Microorganisms in chemotherapy for pancreatic cancer: An overview of current research and future directions

Pancreatic cancer is a malignant tumor of the digestive system with a very high mortality rate. While gemcitabine-based chemotherapy is the predominant treatment for terminal pancreatic cancer, its therapeutic effect is not satisfactory. Recently, many studies have found that microorganisms not only play a consequential role in the occurrence and progression of pancreatic cancer but also modulate the effect of chemotherapy to some extent. Moreover, microorganisms may become an important biomarker for predicting pancreatic carcinogenesis and detecting the prognosis of pancreatic cancer. However, the existing experimental literature is not sufficient or convincing. Therefore, further exploration and experiments are imperative to understanding the mechanism underlying the interaction between microorganisms and pancreatic cancer. In this review, we primarily summarize and discuss the influences of oncolytic viruses and bacteria on pancreatic cancer chemotherapy because these are the two types of microorganisms that are most often studied. We focus on some potential methods specific to these two types of microorganisms that can be used to improve the efficacy of chemotherapy in pancreatic cancer therapy.     

Glioma-derived mutations in isocitrate dehydrogenase 2 beneficial to traditional chemotherapy

Heterozygous mutations in either the R132 residue of isocitrate dehydrogenase I (IDH1) or the R172 residue of IDH2 in human gliomas were recently highlighted. In the present study, we report that mutations of IDH1 and IDH2 are not detected in the rat C6 glioma cell line model, which suggests that these mutations are not required for the development of glioblastoma induced by N,N′-nitroso-methylurea. The effects of IDH2 and IDH2^R172G on C6 cells proliferation and sensitivity to chemotherapy and the possible mechanism are analyzed at the cellular level. IDH1 and IDH2 mutations lead to simultaneous loss and gain of activities in the production of α-ketoglutarate (α-KG) and 2-hydroxyglutarate (2HG), respectively, and result in lowering NADPH levels even further. The low NADPH levels can sensitize tumors to chemotherapy, and account for the prolonged survival of patients harboring the mutations. Our data extrapolate potential importance of the in vitro rat C6 glioma cell model, show that the IDH2^R172G mutation in gliomas may give a benefit to traditional chemotherapy of this cancer and serve as an important complement to existing research on this topic.     

Echinococcus multilocularis: The impact of ionizing radiation on metacestodes

Alveolar echinococcosis is caused by the metacestode stage of the fox tapeworm Echinococcus multilocularis. Current chemotherapeutical options for the treatment of echinococcosis are not satisfactory, and novel drugs and/or other potential means of therapy are needed. E. multilocularis metacestodes are characterized by almost potentially unlimited growth, and also display other features of cancerous tumours. In this study, we exposed metacestodes that were generated in vitro to 50–100 Gy ionizing irradiation, and subsequently investigated the short-term (10–12 days post-treatment) and long-term (14 weeks post-treatment) effects. We found, that in the short-term, no release of alkaline phosphatase (EmAP) activity as a measure for potentially induced damage and loss of viability could be detected, and that the protein expression pattern and protease activities in vesicle fluids and medium supernatants did not alter dramatically following irradiation. However, irradiation was associated with distinct morphological and ultrastructural alterations in the tissue of metacestodes, affecting most notably cell–cell contacts, mitochondrial shape, glycogen-storage cells and lipid droplet formation. These could be detected already at 10 days following treatment and remained as such also in the long-term. In addition, as determined after 14 weeks of culture, irradiation affected the proliferation and the growth of E. multilocularis metacestodes. Thus, we demonstrate that radiotherapy does not have a clear-cut parasitocidal effect, but can lead to metabolic impairment of E. multilocularis metacestodes, as reflected by the distinct morphological and structural alterations induced by irradiation treatment.     

The disulfiram metabolites S-methyl-N,N-diethyldithiocarbamoyl sulfoxide and S-methyl-N,N-diethylthiocarbamoyl sulfone irreversibly inactivate betaine aldehyde dehydrogenase from Pseudomonas aeruginosa, both in vitro and in situ, and arrest bacterial growth

Betaine aldehyde dehydrogenase from the human opportunistic pathogen Pseudomonas aeruginosa (PaBADH) catalyzes the irreversible, NAD(P)⁺-dependent oxidation of betaine aldehyde, producing glycine betaine, an osmoprotectant. PaBADH participates in the catabolism of choline and likely in the defense against the osmotic and oxidative stresses to which the bacterium is exposed when infecting human tissues. Given that choline or choline precursors are abundant in infected tissues, PaBADH is a potential drug target because its inhibition will lead to the build up of the toxic betaine aldehyde inside bacterial cells. We tested the thiol reagents, disulfiram (DSF) and five DSF metabolites—diethyldithiocarbamic acid (DDC), S-methyl-N,N-diethyldithiocarbamoyl sulfoxide (MeDDTC-SO) and sulfone (MeDDTC-SO₂), and S-methyl-N,N-diethylthiocarbamoyl sulfoxide (MeDTC-SO) and sulfone (MeDTC-SO₂)—as inhibitors of PaBADH and P. aeruginosa growth. As in vitro PaBADH inhibitors, their order of potency was: MeDDTC-SO₂ > DSF > MeDTC-SO₂ > MeDDTC-SO > MeDTC-SO. DDC did not inactivate the enzyme. PaBADH inactivation by DSF metabolites (i) was not affected by NAD(P)⁺, (ii) could not be reverted by dithiothreitol, and (iii) did not affect the quaternary structure of the enzyme. Of the DSF metabolites tested, MeDTC-SO₂ and MeDDTC-SO produced significant in situ PaBADH inactivation and arrest of P. aeruginosa growth in choline containing media, in which the expression of PaBADH is induced. They had no effect in media lacking choline, indicating that PaBADH is their main intracellular target, and that arrest of growth is due to accumulation of betaine aldehyde. The in vitro and in situ kinetics of enzyme inactivation by these two compounds were very similar, indicating no restriction on their uptake by the cells. MeDDTC-SO₂ and DSF have no inhibitory effects in situ, probably because their high reactivity towards intracellular nonessential thiols causes their depletion. Our results support that PaBADH is a promising target to treat P. aeruginosa infections, and that some DSF metabolites might be of help in this aim.     

Gold from the sea: marine compounds as inhibitors of the hallmarks of cancer

Cancer is one of the most deadly diseases in the world. Although advances in the field of chemo-preventive and therapeutic medicine have been made regularly over the last ten years, the search for novel anticancer treatments continues. In this field, the marine environment, with its rich variety of organisms, is a largely untapped source of novel compounds with potent antitumor activity. Although many reviews of marine anticancer compounds have been published, we focus here on selected marine compounds that act on the six hallmarks of cancer presented namely self-sufficiency in growth signals, insensitivity to anti-growth signals, evasion of apoptosis, limitless replication, sustained angiogenesis and tissue invasion and metastasis.     

双向电泳联合MALDI-TOF-MS技术在筛选食管癌铂类耐药患者中的应用研究

目的:采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)技术检测食管癌(EC)患者化疗敏感性血清蛋白质谱,指导临床EC患者化疗方案的选择。方法:收集2013年1月至2014年6月我院收治的EC术后复发并行含铂化疗的患者40例,按照化疗疗效分为敏感组和耐药组。将两组蛋白质双向凝胶电泳图谱用Image Master 2D platinum 5.0软件分析并匹配,筛选出两组差异斑点,并采用MALDI-TOF-MS技术检测EC患者化疗敏感性血清蛋白质谱。结果:两组差异斑点共有68个,以耐药组为参照,敏感组患者血清蛋白下调的斑点有42个,上调的斑点有26个。从这68个差异斑点中筛选出8个斑点进行质谱鉴定,通过数据库检索分析和鉴定最终确定上述斑点所对应的蛋白质名称分别为Kininogen-1,Alpha-2-HS-glycoprotein,Fibrinogen beta chain,Clusterin,Retinol-binding protein 4,Beta-2-glycoprotein 1,Ig kappa chain C region,Complement C4-A。结论:基于铂类化疗的EC敏感患者和耐药患者间存在差异表达蛋白。     

A site-selective,irreversible inhibitor of the DNA replication auxiliary factor proliferating cell nuclear antigen (PCNA)

Proliferating cell nuclear antigen (PCNA) assumes an indispensable role in supporting cellular DNA replication and repair by organizing numerous protein components of these pathways via a common PCNA-interacting sequence motif called a PIP-box. Given the multifunctional nature of PCNA, the selective inhibition of PIP-box-mediated interactions may represent a new strategy for the chemosensitization of cancer cells to existing DNA-directed therapies; however, promiscuous blockage of these interactions may also be universally deleterious. To address these possibilities, we utilized a chemical strategy to irreversibly block PIP-box-mediated interactions. Initially, we identified and validated PCNA methionine 40 (M40) and histidine 44 (H44) as essential residues for PCNA/PIP-box interactions in general and, more specifically, for efficient PCNA loading onto chromatin within cells. Next, we created a novel small molecule incorporating an electrophilic di-chloro platinum moiety that preferentially alkylated M40 and H44 residues. The compound, designated T2Pt, covalently cross-linked wild-type but not M40A/H44A PCNA, irreversibly inhibited PCNA/PIP-box interactions, and mildly alkylated plasmid DNA in vitro. In cells, T2Pt persistently induced cell cycle arrest, activated ATR-Chk1 signaling and modestly induced DNA strand breaks, features typical of cellular replication stress. Despite sustained activation of the replication stress response by the compound and its modestly genotoxic nature, T2Pt demonstrated little activity in clonogenic survival assays as a single agent, yet sensitized cells to cisplatin. The discovery of T2Pt represents an original effort directed at the development of irreversible PCNA inhibitors and sets the stage for the discovery of analogues more selective for PCNA over other cellular nucleophiles.     

六君子汤加当归补血汤防治化疗后骨髓抑制的疗效研究

目的：观察六君子汤加当归补血汤对化疗后患者骨髓抑制的疗效。方法：选择来本院就诊并于肿瘤科住院的患者60 例,经病理学检查确诊为恶性肿瘤,并且使用TP 方案化疗。患者随机分为治疗组和对照组,治疗组为TP方案化疗＋ 中药组,对照组为TP 方案化疗组。对照组常规化疗,治疗组在对照组的基础上予以六君子汤加当归补血汤,观察患者的临床症状、骨髓抑制程度以及生活质量等指标。结果：治疗组在临床症状改善程度、白细胞数量、血小板数量以及血红蛋白含量以及生活质量等情况均优于对照组（P＜0.05）。结论：六君子汤加当归补血汤可以有效地改善化疗后患者骨髓抑制的情况。     

肿瘤放化综合治疗中的靶向研究

放化疗综合应用是癌症治疗中的常用方法。研究表明,放化疗综合应用可以有效地控制杀伤肿瘤,但过程中对正常细胞的毒副作用严重制约着放化疗的剂量和疗效。如何在有效杀伤肿瘤细胞的同时减轻放化疗综合应用中对正常细胞的毒副作用已经成为探索更好的治疗策略的关键。随着研究的不断深入,各种相关的新药和新治疗思路层出不穷,比如针对肿瘤发生及代谢过程的靶向类新药、用于辐射增敏的新的基因靶点等都已进入研究者的视线。另外,近年来关于肿瘤细胞中药物转运蛋白的研究也为综合治疗靶点寻找提供了一定依据。本文根据当前研究现状,着重总结近年来放化疗综合治疗靶向研究在上述几方面的一些新进展。     

三阴型乳腺癌的化学治疗和靶向治疗进展

三阴型乳腺癌(Triple negative Breast cancer,TNBC)占乳腺癌总数的15%,是一种免疫组织化学亚型。通常发生于青年女性,有很高的复发率,内脏和中枢神经系统转移早,病程短、死亡率高。对大多数TNBC患者,常规化疗是主要的治疗方式。20%患者有很好的化疗敏感性,对化疗耐药的TNBC患者靶向治疗为当前研究的热点,寻找乳腺癌新的治疗靶点,提出TNBC新的治疗策略,有望去改善TNBC患者的预后。