Therapy for advanced cholangiocarcinoma: Current knowledge and future potential

Cholangiocarcinoma (CCA) is a biliary epithelial tumour that can emerge at any point in the biliary tree. It is commonly classified based on its anatomical site of development into intrahepatic cholangiocarcinoma (ICC), perihilar cholangiocarcinoma (PCC) and distal cholangiocarcinoma (DCC), each of which is associated with varying patient demographics, molecular characteristics and treatment options. CCA patients have poor overall prognoses and 5-year survival rates. Additionally, CCA is often diagnosed at an advanced stage, with surgical treatment restricted to early-stage disease. Owing to an increase in the incidence of ICC, that of CCA is also on the rise, with a corresponding increase in the associated mortality, particularly in South America and Asia. Therefore, the development of an effective treatment is crucial to improve the survival of CCA patients. We aimed to systematically review the current understanding of advanced CCA treatment and discuss potential effective strategies.     

Timed Daily Administration of Prolactin and Corticosteroid Hormone Reduces Murine Tumor Growth and Enhances Immune Reactivity

In the present study, we investigated the time-dependent interactive effects of daily injections of prolactin (PRL) and corticosterone (CORT) on the activation of lymphocyte function and inhibition of tumor growth in vivo in mice. BALB/c mice were injected subcutaneously with EMT-6 fibrosarcoma cells (a murine connective tissue tumor cell derived from mammary gland), and then different groups of animals were treated with PRL (1μg/g body weight [BW] ip) at Oh, 4h, 8h, 12h, 16h, or 20h after CRT (1 μg/g BW ip) daily for 10 days. Different control groups were vehicle treated or treated with either hormone alone. Mice were kept in constant light 1 week before and during injections and in a 14:10 light-dark cycle thereafter. Tumor progression was monitored for up to 21 days after the cessation of treatment, and thereafter spleen lymphocytes were harvested and tested for mitogen-triggered proliferation. Prolactin administration at 8h or 16-20h after cortico-steroid treatment reduced tumor volume by 77% and 49%, respectively, relative to vehicle-treated controls. Other time relations of hormone treatment were ineffectual. Further studies indicated that the immunosuppressant cyclosporin A (CSA) substantially stimulated tumor growth; this effect was completely abrogated by a simultaneous 8h related hormone treatment. However, the 8h hormone treatment was ineffective in inhibiting tumor growth in T-cell-deficient nude mice. Spleen lymphocytes from tumor-bearing (TB) mice showed an elevated basal proliferative capacity stimulated by concanav-alin A (ConA; a stimulus for T-cell proliferation) and lipopolysaccharide (LPS; a stimulus for B-cell proliferation) compared to non-TB mice. Spleen lymphocytes from TB mice treated with CORT and PRL at 8h intervals exhibited an increased spontaneous (as well as LPS- and ConA- triggered) proliferation (by 104%, 48%, and 70%, respectively) compared with vehicle control TB mice. Fluorescence-activated cell sorting (FACS) analysis of splenocytes from hormone-treated animals indicated a 34-100% increase in the CD4⁺ (e.g., T helper cell) population. Treatment of animals with either hormone alone did not inhibit tumor growth or stimulate immune function relative to vehicle controls. The daily rhythms of plasma PRL, CORT, and thyroxine were all substantially altered by the presence of tumor in these mice. These results indicate that appropriately timed daily treatment of PRL and CORT can attenuate tumor growth, in part, via activation of antitumor immune mechanisms. Collectively, these data suggest that circadian neuroen-docrine activities must be temporally organized appropriately to inhibit tumor growth.     

Spatio-temporal pattern formation on spherical surfaces: numerical simulation and application to solid tumour growth

In this paper we examine spatio-temporal pattern formation in reaction-diffusion systems on the surface of the unit sphere in 3D. We first generalise the usual linear stability analysis for a two-chemical system to this geometrical context. Noting the limitations of this approach (in terms of rigorous prediction of spatially heterogeneous steady-states) leads us to develop, as an alternative, a novel numerical method which can be applied to systems of any dimension with any reaction kinetics. This numerical method is based on the method of lines with spherical harmonics and uses fast Fourier transforms to expedite the computation of the reaction kinetics. Numerical experiments show that this method efficiently computes the evolution of spatial patterns and yields numerical results which coincide with those predicted by linear stability analysis when the latter is known. Using these tools, we then investigate the r?le that pre-pattern (Turing) theory may play in the growth and development of solid tumours. The theoretical steady-state distributions of two chemicals (one a growth activating factor, the other a growth inhibitory factor) are compared with the experimentally and clinically observed spatial heterogeneity of cancer cells in small, solid spherical tumours such as multicell spheroids and carcinomas. Moreover, we suggest a number of chemicals which are known to be produced by tumour cells (autocrine growth factors), and are also known to interact with one another, as possible growth promoting and growth inhibiting factors respectively. In order to connect more concretely the numerical method to this application, we compute spatially heterogeneous patterns on the surface of a growing spherical tumour, modelled as a moving-boundary problem. The numerical results strongly support the theoretical expectations in this case. Finally in an appendix we give a brief analysis of the numerical method. Received: 27 July 2000 / Revised version: 15 August 2000 / Published online: 16 February 2001     

A system biology approach to identify regulatory pathways underlying the neuroendocrine control of female puberty in rats and nonhuman primates

This article is part of a Special Issue “Puberty and Adolescence”.     

Getting to the bottom of colorectal cancer

HE, T-C. et al. (1998)Identification of c-MYC as a target of the APC pathwayScience 281, 1509–1512     

Developmental study of neuropeptide Y-like immunoreactivity in the neurohypophysis and intermediate lobe of the rhesus monkey (Macaca mulatta)

Summary The purpose of this study was to examine the development and distribution of neuropeptide Y-immunoreactive fibers in the neurohypophysis of the rhesus monkey (Macaca mulatta) throughout life and the relationship of these fibers to the hypothalamo-hypophyseal portal vasculature. In rhesus monkeys, which varied in age from fetal life to 34 years, neuropeptide Y-immunoreactive fibers were present at all ages examined. In adult monkeys, varicose neuropeptide Y-labeled fibers were concentrated in the upper infundibular stem in association with capillary loops of the portal vasculature and the long portal vessels. Other fibers travelled down the infundibular stem and were distributed at the junction of the lower infundibular stem and infundibular process in the vicinity of the short portal vessels. In the infundibular process, neuropeptide Y-immunoreactive fibers were concentrated along the border of the intermediate lobe. Other stained fibers were sparsely distributed in the infundibular process and were often associated with small vessels. Neuropeptide Y-immunoreactivity was also located in a few fibers and cells of the intermediate lobe. Very few labeled fibers were seen in the fetal neurohypophysis, but their number increased gradually during the first postnatal year. At two years of age, a high density of stained fibers was observed, especially in the infundibular process. The number of axons in the infundibular process was lower at 12 years and continued to decline until 34 years of age. Neuropeptide Y may modulate hormone release at these sites and may also be released directly into vessels in the infundibular process. The close association of neuropeptide Y-labeled fibers with capillaries of the portal vasculature strongly suggests that neuropeptide Y is released into the portal blood of monkeys throughout life and may influence hormone secretion from the anterior pituitary gland.     

Plagiarism of the host immune system: lessons about chemokine immunology from viruses

In their attempts to evade the host immune response, mammalian viruses have evolved a wide range of strategies. These include the expression and modification of various host cytokines and receptors. Understanding the mechanism of action of these virally encoded proteins will clearly deepen our insights into immunology. In the past few months several new virally encoded chemokines have been described which can modify both the host immune and antiviral response. Their manipulation of the cytokine structure-function relationship may also be useful in the development of reagents for treating immune and proliferative diseases.     

Concordant Time-Dependent Patterns of Activities and Enzyme Protein Amounts of V-PPase and V-ATPase in induced (Flowering and CAM or Tumour) and Non-Induced Plant Tissues*

There are two H⁺-pumping enzymes at the tonoplast membrane of plant vacuoles, the V-ATPase and the V-PPase. One attempt to explain the enigma of “two H⁺ pumps, one membrane” was the suggestion that the V-PPase has special functions in young developing and growing tissues in utilization of pyrophosphate produced in particularly active metabolism and in pumping of K⁺ for vacuolization. This should lead to reciprocal expression of both enzymes with time during development. Here we used stimulation of Kalanchoë blossfeldiana Poellnitz cv. Tom Thumb plants by short-day treatments to induce crassulacean acid metabolism and flowering and of Ricinus communis L. stem tissue by infection with Agrobacterium tumefaciens strain C58 to induce vigorous growth of tumours, and we compared these stimulated tissues with leaves of non-stimulated long-day controls and non-infected stem tissue, respectively. Activities and protein levels of both enzymes increased (K. blossfeldiana) or remained high (R. communis) in the stimulated tissues and decreased in the non-stimulated tissues with time. Time-dependent patterns of the two enzymes were concordant in all of the four cases and not inverse, i.e. two plants with two different conditions each, leading to very different developmental situations.