famine in mid gestation had more microalbuminuria and obstructive airways disease. These findings show that maternal undernutrition during gestation has important effects on health in later life, but that the effects on health depend on its timing during gestation. Especially early gestation seems to be a vulnerable period. Adequate dietary advice to women before and during pregnancy seems a promising strategy in preventing chronic diseases in future generations.

Birth Certificates↗

CD95-mediated apoptosis: no variation in cellular sensitivity during cell cycle progression.

Sensitivity of CD95-mediated apoptosis has been reported to vary during cell cycle progression (FEBS Lett. (1997) 412, 91-93). Here, we report that three human glioma cell lines with different p53 status (i) undergo growth arrest and synchronous cell cycle re-entry after prolonged serum deprivation, (ii) do not exhibit cell cycle-related changes in CD95 expression at the cell surface, and (iii) do not exhibit cell cycle-related changes in susceptibility to DC95 ligand-induced apoptosis. In contrast, cell cycle-specific activity was demonstrated for various cancer chemotherapy drugs. Further, CD95 expression and susceptibility to CD95 ligand-induced apoptosis does not vary during cell cycle progression of Jurkat T cells, HeLa cervical carcinoma and HepG2 hepatocellular carcinoma cells. These results do not support a role for the cell cycle phase as an important predictor of vulnerability to CD95-mediated apoptosis.

Antibiotics, Antineoplastic↗

[Photodamage and photoaging--prevention and treatment].

The exposure of human skin to environmental and artificial ultraviolet irradiation has increased significantly. This is not only due to an increased solar UV irradiation as a consequence of the stratospheric ozone depletion, but also the result of an inappropriate social behaviour with the use of tanning parlors being very popular. Besides this, leisure activities and living style with travelling to equatorial regions also add to the individual annual UV load. Since the population in industrialised countries shows an increasing total life span, in parallel the cumulative life time dose of solar and artificial UV-irradiation is dramatically augmented. In addition to the common longterm detrimental effects like immunosuppression and skin cancer, the photooxidative damage due to energy absorption of UV photons in an oxygenized environment leads to alterations of cells, subcellular compartments and macromolecules. The clinical manifestations of UV/ROS induced disturbances result in photoaged skin with wrinkle formation, laxity, leathery appearance as well as fragility, impaired wound healing and higher vulnerability. Strategies to prevent or to minimize photoaging and intrinsic aging of the skin necessarily include protection against UV irradiation and antioxidant homoeostasis. New developments of therapeutic interventions including DNA repair enzymes will be discussed.

Adult↗

Humanistic reflections of a research nurse in a longitudinal study: a personal essay.

The purpose of this paper, first, is to share my 'lived experience' as a research nurse, in a longitudinal survey design study, who followed lung cancer patients and their family caregivers throughout the illness duration. I embraced an overarching 'humanistic' philosophy to 'come to terms' with my intra- and interpersonal reactions arising from my role as a human research tool. These reactions were best captured by Paterson and Zderad's (1976) humanistic concepts of authenticity, vulnerability, relating, disclosure and enclosure, and presence. Second, I will describe how I dealt with these concepts within the context of a research nurse role.

Attitude of Health Personnel↗