Frequent aberrant DNA methylation of ABCB1, FOXC1, PPP2R2B and PTEN in ductal carcinoma in situ and early invasive breast cancer

Introduction

Ductal carcinoma in situ (DCIS) is a non-invasive lesion of the breast that is frequently detected by mammography and subsequently removed by surgery. However, it is estimated that about half of the detected lesions would never have progressed into invasive cancer. Identifying DCIS and invasive cancer specific epigenetic lesions and understanding how these epigenetic changes are involved in triggering tumour progression is important for a better understanding of which lesions are at risk of becoming invasive.

Methods

Quantitative DNA methylation analysis of ABCB1, CDKN2A/p16^INK4a, ESR1, FOXC1, GSTP1, IGF2, MGMT, MLH1, PPP2R2B, PTEN and RASSF1A was performed by pyrosequencing in a series of 27 pure DCIS, 28 small invasive ductal carcinomas (IDCs), 34 IDCs with a DCIS component and 5 normal breast tissue samples. FOXC1, ABCB1, PPP2R2B and PTEN were analyzed in 23 additional normal breast tissue samples. Real-Time PCR expression analysis was performed for FOXC1.

Results

Aberrant DNA methylation was observed in all three diagnosis groups for the following genes: ABCB1, FOXC1, GSTP1, MGMT, MLH1, PPP2R2B, PTEN and RASSF1A. For most of these genes, methylation was already present at the DCIS level with the same frequency as within IDCs. For FOXC1 significant differences in methylation levels were observed between normal breast tissue and invasive tumours (P < 0.001). The average DNA methylation levels were significantly higher in the pure IDCs and IDCs with DCIS compared to pure DCIS (P = 0.007 and P = 0.001, respectively). Real-time PCR analysis of FOXC1 expression from 25 DCIS, 23 IDCs and 28 normal tissue samples showed lower gene expression levels of FOXC1 in both methylated and unmethylated tumours compared to normal tissue (P < 0.001). DNA methylation levels of FOXC1, GSTP1, ABCB1 and RASSF1A were higher in oestrogen receptor (ER) positive vs. ER negative tumours; whereas methylation levels of FOXC1, ABCB1, PPP2R2B and PTEN were lower in tumours with a TP53 mutation.

Conclusions

Quantitative methylation analysis identified ABCB1, FOXC1, PPP2R2B and PTEN as novel genes to be methylated in DCIS. In particular, FOXC1 showed a significant increase in the methylation frequency in invasive tumours. Low FOXC1 gene expression in both methylated and unmethylated DCIS and IDCs indicates that the loss of its expression is an early event during breast cancer progression.     

How we diagnose and manage altered oxygen affinity hemoglobin variants

Altered oxygen affinity variant hemoglobins (Hbs) are caused by mutations of the globin genes. Changes in Hb oxygen affinity shift the oxygen dissociation curve, and can be identified by abnormal p50 measurements of patient red blood cells. Variants are categorized as either low oxygen affinity (high p50) or high oxygen affinity (low p50). Accurate diagnosis requires recognition of typical clinical and laboratory findings. In this case-based review, we present two patients with altered oxygen affinity variants, illustrating barriers to prompt and accurate diagnosis, and issues in management. We then review pathophysiology, diagnostic tests, clinical features, and management strategies.     

Optical properties of composite restorations influenced by dissimilar dentin restoratives

Objectives

To evaluate optical properties (color and translucency) of ‘sandwich’ restorations of resin-based composites and esthetically unfavorable dentin restoratives.

GRB7 is an oncogenic driver and potential therapeutic target in oesophageal adenocarcinoma

Efficacious therapeutic approaches are urgently needed to improve outcomes in patients with oesophageal adenocarcinoma (OAC). However, oncogenic drivers amenable to targeted therapy are limited and their functional characterisation is essential. Among few targeted therapies available, anti-human epidermal growth factor receptor 2 (HER2) therapy showed only modest benefit for patients with OAC. Herein, we investigated the potential oncogenic role of growth factor receptor bound protein 7 (GRB7), which is reported to be co-amplified with HER2 (ERBB2) in OAC. GRB7 was highly expressed in 15% of OAC tumours, not all of which could be explained by co-amplification with HER2, and was associated with a trend for poorer overall survival. Knockdown of GRB7 decreased proliferation and clonogenic survival, and induced apoptosis. Reverse phase protein array (RPPA) analyses revealed a role for PI3K, mammalian target of rapamycin (mTOR), MAPK, and receptor tyrosine kinase signalling in the oncogenic action of GRB7. Furthermore, the GRB7 and HER2 high-expressing OAC cell line Eso26 showed reduced cell proliferation upon GRB7 knockdown but was insensitive to HER2 inhibition by trastuzumab. Consistent with this, GRB7 knockdown in vivo with an inducible shRNA significantly inhibited tumour growth in cell line xenografts. HER2 expression did not predict sensitivity to trastuzumab, with Eso26 xenografts remaining refractory to trastuzumab treatment. Taken together, our study provides strong evidence for an oncogenic role for GRB7 in OAC and suggests that targeting GRB7 may be a potential therapeutic strategy for this cancer. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.     

Thromboxane A2 acts as tonic immunoregulator by preferential disruption of low-avidity CD4+ T cell–dendritic cell interactions

Interactions between dendritic cells (DCs) and T cells control the decision between activation and tolerance induction. Thromboxane A2 (TXA2) and its receptor TP have been suggested to regulate adaptive immune responses through control of T cell–DC interactions. Here, we show that this control is achieved by selectively reducing expansion of low-avidity CD4⁺ T cells. During inflammation, weak tetramer-binding TP-deficient CD4⁺ T cells were preferentially expanded compared with TP-proficient CD4⁺ T cells. Using intravital imaging of cellular interactions in reactive peripheral lymph nodes (PLNs), we found that TXA2 led to disruption of low- but not high-avidity interactions between DCs and CD4⁺ T cells. Lack of TP correlated with higher expression of activation markers on stimulated CD4⁺ T cells and with augmented accumulation of follicular helper T cells (T_FH), which correlated with increased low-avidity IgG responses. In sum, our data suggest that tonic suppression of weak CD4⁺ T cell–DC interactions by TXA2–TP signaling improves the overall quality of adaptive immune responses.T cells have evolved to quickly react to potentially dangerous microbes by recognizing pathogen-derived peptide (p)-MHC complexes displayed on antigen-presenting cells, in particular DCs. Because T cells are selected in the thymus for their ability to recognize self-pMHC complexes (Morris and Allen, 2012) and numerous self-reactive T cells are released into the periphery (Su et al., 2013), peripheral tolerance education is critical to avoid activation of autoreactive T cells. Studies using intravital two-photon microscopy (2PM) of reactive PLNs have shed light on the dynamic T cell–DC interactions and their correlation with full versus curtailed T cell activation and tolerance induction. The amount of cognate pMHC complexes on activated DCs is critical in determining the transition of a highly motile scanning-mode T cell to an immotile, stably interacting one (Cahalan and Parker, 2006; Henrickson and von Andrian, 2007; Bajénoff and Germain, 2007). Such stable T cell–DC interactions (>8h) are a prerequisite for full effector T cell differentiation (Rachmilewitz and Lanzavecchia, 2002). Thus, in presence of high amounts of cognate pMHC on activated DCs, T cells decelerate rapidly, whereas T cells show a motile DC sampling behavior when cognate pMHC levels are low. Altered peptide ligands (APLs) with reduced affinity for a given TCR also decrease the length of T cell–DC interactions, limiting T cell activation. Under tolerogenic conditions (i.e., in the absence of co-stimulation), 2PM studies uncovered shortened T cell–DC interactions (Hugues et al., 2004) although this is still controversial (Shakhar et al., 2005). Similarly, the presence of regulatory T (T reg) cells reduces T cell–DC interactions and subsequent T cell activation (Tadokoro et al., 2006; Tang et al., 2006).A perhaps counterintuitive recent finding has revealed a significant increase in CD8⁺ T cell immune response avidity in presence of T reg cells (Pace et al., 2012). This is due to T reg cell–mediated suppression of excessive interactions between DCs and CD8⁺ T cells bearing TCRs with low avidity for pMHC complexes. In the absence of T reg cells, uncontrolled CCR5 ligand secretion by activated DCs induces attraction of bystander TCR clones with low affinity for pMHC complexes, which decreases overall avidity and memory T cell generation of the resulting immune response. Whether a comparable mechanism also exists to selectively support activation of high avidity CD4⁺ T cells by immunoregulatory factors is currently unknown.The short-lived arachidonic acid–derived lipid thromboxane A2 (TXA2) has been suggested to regulate adaptive immune responses (Kabashima et al., 2003). Activated DCs and other cell types produce TXA2, which binds its G-protein coupled receptor TP expressed in thymocytes and naive but not effector/memory CD4⁺ and CD8⁺ T cells. Addition of high amounts of the TP agonist I-BOP induces chemokinesis in naive T cells and decreases in vitro aggregate formation between T cells and DCs, causing reduced T cell activation (Kabashima et al., 2003). Combined with the observation that TXA2 levels rapidly rise in reactive PLN during immune responses (Moore et al., 1989), these data suggest a model where TXA2 may act as a general suppressor of T cell–DC interactions. In line with this hypothesis, aged TP-deficient T cells develop lymphoid hyperplasia and high antibody titers (Kabashima et al., 2003). Yet, it has remained unknown how TXA2 signaling affects dynamic CD4⁺ T cell interactions with DC displaying varying pMHC abundance and affinity in vivo, and how this impacts avidity patterns of responding T cells.Here, we show that during sterile and microbial inflammation, absence of TP resulted in increased expansion of low-avidity CD4⁺ T cells. Using 2PM imaging of cellular interactions in reactive PLNs, we report that paracrine TXA2 signaling preferentially disrupted low-avidity interactions between DCs and OT-II CD4⁺ T cells induced by low cognate pMHC levels or low-affinity peptide. As a consequence, TP^−/− OT-II CD4⁺ T cells show increased expression of early activation markers, as well as augmented accumulation of follicular helper T cells (T_FH) compared with WT OT-II CD4⁺ cells. High numbers of TP^−/− T_FH correlated with increased low-avidity IgG production, thus thwarting the overall quality of the adaptive immune response. In sum, our data uncover a previously unappreciated contribution of a tolerance-inducing mechanism for preferential activation of high avidity CD4⁺ T cells.     

Impact of the mouth breathing occurred during childhood in the adult age: biophotogrammetric postural analysis

Objective

This study aims to evaluate the impact of the mouth breathing occurred during childhood on the body posture in the adult age.

Methods

24 adults, of both genders, aged from 18 to 30 years old with report of clinical manifestations of mouth breathing during the childhood composed the study group (SG). The control group (CG) was composed by 20 adults in the same age, without any respiratory problem since the childhood up to the present time. All the volunteers underwent a physiotherapeutic evaluation consisted of anamnesis and postural biophotogrammetry (SAPo v 0.68^®). The comparison between the data of the SG and CG was accomplished by Student's t-test.

Results

The biophotogrammetric analysis demonstrated that the SG showed more forward head posture confirmed by the angles A9 (p = 0.0000) and CL (p = 0.0414) and also by the cervical distance (p = 0.0079). Additionally, this group presented a larger angular measure of the lumbar lordosis (p = 0.0141) compared to the CG.

Conclusion

The results indicate that adults with mouth-breathing childhood have postural alterations, mainly in the head and lumbar column, which keeps for the whole life.     

Ratiometric temperature measurement using negative thermal quenching of intrinsic BiFeO3 semiconductor nanoparticles

A strategy for optical nanothermometry using the negative thermal quenching behavior of intrinsic BiFeO₃ semiconductor nanoparticles has been reported here. X-ray diffraction measurement shows polycrystalline BiFeO₃ nanoparticles with a rhombohedral distorted perovskite structure. Transmission electron microscopy shows agglomerated crystalline nanoparticles around 20 nm in size. Photoluminescence measurements show that intensity of the defect level emission increases significantly with temperature, while the intensity of near band emission and other defect levels emissions show an opposite trend. The most important figures of merit for luminescence nanothermometry: the absolute (S_a) and the relative sensor sensitivity (S_r) and the temperature resolution (ΔT_m) were effectively resolved and calculated. The relative sensitivity and temperature resolution values are found to be 2.5% K⁻¹ and 0.2 K, respectively which are among the highest reported values observed so far for semiconductors.

Negative thermal quenching of intrinsic BiFeO₃ semiconductor nanoparticles for ratiometric luminescence thermometry with 2.5% K⁻¹ relative sensitivity and 0.2 K temperature resolution.