Hyperglycemia Increases Interstitial Cells of Cajal via MAPK1 and MAPK3 Signaling to ETV1 and KIT, Leading to Rapid Gastric Emptying
GASTROENTEROLOGY
Authors: Hayashi, Yujiro; Toyomasu, Yoshitaka; Saravanaperumal, Siva Arumugam; Bardsley, Michael R.; Smestad, John A.; Lorincz, Andrea; Eisenman, Seth T.; Cipriani, Gianluca; Holte, Molly H. Nelson; Al Khazal, Fatimah J.; Syed, Sabriya A.; Gajdos, Gabriella B.; Choi, Kyoung Moo; Stoltz, Gary J.; Miller, Katie E.; Kendrick, Michael L.; Rubin, Brian P.; Gibbons, Simon J.; Bharucha, Adil E.; Linden, David R.; Maher, Louis James, III; Farrugia, Gianrico; Ordog, Tamas
Abstract
BACKGROUND & AIMS: Depletion of interstitial cells of Cajal (ICCs) is common in diabetic gastroparesis. However, in approximately 20% of patients with diabetes, gastric emptying (GE) is accelerated. GE also occurs faster in obese individuals, and is associated with increased blood levels of glucose in patients with type 2 diabetes. To understand the fate of ICCs in hyperinsulinemic, hyperglycemic states characterized by rapid GE, we studied mice with mutation of the leptin receptor (Lepr(db/db)), which in our colony had accelerated GE. We also investigated hyperglycemia-induced signaling in the ICC lineage and ICC dependence on glucose oxidative metabolism in mice with disruption of the succinate dehydrogenase complex, subunit C gene (Sdhc). METHODS: Mice were given breath tests to analyze GE of solids. ICCs were studied by flow cytometry, intracellular electrophysiology, isometric contractility measurement, reverse-transcription polymerase chain reaction, immunoblot, immunohistochemistry, enzyme-linked immunosorbent assays, and metabolite assays; cells and tissues were manipulated pharmacologically and by RNA interference. Viable cell counts, proliferation, and apoptosis were determined by methyltetrazolium, Ki-67, proliferating cell nuclear antigen, bromodeoxyuridine, and caspase-Glo 3/7 assays. Sdhc was disrupted in 2 different strains of mice via cre recombinase. RESULTS: In obese, hyperglycemic, hyperinsulinemic female Lepr(db/db) mice, GE was accelerated and gastric ICC and phasic cholinergic responses were increased. Female Kit(K641E/+) mice, which have genetically induced hyperplasia of ICCs, also had accelerated GE. In isolated cells of the ICC lineage and gastric organotypic cultures, hyperglycemia stimulated proliferation by mitogen-activated protein kinase 1 (MAPK1)- and MAPK3-dependent stabilization of ets variant 1-a master transcription factor for ICCs-and consequent up-regulation of v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog (KIT) receptor tyrosine kinase. Opposite changes occurred in mice with disruption of Sdhc. CONCLUSIONS: Hyperglycemia increases ICCs via oxidative metabolism-dependent, MAPK1- and MAPK3-mediated stabilization of ets variant 1 and increased expression of KIT, causing rapid GE. Increases in ICCs might contribute to the acceleration in GE observed in some patients with diabetes.
Expression Patterns of Growth and Survival Genes with Prognostic Implications in Advanced Pancreatic Cancer
ANTICANCER RESEARCH
Authors: Pectasides, Dimitrios; Kotoula, Vasiliki; Papaxoinis, George; Alexopoulou, Zoi; Dervenis, Christos; Samantas, Epaminontas; Papaparaskeva, Kleo; Charalambous, Elpida; Gkakou, Chrysoula; Agalianos, Christos; Kalogeras, Konstantine T.; Pentheroudakis, George; Fountzilas, George
Abstract
Aim: The aim of this study was to evaluate the mRNA expression pattern of growth-and survival-related genes and assess their prognostic significance in patients with advanced pancreatic cancer. Patients and Methods: In total, 98 patients were included in this retrospective translational research study and were evaluated for Kirsten rat sarcoma viral oncogene homolog (KRAS) mutational status, and v-akt murine thymoma viral oncogene homolog 1 (AKT1), AKT serine/threonine kinase 2 (AKT2), AKT serine/threonine kinase 3 (AKT3), cyclin D1 (CCND1), epidermal growth factor receptor (EGFR), mitogen-activated protein kinase 1 (MAPK1), hepatocellular growth factor receptor (MET), avian myelomatosis viral oncogene homolog (MYC), nuclear factor kappa B subunit 1 (NFKb1), phosphatase and tensin homolog (PTEN) and mechanistic target of rapamycin (FRAP1) genes mRNA expression. Among these patients, 73 received first-line gemcitabine combined with erlotinib (N=57) or gefitinib (N=16). Results: KRAS mutation did not correlate with mRNA gene expression. Unsupervised hierarchical clustering according to mRNA gene expression successfully distinguished four prognostically distinct groups of tumors. Overexpression of all genes was associated with best prognosis, while suppression or heterogeneous expression patterns of the examined genes were associated with expression patterns of growth- and survival-related genes, classifying pancreatic tumors into distinct groups with possibly different outcomes.