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The National Cancer Research Institute (NCRI) identified top 10 research priorities for people living with cancer to consider to improve treatment and quality of life. 

Reporter: Gail S. Thornton

By 2030 four million people in the UK will be living with the long-term consequences of cancer, but currently there is very little research on the problems they face and how these can be tackled. To help them live better lives, more focused research is needed.

To determine priorities for research that will help people live better with and beyond cancer, NCRI partnered with the James Lind Alliance on a Priority Setting Partnership. The two-year project involved two UK-wide surveys which attracted more than 3500 responses from patients, carers, and health and social care professionals. From these, we identified 26 key questions and distilled these down to 10 top research priorities.

This is the first time that clear research priorities have been identified in this area.

Questions 1 – 10 Questions 11 – 26

SOURCE

https://www.ncri.org.uk/lwbc/

 

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Study Finds that Both Women and their Primary Care Physicians Confusion over Ovarian Cancer Symptoms May Lead to Misdiagnosis

Reporter: Stephen J. Williams, Ph.D.

This post discusses the recently released “The Every Woman Study” conducted by the World Ovarian Cancer Coalition.  For full PDF of the study please click here: WOCC-Every-Woman-Study-Summary-Report-Oct-16

The findings are summarized nicely in the NPR article from Joanne Silberner below but just want to list a few takeaways from the study

  1.  Ovarian Cancer, while not the most common cancer in women, is still one of the most deadly malignancies.  A major reason for this is the inability to catch the disease in its early, and most treatable stages.  Much work is being done on early detection (a few posts on this area from this online journal are given at the end of this post for reference)
  2. The symptoms of ovarian cancer closely mimic symptoms of gastrointestinal distress and disorders and many times these symptoms are overlooked by women as benign, temporary issues and may be mis-self diagnosed.  In addition, if mistaken for common gastrointestinal discomfort or gynecologic discomfort (cramping)  women may self-medicate with over the counter agents which mask the symptoms of ovarian cancer
  3. certain lessons can be learned from the experiences in other countries regarding access to healthcare and diagnosis. For instance

Looking at the key findings of the study it becomes clear that countries have significant potential to
learn from each other:
• Women in Germany had the shortest time to diagnosis, but much less access to
specialist clinicians that are key to successful treatment.
• Women in the UK have almost universal access to specialists but the lowest
proportion of women diagnosed within a month of visiting a doctor.
• Women in Japan had one of the shortest times to diagnosis, but very little access to
genetic testing, and were least likely to get the emotional support they needed.
• Women in the USA were most likely to wait more than three months before
consulting a doctor about symptoms, but most likely to receive genetic testing.
• Women with ovarian cancer in Hungary were most aware of ovarian cancer before
their diagnosis, but were much less likely to be offered surgery to treat their disease.

 

In summary it appears there are three key areas needing to be addressed with regard to improving early reporting of symptoms of ovarian cancer

  1. information and awareness of symptoms by BOTH women and their physicians
  2. family risk assessment programs are very important to make women aware of their risks and needs for screening
  3. access to specialist treatment is important in the early diagnosis and treatment of this disease

 

Learn the Symptoms

Symptoms (from the Sandy Rollman Ovarian Cancer Foundation)

Historically ovarian cancer was called the “silent killer” because symptoms were not thought to develop until the chance of cure was poor. However, recent studies have shown this term is untrue and that the following symptoms are much more likely to occur in women with ovarian cancer than women in the general population. These symptoms include:

  • Bloating
  • Pelvic or abdominal pain
  • Difficulty eating or feeling full quickly
  • Urinary symptoms (urgency or frequency)

Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies. The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early stage ovarian cancer can produce these symptoms.

Women who have these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist. Prompt medical evaluation may lead to detection at the earliest possible stage of the disease. Early stage diagnosis is associated with an improved prognosis.

Several other symptoms have been commonly reported by women with ovarian cancer. These symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities. However, these other symptoms are not as useful in identifying ovarian cancer because they are also found in equal frequency in women in the general population who do not have ovarian cancer.

 

In addition there are serum biomarker tests which have shown useful in the screening for ovarian cancer however these tests have their caveats and not generally suggested for whole population screening due to number of false postitives which may occur (these tests will be discussed in further posts)

Serum biomarker tests include:

 Taken From NPR at https://www.npr.org/sections/goatsandsoda/2018/10/21/658798956/report-women-everywhere-dont-know-enough-about-ovarian-cancer

Report: Women Everywhere Don’t Know Enough About Ovarian Cancer

Colored scanning electron micrograph of dividing ovarian cancer cells.

Steve Gschmeissner/Science Source

new study of women with ovarian cancer shows that ignorance about the condition is common among patients in all 44 countries surveyed. And that ignorance has a cost. The disease is more treatable, even potentially curable, in its early stages.

The women’s answers also suggested their doctors were ignorant. Many of them reported that diagnosis took a long time and that they weren’t referred to proper specialists.

The study was based on an online survey of 1,531 women who had been diagnosed with the cancer and was conducted by the World Ovarian Cancer Coalition, a nonprofit support group between March and May of this year.

Ovarian cancer is the eighth leading cause of cancer in women, according to the World Health Organization. Nearly 300,000 women will develop it this year. The World Ovarian Cancer Coalition estimates that one in six will die within three months of diagnosis and fewer than half will be alive in five years.

Prior to their diagnosis, two-thirds of the women surveyed either had never heard of ovarian cancer or were familiar with the name but didn’t know anything about the disease.

 

Other articles related to Ovarian Cancer on this online Open Access Journal Include:

Model mimicking clinical profile of patients with ovarian cancer @ Yale School of Medicine

New Findings in Endometrial Cancer: Mutations, Molecular Types and Immune Responses Evoked by Mutation-prone Endometrial, Ovarian Cancer Subtypes

Good and Bad News Reported for Ovarian Cancer Therapy

Efficacy of Ovariectomy in Presence of BRCA1 vs BRCA2 and the Risk for Ovarian Cancer

Testing for Multiple Genetic Mutations via NGS for Patients: Very Strong Family History of Breast & Ovarian Cancer, Diagnosed at Young Ages, & Negative on BRCA Test

Ultrasound-based Screening for Ovarian Cancer

Warning signs may lead to better early detection of ovarian cancer

Epigenetics, Environment and Cancer: Articles of Note @PharmaceuticalIntelligence.com

Early Diagnosis [Early Detection Research Networks]

 

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Live 12:00 – 1:00 P.M  Mediterranean Diet and Lifestyle: A Symposium on Diet and Human Health : October 19, 2018

Reporter: Stephen J. Williams, Ph.D.

12.00 The Italian Mediterranean Diet as a Model of Identity of a People with a Universal Good to Safeguard Health?

Prof. Antonino De Lorenzo, MD, PhD.

Director of the School of Specialization in Clinical Nutrition, University of Rome “Tor Vergata”

It is important to determine how our bodies interacts with the environment, such as absorption of nutrients.

Studies shown here show decrease in life expectancy of a high sugar diet, but the quality of the diet, not just the type of diet is important, especially the role of natural probiotics and phenolic compounds found in the Mediterranean diet.

The WHO report in 2005 discusses the unsustainability of nutrition deficiencies and suggest a proactive personalized and preventative/predictive approach of diet and health.

Most of the noncommunicable diseases like CV (46%) cancer 21% and 11% respiratory and 4% diabetes could be prevented and or cured with proper dietary approaches

Italy vs. the US diseases: in Italy most disease due to environmental contamination while US diet plays a major role

The issue we are facing in less than 10% of the Italian population (fruit, fibers, oils) are not getting the proper foods, diet and contributing to as we suggest 46% of the disease

The Food Paradox: 1.5 billion are obese; we notice we are eating less products of quality and most quality produce is going to waste;

  •  growing BMI and junk food: our studies are correlating the junk food (pre-prepared) and global BMI
  • modern diet and impact of human health (junk food high in additives, salt) has impact on microflora
  • Western Diet and Addiction: We show a link (using brain scans) showing correlation of junk food, sugar cravings, and other addictive behaviors by affecting the dopamine signaling in the substantia nigra
  • developed a junk food calculator and a Mediterranean diet calculator
  • the intersection of culture, food is embedded in the Mediterranean diet; this is supported by dietary studies of two distinct rural Italian populations (one of these in the US) show decrease in diet
  • Impact of diet: have model in Germany how this diet can increase health and life expectancy
  • from 1950 to present day 2.7 unit increase in the diet index can increase life expectancy by 26%
  • so there is an inverse relationship with our index and breast cancer

Environment and metal contamination and glyphosate: contribution to disease and impact of maintaining the healthy diet

  • huge problem with use of pesticides and increase in celiac disease

12:30 Environment and Health

Dr. Iris Maria Forte, PhD.

National Cancer Institute “Pascale” Foundation | IRCCS · Department of Research, Naples, Italy

Cancer as a disease of the environment.  Weinberg’s hallmarks of Cancer reveal how environment and epigenetics can impact any of these hallmarks.

Epigenetic effects

  • gene gatekeepers (Rb and P53)
  • DNA repair and damage stabilization

Heavy Metals and Dioxins:( alterations of the immune system as well as epigenetic regulations)

Asbestos and Mesothelioma:  they have demonstrated that p53 can be involved in development of mesothelioma as reactivating p53 may be a suitable strategy for therapy

Diet, Tomato and Cancer

  • looked at tomato extract on p53 function in gastric cancer: tomato extract had a growth reduction effect and altered cell cycle regulation and results in apoptosis
  • RBL2 levels are increased in extract amount dependent manner so data shows effect of certain tomato extracts of the southern italian tomato (     )

Antonio Giordano: we tested whole extracts of almost 30 different varieties of tomato.  The tomato variety  with highest activity was near Ravela however black tomatoes have shown high antitumor activity.  We have done a followup studies showing that these varieties, if grow elsewhere lose their antitumor activity after two or three generations of breeding, even though there genetics are similar.  We are also studying the effects of different styles of cooking of these tomatoes and if it reduces antitumor effect

please see post https://news.temple.edu/news/2017-08-28/muse-cancer-fighting-tomatoes-study-italian-food

 

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Please see related articles on Live Coverage of Previous Meetings on this Open Access Journal

Real Time Conference Coverage for Scientific and Business Media: Unique Twitter Hashtags and Handles per Conference Presentation/Session

LIVE – Real Time – 16th Annual Cancer Research Symposium, Koch Institute, Friday, June 16, 9AM – 5PM, Kresge Auditorium, MIT

Real Time Coverage and eProceedings of Presentations on 11/16 – 11/17, 2016, The 12th Annual Personalized Medicine Conference, HARVARD MEDICAL SCHOOL, Joseph B. Martin Conference Center, 77 Avenue Louis Pasteur, Boston

Tweets Impression Analytics, Re-Tweets, Tweets and Likes by @AVIVA1950 and @pharma_BI for 2018 BioIT, Boston, 5/15 – 5/17, 2018

BIO 2018! June 4-7, 2018 at Boston Convention & Exhibition Center

LIVE 2018 The 21st Gabay Award to LORENZ STUDER, Memorial Sloan Kettering Cancer Center, contributions in stem cell biology and patient-specific, cell-based therapy

HUBweek 2018, October 8-14, 2018, Greater Boston – “We The Future” – coming together, of breaking down barriers, of convening across disciplinary lines to shape our future

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A magnetic wire could replace the lottery of cancer blood tests

Reporter: Irina Robu, PhD

Stanford University scientists developed a magnetic wire which doctors can use to detect cancer before symptoms are detected in patients. The device is threaded into a vein, screens for the disease by attracting scarce and hard to capture tumor cells just like a magnet. The wire would be predominantly valuable to detect ‘silent killers’ such as pancreatic, ovarian and kidney cancer where symptoms only seem in the late stages when it has spread too far to treat. The magnetic wire can save thousands of lives by catching the disease at a time when drugs would be effective. Cells that have broken off a tumor to wander the bloodstream easily can assist as cancer biomarkers signaling the presence of the disease.

Dr. Gambhir’s team published the results in Nature Biomedical Engineering which described how using a wire that has magnetic nano-particles engineered to stick to cancerous cells. The original experiment is on pigs, which are structurally alike to humans and suffer from the same genetic malfunctions that cause cancer. The wire captured 10 to 80 times more tumor cells and was placed in a vein near the pig’s ear which can be removed from and the cells can be used for analysis. In real standings it chosen up 500 to 5,000 more cancerous cells than normal blood samples.

The circulating tumor cells were magnetized with nanoparticles containing an antibody that latch onto them. When attached, the cell carries the tiny magnet around with it and flows past the wire to veer from its regular path in the bloodstream and stick to the wire.  Professor Gambhir hopes that this approach will enrich detection capability and give insight how circulating tumor cells are and how early on they exist once the cancer is present. Once the technology is accepted for humans, the goal is to mature it into a multi-pronged tool that will increase detection, diagnosis, treatment and evaluation of cancer therapy.

It can also be used to gather genetic information about tumors located in places from where it’s hard to take biopsies.

Source

http://med.stanford.edu/news/all-news/2018/07/magnetized-wire-could-be-used-to-detect-cancer-in-people.html

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Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

The CRISPR-Cas9 system has proven to be a powerful tool for genome editing allowing for the precise modification of specific DNA sequences within a cell. Many efforts are currently underway to use the CRISPR-Cas9 system for the therapeutic correction of human genetic diseases. CRISPR/Cas9 has revolutionized our ability to engineer genomes and conduct genome-wide screens in human cells.

 

CRISPR–Cas9 induces a p53-mediated DNA damage response and cell cycle arrest in immortalized human retinal pigment epithelial cells, leading to a selection against cells with a functional p53 pathway. Inhibition of p53 prevents the damage response and increases the rate of homologous recombination from a donor template. These results suggest that p53 inhibition may improve the efficiency of genome editing of untransformed cells and that p53 function should be monitored when developing cell-based therapies utilizing CRISPR–Cas9.

 

Whereas some cell types are amenable to genome engineering, genomes of human pluripotent stem cells (hPSCs) have been difficult to engineer, with reduced efficiencies relative to tumour cell lines or mouse embryonic stem cells. Using hPSC lines with stable integration of Cas9 or transient delivery of Cas9-ribonucleoproteins (RNPs), an average insertion or deletion (indel) efficiency greater than 80% was achieved. This high efficiency of insertion or deletion generation revealed that double-strand breaks (DSBs) induced by Cas9 are toxic and kill most hPSCs.

 

The toxic response to DSBs was P53/TP53-dependent, such that the efficiency of precise genome engineering in hPSCs with a wild-type P53 gene was severely reduced. These results indicate that Cas9 toxicity creates an obstacle to the high-throughput use of CRISPR/Cas9 for genome engineering and screening in hPSCs. As hPSCs can acquire P53 mutations, cell replacement therapies using CRISPR/Cas9-enginereed hPSCs should proceed with caution, and such engineered hPSCs should be monitored for P53 function.

 

CRISPR-based editing of T cells to treat cancer, as scientists at the University of Pennsylvania are studying in a clinical trial, should also not have a p53 problem. Nor should any therapy developed with CRISPR base editing, which does not make the double-stranded breaks that trigger p53. But, there are pre-existing humoral and cell-mediated adaptive immune responses to Cas9 in humans, a factor which must be taken into account as the CRISPR-Cas9 system moves forward into clinical trials.

 

References:

 

https://techonomy.com/2018/06/new-cancer-concerns-shake-crispr-prognosis/

 

https://www.statnews.com/2018/06/11/crispr-hurdle-edited-cells-might-cause-cancer/

 

https://www.biorxiv.org/content/early/2017/07/26/168443

 

https://www.nature.com/articles/s41591-018-0049-z.epdf?referrer_access_token=s92jDP_yPBmDmi-USafzK9RgN0jAjWel9jnR3ZoTv0MRjuB3dEnTctGtoy16n3DDbmISsvbln9SCISHVDd73tdQRNS7LB8qBlX1vpbLE0nK_CwKThDGcf344KR6RAm9k3wZiwyu-Kb1f2Dl7pArs5yYSiSLSdgeH7gst7lOBEh9qIc6kDpsytWLHqX_tyggu&tracking_referrer=www.statnews.com

 

https://www.nature.com/articles/s41591-018-0050-6.epdf?referrer_access_token=2KJ0L-tmvjtQdzqlkVXWVNRgN0jAjWel9jnR3ZoTv0Phq6GCpDlJx7lIwhCzBRjHJv0mv4zO0wzJJCeuxJjzoUWLeemH8T4I3i61ftUBkYkETi6qnweELRYMj4v0kLk7naHF-ujuz4WUf75mXsIRJ3HH0kQGq1TNYg7tk3kamoelcgGp4M7UTiTmG8j0oog_&tracking_referrer=www.statnews.com

 

https://www.biorxiv.org/content/early/2018/01/05/243345

 

https://www.nature.com/articles/nmeth.4293.epdf

 

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Lesson 9 Cell Signaling:  Curations and Articles of reference as supplemental information for lecture section on WNTs: #TUBiol3373

Stephen J. Wiilliams, Ph.D: Curator

UPDATED 4/23/2019

This has an updated lesson on WNT signaling.  Please click on the following and look at the slides labeled under lesson 10

cell motility 9b lesson_2018_sjw

Remember our lessons on the importance of signal termination.  The CANONICAL WNT signaling (that is the β-catenin dependent signaling)

is terminated by the APC-driven degradation complex.  This leads to the signal messenger  β-catenin being degraded by the proteosome.  Other examples of growth factor signaling that is terminated by a proteosome-directed include the Hedgehog signaling system, which is involved in growth and differentiation as well as WNTs and is implicated in various cancers.

A good article on the Hedgehog signaling pathway is found here:

The Voice of a Pathologist, Cancer Expert: Scientific Interpretation of Images: Cancer Signaling Pathways and Tumor Progression

All images in use for this article are under copyrights with Shutterstock.com

Cancer is expressed through a series of transformations equally involving metabolic enzymes and glucose, fat, and protein metabolism, and gene transcription, as a result of altered gene regulatory and transcription pathways, and also as a result of changes in cell-cell interactions.  These are embodied in the following series of graphics.

Figure 1: Sonic_hedgehog_pathwaySonic_hedgehog_pathway

The Voice of Dr. Larry

The figure shows a modification of nuclear translocation by Sonic hedgehog pathway. The hedgehog proteins have since been implicated in the development of internal organs, midline neurological structures, and the hematopoietic system in humans. The Hh signaling pathway consists of three main components: the receptor patched 1 (PTCH1), the seven transmembrane G-protein coupled receptor smoothened (SMO), and the intracellular glioma-associated oncogene homolog (GLI) family of transcription factors.5The GLI family is composed of three members, including GLI1 (gene activating), GLI2 (gene activating and repressive), and GLI3 (gene repressive).6 In the absence of an activating signal from either Shh, Ihh or Dhh, PTCH1 exerts an inhibitory effect on the signal transducer SMO, preventing any downstream signaling from occurring.7 When Hh ligands bind and activate PTCH1, the inhibition on SMO is released, allowing the translocation of SMO into the cytoplasm and its subsequent activation of the GLI family of transcription factors.

 

And from the review of  Elaine Y. C. HsiaYirui Gui, and Xiaoyan Zheng   Regulation of Hedgehog Signaling by Ubiquitination  Front Biol (Beijing). 2015 Jun; 10(3): 203–220.

the authors state:

Finally, termination of Hh signaling is also important for controlling the duration of pathway activity. Hh induced ubiquitination and degradation of Ci/Gli is the most well-established mechanism for limiting signal duration, and inhibiting this process can lead to cell patterning disruption and excessive cell proliferation (). In addition to Ci/Gli, a growing body of evidence suggests that ubiquitination also plays critical roles in regulating other Hh signaling components including Ptc, Smo, and Sufu. Thus, ubiquitination serves as a general mechanism in the dynamic regulation of the Hh pathway.

Overview of Hedgehog signaling showing the signal termination by ubiquitnation and subsequent degradation of the Gli transcriptional factors. obtained from Oncotarget 5(10):2881-911 · May 2014. GSK-3B as a Therapeutic Intervention in Cancer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Note that in absence of Hedgehog ligands Ptch inhibits Smo accumulation and activation but upon binding of Hedgehog ligands (by an autocrine or paracrine fashion) Ptch is now unable to inhibit Smo (evidence exists that Ptch is now targeted for degradation) and Smo can now inhibit Sufu-dependent and GSK-3B dependent induced degradation of Gli factors Gli1 and Gli2.  Also note the Gli1 and Gli2 are transcriptional activators while Gli3 is a transcriptional repressor.

UPDATED 4/16/2019

Please click on the following links for the Powerpoint presentation for lesson 9.  In addition click on the mp4 links to download the movies so you can view them in Powerpoint slide 22:

cell motility 9 lesson_SJW 2019

movie file 1:

Tumorigenic but noninvasive MCF-7 cells motility on an extracellular matrix derived from normal (3DCntrol) or tumor associated (TA) fibroblasts.  Note that TA ECM is “soft” and not organized and tumor cells appear to move randomly if  much at all.

Movie 2:

 

Note that these tumorigenic and invasive MDA-MB-231 breast cancer cells move in organized patterns on organized ECM derived from Tumor Associated (TA) fibroblasts than from the ‘soft’ or unorganized ECM derived from normal  (3DCntrl) fibroblasts

 

The following contain curations of scientific articles from the site https://pharmaceuticalintelligence.com  intended as additional reference material  to supplement material presented in the lecture.

Wnts are a family of lipid-modified secreted glycoproteins which are involved in:

Normal physiological processes including

A. Development:

– Osteogenesis and adipogenesis (Loss of wnt/β‐catenin signaling causes cell fate shift of preosteoblasts from osteoblasts to adipocytes)

  – embryogenesis including body axis patterning, cell fate specification, cell proliferation and cell migration

B. tissue regeneration in adult tissue

read: Wnt signaling in the intestinal epithelium: from endoderm to cancer

And in pathologic processes such as oncogenesis (refer to Wnt/β-catenin Signaling [7.10]) and to your Powerpoint presentation

 

The curation Wnt/β-catenin Signaling is a comprehensive review of canonical and noncanonical Wnt signaling pathways

 

To review:

 

 

 

 

 

 

 

 

 

 

 

Activating the canonical Wnt pathway frees B-catenin from the degradation complex, resulting in B-catenin translocating to the nucleus and resultant transcription of B-catenin/TCF/LEF target genes.

Fig. 1 Canonical Wnt/FZD signaling pathway. (A) In the absence of Wnt signaling, soluble β-catenin is phosphorylated by a degradation complex consisting of the kinases GSK3β and CK1α and the scaffolding proteins APC and Axin1. Phosphorylated β-catenin is targeted for proteasomal degradation after ubiquitination by the SCF protein complex. In the nucleus and in the absence of β-catenin, TCF/LEF transcription factor activity is repressed by TLE-1; (B) activation of the canonical Wnt/FZD signaling leads to phosphorylation of Dvl/Dsh, which in turn recruits Axin1 and GSK3β adjacent to the plasma membrane, thus preventing the formation of the degradation complex. As a result, β-catenin accumulates in the cytoplasm and translocates into the nucleus, where it promotes the expression of target genes via interaction with TCF/LEF transcription factors and other proteins such as CBP, Bcl9, and Pygo.

NOTE: In the canonical signaling, the Wnt signal is transmitted via the Frizzled/LRP5/6 activated receptor to INACTIVATE the degradation complex thus allowing free B-catenin to act as the ultimate transducer of the signal.

Remember, as we discussed, the most frequent cancer-related mutations of WNT pathway constituents is in APC.

This shows how important the degradation complex is in controlling canonical WNT signaling.

Other cell signaling systems are controlled by protein degradation:

A.  The Forkhead family of transcription factors

Read: Regulation of FoxO protein stability via ubiquitination and proteasome degradation

B. Tumor necrosis factor α/NF κB signaling

Read: NF-κB, the first quarter-century: remarkable progress and outstanding questions

1.            Question: In cell involving G-proteins, the signal can be terminated by desensitization mechanisms.  How is both the canonical and noncanonical Wnt signal eventually terminated/desensitized?

We also discussed the noncanonical Wnt signaling pathway (independent of B-catenin induced transcriptional activity).  Note that the canonical and noncanonical involve different transducers of the signal.

Noncanonical WNT Signaling

Note: In noncanonical signaling the transducer is a G-protein and second messenger system is IP3/DAG/Ca++ and/or kinases such as MAPK, JNK.

Depending on the different combinations of WNT ligands and the receptors, WNT signaling activates several different intracellular pathways  (i.e. canonical versus noncanonical)

 

In addition different Wnt ligands are expressed at different times (temporally) and different cell types in development and in the process of oncogenesis. 

The following paper on Wnt signaling in ovarian oncogenesis shows how certain Wnt ligands are expressed in normal epithelial cells but the Wnt expression pattern changes upon transformation and ovarian oncogenesis. In addition, differential expression of canonical versus noncanonical WNT ligands occur during the process of oncogenesis (for example below the authors describe the noncanonical WNT5a is expressed in normal ovarian  epithelia yet WNT5a expression in ovarian cancer is lower than the underlying normal epithelium. However the canonical WNT10a, overexpressed in ovarian cancer cells, serves as an oncogene, promoting oncogenesis and tumor growth.

Wnt5a Suppresses Epithelial Ovarian Cancer by Promoting Cellular Senescence

Benjamin G. Bitler,1 Jasmine P. Nicodemus,1 Hua Li,1 Qi Cai,2 Hong Wu,3 Xiang Hua,4 Tianyu Li,5 Michael J. Birrer,6Andrew K. Godwin,7 Paul Cairns,8 and Rugang Zhang1,*

A.           Abstract

Epithelial ovarian cancer (EOC) remains the most lethal gynecological malignancy in the US. Thus, there is an urgent need to develop novel therapeutics for this disease. Cellular senescence is an important tumor suppression mechanism that has recently been suggested as a novel mechanism to target for developing cancer therapeutics. Wnt5a is a non-canonical Wnt ligand that plays a context-dependent role in human cancers. Here, we investigate the role of Wnt5a in regulating senescence of EOC cells. We demonstrate that Wnt5a is expressed at significantly lower levels in human EOC cell lines and in primary human EOCs (n = 130) compared with either normal ovarian surface epithelium (n = 31; p = 0.039) or fallopian tube epithelium (n = 28; p < 0.001). Notably, a lower level of Wnt5a expression correlates with tumor stage (p = 0.003) and predicts shorter overall survival in EOC patients (p = 0.003). Significantly, restoration of Wnt5a expression inhibits the proliferation of human EOC cells both in vitro and in vivo in an orthotopic EOC mouse model. Mechanistically, Wnt5a antagonizes canonical Wnt/β-catenin signaling and induces cellular senescence by activating the histone repressor A (HIRA)/promyelocytic leukemia (PML) senescence pathway. In summary, we show that loss of Wnt5a predicts poor outcome in EOC patients and Wnt5a suppresses the growth of EOC cells by triggering cellular senescence. We suggest that strategies to drive senescence in EOC cells by reconstituting Wnt5a signaling may offer an effective new strategy for EOC therapy.

Oncol Lett. 2017 Dec;14(6):6611-6617. doi: 10.3892/ol.2017.7062. Epub 2017 Sep 26.

Clinical significance and biological role of Wnt10a in ovarian cancer. 

Li P1Liu W1Xu Q1Wang C1.

Ovarian cancer is one of the five most malignant types of cancer in females, and the only currently effective therapy is surgical resection combined with chemotherapy. Wnt family member 10A (Wnt10a) has previously been identified to serve an oncogenic function in several tumor types, and was revealed to have clinical significance in renal cell carcinoma; however, there is still only limited information regarding the function of Wnt10a in the carcinogenesis of ovarian cancer. The present study identified increased expression levels of Wnt10a in two cell lines, SKOV3 and A2780, using reverse transcription-polymerase chain reaction. Functional analysis indicated that the viability rate and migratory ability of SKOV3 cells was significantly inhibited following Wnt10a knockdown using short interfering RNA (siRNA) technology. The viability rate of SKOV3 cells decreased by ~60% compared with the control and the migratory ability was only ~30% of that in the control. Furthermore, the expression levels of β-catenin, transcription factor 4, lymphoid enhancer binding factor 1 and cyclin D1 were significantly downregulated in SKOV3 cells treated with Wnt10a-siRNA3 or LGK-974, a specific inhibitor of the canonical Wnt signaling pathway. However, there were no synergistic effects observed between Wnt10a siRNA3 and LGK-974, which indicated that Wnt10a activated the Wnt/β-catenin signaling pathway in SKOV3 cells. In addition, using quantitative PCR, Wnt10a was overexpressed in the tumor tissue samples obtained from 86 patients with ovarian cancer when compared with matching paratumoral tissues. Clinicopathological association analysis revealed that Wnt10a was significantly associated with high-grade (grade III, P=0.031) and late-stage (T4, P=0.008) ovarian cancer. Furthermore, the estimated 5-year survival rate was 18.4% for patients with low Wnt10a expression levels (n=38), whereas for patients with high Wnt10a expression (n=48) the rate was 6.3%. The results of the present study suggested that Wnt10a serves an oncogenic role during the carcinogenesis and progression of ovarian cancer via the Wnt/β-catenin signaling pathway.

Targeting the Wnt Pathway includes curations of articles related to the clinical development of Wnt signaling inhibitors as a therapeutic target in various cancers including hepatocellular carcinoma, colon, breast and potentially ovarian cancer.

 

2.         Question: Given that different Wnt ligands and receptors activate different signaling pathways, AND  WNT ligands  can be deferentially and temporally expressed  in various tumor types and the process of oncogenesis, how would you approach a personalized therapy targeting the WNT signaling pathway?

3.         Question: What are the potential mechanisms of either intrinsic or acquired resistance to Wnt ligand antagonists being developed?

 

Other related articles published in this Open Access Online Scientific Journal include the following:

Targeting the Wnt Pathway [7.11]

Wnt/β-catenin Signaling [7.10]

Cancer Signaling Pathways and Tumor Progression: Images of Biological Processes in the Voice of a Pathologist Cancer Expert

e-Scientific Publishing: The Competitive Advantage of a Powerhouse for Curation of Scientific Findings and Methodology Development for e-Scientific Publishing – LPBI Group, A Case in Point 

Electronic Scientific AGORA: Comment Exchanges by Global Scientists on Articles published in the Open Access Journal @pharmaceuticalintelligence.com – Four Case Studies

 

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Knowing the genetic vulnerability of bladder cancer for therapeutic intervention, Volume 2 (Volume Two: Latest in Genomics Methodologies for Therapeutics: Gene Editing, NGS and BioInformatics, Simulations and the Genome Ontology), Part 1: Next Generation Sequencing (NGS)

Knowing the genetic vulnerability of bladder cancer for therapeutic intervention

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

A mutated gene called RAS gives rise to a signalling protein Ral which is involved in tumour growth in the bladder. Many researchers tried and failed to target and stop this wayward gene. Signalling proteins such as Ral usually shift between active and inactive states.

 

So, researchers next tried to stop Ral to get into active state. In inacvtive state Ral exposes a pocket which gets closed when active. After five years, the researchers found a small molecule dubbed BQU57 that can wedge itself into the pocket to prevent Ral from closing and becoming active. Now, BQU57 has been licensed for further development.

 

Researchers have a growing genetic data on bladder cancer, some of which threaten to overturn the supposed causes of bladder cancer. Genetics has also allowed bladder cancer to be reclassified from two categories into five distinct subtypes, each with different characteristics and weak spots. All these advances bode well for drug development and for improved diagnosis and prognosis.

 

Among the groups studying the genetics of bladder cancer are two large international teams: Uromol (named for urology and molecular biology), which is based at Aarhus University Hospital in Denmark, and The Cancer Genome Atlas (TCGA), based at institutions in Texas and Boston. Each team tackled a different type of cancer, based on the traditional classification of whether or not a tumour has grown into the muscle wall of the bladder. Uromol worked on the more common, earlier form, non-muscle-invasive bladder cancer, whereas TCGA is looking at muscle-invasive bladder cancer, which has a lower survival rate.

 

The Uromol team sought to identify people whose non-invasive tumours might return after treatment, becoming invasive or even metastatic. Bladder cancer has a high risk of recurrence, so people whose non-invasive cancer has been treated need to be monitored for many years, undergoing cystoscopy every few months. They looked for predictive genetic footprints in the transcriptome of the cancer, which contains all of a cell’s RNA and can tell researchers which genes are turned on or off.

 

They found three subgroups with distinct basal and luminal features, as proposed by other groups, each with different clinical outcomes in early-stage bladder cancer. These features sort bladder cancer into genetic categories that can help predict whether the cancer will return. The researchers also identified mutations that are linked to tumour progression. Mutations in the so-called APOBEC genes, which code for enzymes that modify RNA or DNA molecules. This effect could lead to cancer and cause it to be aggressive.

 

The second major research group, TCGA, led by the National Cancer Institute and the National Human Genome Research Institute, that involves thousands of researchers across USA. The project has already mapped genomic changes in 33 cancer types, including breast, skin and lung cancers. The TCGA researchers, who study muscle-invasive bladder cancer, have looked at tumours that were already identified as fast-growing and invasive.

 

The work by Uromol, TCGA and other labs has provided a clearer view of the genetic landscape of early- and late-stage bladder cancer. There are five subtypes for the muscle-invasive form: luminal, luminal–papillary, luminal–infiltrated, basal–squamous, and neuronal, each of which is genetically distinct and might require different therapeutic approaches.

 

Bladder cancer has the third-highest mutation rate of any cancer, behind only lung cancer and melanoma. The TCGA team has confirmed Uromol research showing that most bladder-cancer mutations occur in the APOBEC genes. It is not yet clear why APOBEC mutations are so common in bladder cancer, but studies of the mutations have yielded one startling implication. The APOBEC enzyme causes mutations early during the development of bladder cancer, and independent of cigarette smoke or other known exposures.

 

The TCGA researchers found a subset of bladder-cancer patients, those with the greatest number of APOBEC mutations, had an extremely high five-year survival rate of about 75%. Other patients with fewer APOBEC mutations fared less well which is pretty surprising.

 

This detailed knowledge of bladder-cancer genetics may help to pinpoint the specific vulnerabilities of cancer cells in different people. Over the past decade, Broad Institute researchers have identified more than 760 genes that cancer needs to grow and survive. Their genetic map might take another ten years to finish, but it will list every genetic vulnerability that can be exploited. The goal of cancer precision medicine is to take the patient’s tumour and decode the genetics, so the clinician can make a decision based on that information.

 

References:

 

https://www.ncbi.nlm.nih.gov/pubmed/29117162

 

https://www.ncbi.nlm.nih.gov/pubmed/27321955

 

https://www.ncbi.nlm.nih.gov/pubmed/28583312

 

https://www.ncbi.nlm.nih.gov/pubmed/24476821

 

https://www.ncbi.nlm.nih.gov/pubmed/28988769

 

https://www.ncbi.nlm.nih.gov/pubmed/28753430

 

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Detecting Multiple Types of Cancer With a Single Blood Test

Reporter and Curator: Irina Robu, PhD

Monitoring cancer patients and evaluating their response to treatment can sometimes involve invasive procedures, including surgery.

The liquid biopsies have become something of a Holy Grail in cancer treatment among physicians, researchers and companies gambling big on the technology. Liquid biopsies, unlike traditional biopsies involving invasive surgery — rely on an ordinary blood draw. Developments in sequencing the human genome, permitting researchers to detect genetic mutations of cancers, have made the tests conceivable. Some 38 companies in the US alone are working on liquid biopsies by trying to analyze blood for fragments of DNA shed by dying tumor cells.

Premature research on the liquid biopsy has concentrated profoundly on patients with later-stage cancers who have suffered treatments, including chemotherapy, radiation, surgery, immunotherapy or drugs that target molecules involved in the growth, progression and spread of cancer. For cancer patients undergoing treatment, liquid biopsies could spare them some of the painful, expensive and risky tissue tumor biopsies and reduce reliance on CT scans. The tests can rapidly evaluate the efficacy of surgery or other treatment, while old-style biopsies and CT scans can still remain inconclusive as a result of scar tissue near the tumor site.

As recently as a few years ago, the liquid biopsies were hardly used except in research. At the moment, thousands of the tests are being used in clinical practices in the United States and abroad, including at the M.D. Anderson Cancer Center in Houston; the University of California, San Diego; the University of California, San Francisco; the Duke Cancer Institute and several other cancer centers.

With patients for whom physicians cannot get a tissue biopsy, the liquid biopsy could prove a safe and effective alternative that could help determine whether treatment is helping eradicate the cancer. A startup, Miroculus developed a cheap, open source device that can test blood for several types of cancer at once. The platform, called Miriam finds cancer by extracting RNA from blood and spreading it across plates that look at specific type of mRNA. The technology is then hooked up at a smartphone which sends the information to an online database and compares the microRNA found in the patient’s blood to known patterns indicating different type of cancers in the early stage and can reduce unnecessary cancer screenings.

Nevertheless, experts warn that more studies are essential to regulate the accuracy of the test, exactly which cancers it can detect, at what stages and whether it improves care or survival rates.

SOURCE

https://www.fastcompany.com/3037117/a-new-device-can-detect-multiple-types-of-cancer-with-a-single-blood-test

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356857/

Other related articles published in this Open Access Online Scientific Publishing Journal include the following:

Liquid Biopsy Chip detects an array of metastatic cancer cell markers in blood – R&D @Worcester Polytechnic Institute, Micro and Nanotechnology Lab

Reporters: Tilda Barliya, PhD and Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2016/12/28/liquid-biopsy-chip-detects-an-array-of-metastatic-cancer-cell-markers-in-blood-rd-worcester-polytechnic-institute-micro-and-nanotechnology-lab/

Liquid Biopsy Assay May Predict Drug Resistance

Curator: Larry H. Bernstein, MD, FCAP

https://pharmaceuticalintelligence.com/2015/11/06/liquid-biopsy-assay-may-predict-drug-resistance/

One blood sample can be tested for a comprehensive array of cancer cell biomarkers: R&D at WPI

Curator: Marzan Khan, B.Sc

https://pharmaceuticalintelligence.com/2017/01/05/one-blood-sample-can-be-tested-for-a-comprehensive-array-of-cancer-cell-biomarkers-rd-wpi

 

 

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Nutrition: Articles of Note @PharmaceuticalIntelligence.com

Author and Curator: Larry H. Bernstein, MD, FCAP and Curator: Aviva Lev-Ari, PhD, RN

 

 

Nutrition and Wellbeing

 

Introduction 

Larry H. Bernstein, MD, FCAP

 

The chapters that follow are divided into three parts, but they are also a summary of 25 years of work with nutritional support research and involvement with nutritional support teams in Connecticut and New York, attendance and presentations at the American Association for Clinical Chemistry and the American Society for Parenteral and Enteral Nutrition, and long term collaborations with the surgeons Walter Pleban and Prof. Stanley Dudrick, and Prof. Yves Ingenbleek at the Laboratory of Nutrition, Department of Pharmacy, University Louis Pasteur, Strasbourg, Fr.   They are presented in the order: malnutrition in childhood; cancer, inflammation, and nutrition; and vegetarian diet and nutrition role in alternative medicines. These are not unrelated as they embrace the role of nutrition throughout the lifespan, the environmental impact of geo-ecological conditions on nutritional wellbeing and human development, and the impact of metabolism and metabolomics on the outcomes of human disease in relationship to severe inflammatory disorders, chronic disease, and cancer. Finally, the discussion emphasizes the negative impact of a vegan diet on long term health, and it reviews the importance of protein sources during phases of the life cycle.

Malnutrition in Childhood

 

Protein Energy Malnutrition and Early Child Development

Curator: Larry H. Bernstein, MD, FCAP

 

The Significant Burden of Childhood Malnutrition and Stunting

Curator: Larry H. Bernstein, MD, FCAP

 

Is Malnutrition the Cost of Civilization?

Curation: Larry H. Bernstein, MD, FCAP

 

Malnutrition in India, High Newborn Death Rate and Stunting of Children Age Under Five Years

Curator: Larry H Bernstein, MD, FCAP

 

Under Nutrition Early in Life may lead to Obesity

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

Protein Malnutrition

Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

Cancer, Inflammation and Nutrition

 

A Second Look at the Transthyretin Nutrition Inflammatory Conundrum

Author and Curator: Larry H. Bernstein, MD, FACP

 

Cancer and Nutrition

Writer and Curator: Larry H. Bernstein, MD, FCAP

 

The history and creators of total parenteral nutrition

Curator: Larry H. Bernstein, MD, FCAP

 

Nutrition Plan

Curator: Larry H. Bernstein, MD, FCAP

 

Nutrition and Aging

Curator: Larry H Bernstein, MD, FCAP

 

Vegetarian Diet and Nutrition Role in Alternative Medicines

 

Plant-based Nutrition, Neutraceuticals and Alternative Medicine: Article Compilation the Journal PharmaceuticalIntelligence.com

Curator: Larry H. Bernstein, MD, FCAP

 

Metabolomics, Metabonomics and Functional Nutrition: the next step in nutritional metabolism and biotherapeutics

Reviewer and Curator: Larry H. Bernstein, MD, FCAP

 

2014 Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism Conference: San Francisco, Ca. Conference Dates: San Francisco, CA 3/18-21, 2014

Reporter: Aviva Lev-Ari, PhD, RN

 

Metabolomics: its Applications in Food and Nutrition Research

Reporter and Curator: Sudipta Saha, Ph.D.

 

Summary

Larry H. Bernstein, MD, FCAP 

The interest in human malnutrition became a major healthcare issue in the 1980’s with the publication of several seminal papers on hospital malnutrition. However, the basis for protein-energy malnutrition that focused on the distinction between kwashiorkor and marasmus was first identified in seminal papers by Ingenbleek and others:

Ingenbleek Y. La malnutrition protein-calorique chez l’enfant en bas age. Repercussions sur la function thyroidienne et les protein vectrices du serum. PhD Thesis. Acco Press. 1997. Univ Louvain.

Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutrition index scoring critically ill patients. Internat J Vit Nutr Res 1985; 55:91-101.

Ingenbleek Y, Young VR. Transthyretin (prealbumin) in health and disease. Nutritional implications. Ann Rev Nutr 1994; 14:495-533.

Ingenbleek Y, Hardillier E, Jung L. Subclinical protein malnutrition is a determinant of hyperhomocysteinemia. Nutrition 2002; 18:40-46.

It was these early papers that transfixed my attention, and drove me to establish early the transthyretin test by immunodiffusion and later by automated immunoassay at Bridgeport Hospital.

Among the important studies often referred to with respect to hospital malnutrition are:

  1. Hill GL, Blackett RL, Pickford I, Burkinshaw L, Young GA, Warren JV. Malnutrition in surgical patients: An unrecognised problem. Lancet.1977; 310:689–692. [PubMed]
  2. Bistrian BR, Blackburn GL, Vitale J, Cochrane D, Naylor J. Prevalence of malnutrition in general medical patients. JAMA. 1976; 235:1567–1570. [PubMed]
  3. Butterworth CE. The skeleton in the hospital closet. Nutrition Today.1974; 9:4–8.
  4. Buzby GP, Mullen JL, Matthews DC, Hobbs CL, Rosato EF. Prognostic nutritional index in gastrointestinal surgery. Am. J. Surg. 1980; 139:160–167.[PubMed]
  5. Dempsey DT, Mullen JL, Buzby GP. The link between nutritional status and clinical outcomes: can nutritional intervention modify it? Am. J. Clin. Nutr. 1988; 47:352–356. [PubMed]
  6. Detsky AS, Mclaughlin JR, Baker JP, Johnston N, Whittaker S, Mendleson RA, Jeejeebhoy KN. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987; 11:8–13. [PubMed]
  7. Scrimshaw NS, DanGiovanni JP. Synergism of nutrition, infection and immunity, an overview. J. Nutr. 1997; 133:S316–S321.
  8. Chandra RK. Nutrition and the immune system: an introduction. Am. J. Clin. Nutr. 1997; 66:460S–463S. [PubMed]
  9. Hill GL. Body composition reserach: Implications for the practice of clinical nutrition. JPEN J. Parenter. Enteral Nutr. 1992; 16:197. [PubMed]
  10. Smith PE, Smith AE. High-quality nutritional interventions reduce costs.Healthc. Financ. Manage. 1997; 5:66–69. [PubMed]
  11. Gallagher-Allred CR, Voss AC, Finn SC, McCamish MA. Malnutrition and clinical outcomes. J. Am. Diet. Assoc. 1996; 96:361–366. [PubMed]
  12. Ferguson M. Uncovering the skeleton in the hoapital closet. What next? Aust. J. Nutr. Diet. 2001; 58:83–84.
  13. Waitzberg DL, Caiaffa WT, Correia MITD. Hospital malnutrition: The Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition.2001; 17:573–580. [PubMed]

The work on hospital (and nursing home) treatment of malnutrition described in this series led to established standards. It first requires identifying a patient at malnutrition risk to be identified via either screening or assessment. This needs to be done on admission, and it has been made mandatory by health care accrediting bodies. In order to achieve this, dietitians need to have the confidence and knowledge to detect malnutrition, which is ideally done using a validated assessment for patient outcomes and financial benefits to be realized.

There is a worldwide relationship between ecological conditions, religious practices, soil conditions, availability of animal food sources, and altitude and river flows has not received the attention that evidence requires. We have seen that the emphasis on the Hindu tradition of not eating beef or having dairy is possibly problematic in the Ganges River basin. There may be other meat sources, but it is questionable that sufficient animal protein is available for the large population. The additional problem of water pollution is an aggravating situation. However, it is this region that is one of the most affected by stunting of children. We have a situation here and in other poor societies where veganism is present, and there is also voluntary veganism in western societies. This is not a practice that leads to any beneficial effect, and it has been shown to lead to a hyperhomocystenemia with the associated risk of arterial vascular disease. For those who voluntarily choose veganism, this is an unexpected result.

Met is implicated in a large spectrum of metabolic and enzyme activities and participates in the conformation of a large number of molecules of survival importance. Due to the fact that plant products are relatively Met-deficient, vegan subjects are more exposed than omnivorous to develop hyperhomocysteinemia – related disorders. Dietary protein restriction may promote supranormal Hcy concentrations which appears as the dark side of adaptive attempts developed by the malnourished and/or stressed body to preserve Met homeostasis.  Summing up, we assume that the low TTR concentrations reported in the blood and CSF of AD or MID patients result in impairment of their normal scavenging capacity and in the excessive accumulation of Hcy in body fluids, hence causing direct harmful damage to the brain and cardiac vasculature.

The content of these discussions has also included nutrition and cancer. This is perhaps least well understood. Reasons for such an association may well include chronic exposure to radiation damage, or persistent focal chronic inflammatory conditions. These would result in a cirumferential and repeated cycle of injury and repair combined with an underlying hypoxia. I have already established a fundamental relationship between inflammation, the cytokine storm, the decreased hepatic synthesis of essential plasma proteins, such as, albumin, transferrin, retinol-binding protein, and transthyretin, and the surge of steroid hormones. This results in an imbalance in the protein and free protein equilibrium of essential vitamins, the retinoids, and other circulating ligands transported. This is discussed in the ‘nutrition-inflammatory conundrum”. As stated, whatever the nutritional status and the disease condition, the actual transthyretin (TTR) plasma level is determined by opposing influences between anabolic and catabolic alterations. Rising TTR values indicate that synthetic processes prevail over tissue breakdown with a nitrogen balance (NB) turning positive as a result of efficient nutritional support and / or anti-inflammatory therapy. Declining TTR values are associated with an effect of maladjusted dietetic management and / or further worsening of the morbid condition.

Inflammatory disorders of any cause are initiated by activated leukocytes releasing a shower of cytokines working as autocrine, paracrine and endocrine molecules. Cytokines regulate the overproduction of acute-phase proteins (APPs), notably that of CRP, 1-acid glycoprotein (AGP), fibrinogen, haptoglobin, 1-antitrypsin and antichymotrypsin. APPs contribute in several ways to defense and repair mechanisms, being characterized by proper kinetic and functional properties. Interleukin-6 (IL-6) is regarded as a key mediator governing both the acute and chronic inflammatory processes, as documented by data recorded on burn, sepsis and AIDS patients. IL-6-NF possesses a high degree of homology with C/EBP-NF1 and competes for the same DNA response element of the IL-6 gene. IL-6-NF is not expressed under normal circumstances, explaining why APP concentrations are kept at baseline levels. In stressful conditions, IL-6-NF causes a dramatic surge in APP values with a concomitant suppressed synthesis of TTR.

Inadequate nutritional management, multiple injuries, occurrence of severe sepsis and metabolic complications result in persistent proteolysis and subnormal TTR concentrations. The evolutionary patterns of urinary N output and of TTR thus appear as mirror images of each other, which supports the view that TTR might well reflect the depletion of TBN in both acute and chronic disease processes. Even in the most complex stressful conditions, the synthesis of visceral proteins is submitted to opposing anabolic or catabolic influences yielding ultimately TTR as an end-product reflecting the prevailing tendency. Whatever the nutritional and/or inflammatory causal factors, the actual TTR plasma level and its course in process of time indicates the exhaustion or restoration of the body N resources, hence its likely (in)ability to assume defense and repair mechanisms.

In westernized societies, elderly persons constitute a growing population group. A substantial proportion of them may develop a syndrome of frailty characterized by weight loss, clumsy gait, impaired memory and sensorial aptitudes, poor physical, mental and social activities, depressive trends. Hallmarks of frailty combine progressive depletion of both structural and metabolic N compartments. Sarcopenia and limitation of muscle strength are naturally involutive events of normal ageing which may nevertheless be accelerated by cytokine-induced underlying inflammatory disorders. Depletion of visceral resources is substantiated by the shrinking of FFM and its partial replacement by FM, mainly in abdominal organs, and by the down-regulation of indices of growth and protein status. Due to reduced tissue reserves and diminished efficiency of immune and repair mechanisms, any stressful condition affecting old age may trigger more severe clinical impact whereas healing processes require longer duration with erratical setbacks. As a result, protein malnutrition is a common finding in most elderly patients with significantly increased morbidity and mortality rates.

TTR has proved to be a useful marker of nutritional alterations with prognostic implications in large bowel cancer, bronchopulmonary carcinoid tumor, ovarian carcinoma and squamous carcinoma of bladder. Many oncologists have observed a rapid TTR fall 2 or 3 months prior to the patient’s death. In cancer patients submitted to surgical intervention, most postoperative complications occurred in subjects with preoperative TTR  180 mg/L. Two independent studies came to the same conclusion that a TTR threshold of 100 mg/L is indicative of extremely weak survival likelihood and that these terminally ill patients better deserve palliative care rather than aggressive therapeutic strategies.

Thyroid hormones and retinoids indeed function in concert through the mediation of common heterodimeric motifs bound to DNA response elements. The data also imply that the provision of thyroid molecules within the CSF works as a relatively stable secretory process, poorly sensitive to extracerebral influences as opposed to the delivery of retinoid molecules whose plasma concentrations are highly dependent on nutritional and/or inflammatory alterations. This last statement is documented by mice experiments and clinical investigations showing that the level of TTR production by the liver operates as a limiting factor for retinol transport. Defective TTR synthesis determines the occurrence of secondary hyporetinolemia which nevertheless results from entirely different kinetic mechanisms in the two quoted studies.

Points to consider:

Protein energy malnutrition has an unlikely causal relationship to carcinogenesis. Perhaps the opposite is true. However, cancer has a relationship to protein energy malnutrition without any doubt. PEM is the consequence of cachexia, whether caused by dietary insufficiency, inflammatory or cancer.

Protein energy malnutrition leads to hyperhomocysteinemia, and by that means, the relationship of dietary insufficiency of methionine has a relationship to heart disease. This is the significant link between veganism and cardiovascular disease, whether voluntary or by unavailability of adequate source.

The last portion of these chapters deals with metabolomics and functional nutrition. This is an emerging and important area of academic interest. There is a significant relationship between these emerging studies and pathways to understanding natural products medicinal chemistry.

 

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The Human Proteome Map Completed

Reporter and Curator: Larry H. Bernstein, MD, FCAP

UPDATED 6/02/2024

The genetic, pharmacogenomic, and immune landscapes associated with protein expression across human cancers.

Source: Chen C, Liu Y, Li Q, Zhang Z, Luo M, Liu Y, Han L. The Genetic, Pharmacogenomic, and Immune Landscapes Associated with Protein Expression across Human Cancers. Cancer Res. 2023 Nov 15;83(22):3673-3680. doi: 10.1158/0008-5472.CAN-23-0758. PMID: 37548539; PMCID: PMC10843800.

Abstract

Proteomics is a powerful approach that can rapidly enhance our understanding of cancer development. Detailed characterization of the genetic, pharmacogenomic, and immune landscape in relation to protein expression in cancer patients could provide new insights into the functional roles of proteins in cancer. By taking advantage of the genotype data from The Cancer Genome Atlas (TCGA) and protein expression data from The Cancer Proteome Atlas (TCPA), we characterized the effects of genetic variants on protein expression across 31 cancer types and identified approximately 100,000 protein quantitative trait loci (pQTL). Among these, over 8000 pQTL were associated with patient overall survival. Furthermore, characterization of the impact of protein expression on more than 350 imputed anticancer drug responses in patients revealed nearly 230,000 significant associations. In addition, approximately 21,000 significant associations were identified between protein expression and immune cell abundance. Finally, a user-friendly data portal, GPIP (https://hanlaboratory.com/GPIP), was developed featuring multiple modules that enable researchers to explore, visualize, and browse multidimensional data. This detailed analysis reveals the associations between the proteomic landscape and genetic variation, patient outcome, the immune microenvironment, and drug response across cancer types, providing a resource that may offer valuable clinical insights and encourage further functional investigations of proteins in cancer.

Introduction

Functional proteomics is a powerful approach that helps us understand cancer pathophysiology and identify potential therapeutic strategies (). Functional protein analysis using reverse-phase protein arrays (RPPA) has already proven highly effective in studying large numbers of TCGA samples, especially when integrated with genomic, transcriptomic, and clinical information (). Previous works demonstrated that a QTL mapping approach is effective to understand the genetic basis of multiple molecular features in human diseases (). Identifying the sequence determinants of protein levels (pQTLs) may guide the search for causal genes and facilitate understanding the underlying mechanisms of human diseases. However, it remains challenging to further understand the functional roles of protein expression in cancers. For example, it is unclear whether proteins are associated with drug response and/or immune features in patients. In this study, we systematically investigated the effects of genetic variants on protein expression and characterized the impact of protein expression on imputed drug responses and immune cell abundances from different sources (Fig. 1). To facilitate broad access of these data for the biomedical research community, we developed a user-friendly database, GPIP (https://hanlaboratory.com/GPIP). We expect this study to have a significant clinical impact on the future development of protein-based targeted therapies.

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Impact of genetic variants on protein expression.

A Workflow of GPIP to identify pQTLs and survival-associated pQTLs. B The number of pQTLs identified for each cancer type. C Association between CYCLINB1 protein expression level and rs12576855 in LUAD patients. D Association between CYCLINB1 protein expression level and rs2722796 in LGG patients. E The number of survival-associated pQTLs identified for each cancer type. F Kaplan–Meier plot showing the association between rs10918659 (pQTL of HER2_pY1248) genotypes and overall survival times of STAD patients. G Kaplan–Meier plot showing the association between rs13158796 (pQTL of HER2_pY1248) genotypes and overall survival times of STAD patients.

Identification of protein–drug associations

To investigate potential associations between protein expression and drug response, we calculated the Spearman rank correlation between protein expression data and drug response from DrVAEN and cancerRxTissue. These two datasets employed distinct predictive models that integrated omics data from CCLE and drug response data from GDSC to predict drug response in TCGA samples (Fig. 2A) (,). Association with |Rs| > 0.3 and FDR < 0.05 were considered as significant associations in each cancer type.

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Exploring the pharmacogenomics of protein in human cancer.

A Workflow of GPIP to identify Drug-associated proteins. B The number of protein-drug response pairs identified from DrVAEN (left) and cancerRxTissue (right) for each cancer type. C Visualization of the associations between proteins and drugs (DrVAEN) within and across different cancer signaling pathways. Blue links represent associations within a single pathway, while orange links represent associations cross pathways. D Enrichment analysis of drug target pathways among significant protein-drug response pairs. The color represents the log2 (odds ratio) of Fisher’s exact test. The size represents the FDR value.

Identification of protein–immune cell associations

To examine the relationship between protein expression and immune cell abundance, we utilized Spearman rank correlation coefficient to calculate the associations between protein expression data and immune cell abundance data from TIMER, CIBERSORT, ImmuneCellAI, and ImmuneCellGSVA (Fig. 3). These datasets utilized different methods to evaluate immune cell abundance by leveraging immune gene signatures as a proxy (). We considered correlations with |Rs| > 0.3 and FDR < 0.05 as significant associations.

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Exploring the immune landscapes of protein in human cancer.

A Workflow of GPIP to identify Immune cell-associated proteins. B The number of protein-drug response pairs identified from ImmuneCellsGSVA (purple), ImmuCellAI (yellow), TIMER (red) and CIBERSORT (green) for each cancer type. C The top 10 proteins with the highest number of significantly associated immune cell types in HNSC. The color represents the Rs between protein expression and immune cell abundance (ImmuneCellGSVA). The size represents the FDR value. D Association between PREX1expression and impute MDSC abundance in HNSC patients.

Database construction

GPIP was developed using Python Flask-RESTful API frameworks (https://flask-restful.readthedocs.io/), AngularJS (https://angularjs.org), and Bootstrap (https://getbootstrap.com/). The database for GPIP was implemented using the NoSQL database program MongoDB (https://www.mongodb.com/). The user-friendly interface of the GPIP web application was served through the Apache HTTP Server, allowing users to access the database and perform queries and analysis through a web browser.

Data availability

All results generated in this study can be found in GPIP database, (https://hanlaboratory.com/GPIP). Publicly available data generated by others were used by the authors in this study: The genotype data and clinical data were obtained from The Cancer Genome Atlas (TCGA) data portal at https://tcga-data.nci.nih.gov/tcga/. The reverse-phase protein array (RPPA) protein expression data was obtained from The Cancer Proteome Atlas (TCPA) data portal at https://www.tcpaportal.org/. The imputed pharmacogenomic data were obtained from DrVAEN at https://bioinfo.uth.edu/drvaen/ and cancerRxTissue at https://manticore.niehs.nih.gov/cancerRxTissue/. The immune-cell infiltration data were obtained from Tumor Immune Estimation Resource (TIMER) at http://timer.cistrome.org/, Immune Cell Abundance Identifier (ImmuCellAI) at http://bioinfo.life.hust.edu.cn/ImmuCellAI/, and CIBERSORT at https://cibersort.stanford.edu/.

A comprehensive data portal

We developed a user-friendly data portal, GPIP (https://hanlaboratory.com/GPIP), to facilitate visualizing, searching, and browsing of our results by the biomedical research community (Fig. 4A). GPIP contains four main modules: Protein-QTLs, Surivial-QTLs, Drug Response, and Immune Infiltration (Fig. 4B). Querying can be easily performed by selecting cancer type, protein, drug, immune cell abundance, or entering the SNP ID of interest (Fig. 4C). For example, in the Protein-QTLs and Survival-QTLs modules, users can search for pQTLs by selecting a cancer type (e.g., LUAD) and entering a protein name (e.g., CYCLINB1) or an SNP ID (e.g., rs12576855). In the Drug Response module, users can search for protein-drug response associations by selecting a data source for imputed drug response (e.g., DrVAEN) and selecting an anticancer drug (e.g., Talazoparib) or a protein (e.g., PARP1). In the Immune Infiltration module, users can search for protein-immune infiltration pairs by selecting a data source for imputed immune cell abundance (e.g., ImmuneCellsGSVA), and selecting an immune cell type (e.g., Activated B cell) or a protein (e.g., PDL1). In addition, on the bottom of the main page, we developed a cancer type module where users can click on a specific cancer type (e.g., BLCA) to search for related information across all 4 modules (Fig. 4D). The search results for each module included a table to list related information accordingly (Fig. 4E). A “Details” button for each result item was clicked for generating a box plot in protein-QTLs module (Fig. 4F), a Kaplan–Meier plot in Survival-QTLs module (Fig. 4G) and a scatter plot in Drug Response and Immune Infiltration modules, respectively (Fig. 4H,I).I). Our database provides a valuable resource for cancer research and will be of great interest to the research community.

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Object name is nihms-1924390-f0004.jpg
Content and interface of GPIP.

A GPIP homepage and browser bar. B The four main modules of GPIP. C Search boxes in the pQTLs module. D Search boxes in the cancer type-specific search module. E An example of resulting list in the pQTL module. F An example of boxplot for the pQTLs module result. G An example of Kaplan–Meier plot for the Survival protein-QTLs module result. H An example of scatter plot for the Drug Response module result. I An example of scatter plot for the Immune Infiltration module result.

Discussion

Proteomics plays a crucial role in identifying potential therapeutic strategies and understanding cancer pathophysiology (). In this study, we investigated the effects of genetic variants on protein expression and characterized the impact of protein expression on imputed drug responses and immune cell abundances across human cancers. We also developed the user-friendly data portal, GPIP, to provide access to these results. Our study provides a comprehensive analysis of protein expression in different cancer types and their association with drug response and immune cell abundance.

Identifying genetic variants associated with cancer has revolutionized our understanding of the disease and holds promise for improved diagnosis and treatment. In GPIP, we identified ~100,000 pQTLs across 31 cancer types and 8.8% of them were found to be associated with patient survival (Fig. 1). These genetic variants hold significant promise for unraveling the underlying biological mechanisms of disease progression and response to treatments. For example, a survival-associated pQTL may help to identify a genetic variant that controls the expression of a protein crucial for tumor growth or immune response, thus impacting patient survival. Our results suggest that pQTLs have the potential to serve as prognostic biomarkers and aid in the development of precision medicine.

Despite the promising implications, it is crucial to consider potential limitations of pQTL identification. One limitation is the small number of tumor samples in rare cancers, which limits statistical power and the detection of significant pQTLs. For example, only 8 proteins with pQTLs were found in CHOL, likely due to the small sample size (Table S1). Additionally, we observed that some cancer types with large sample sizes identified only a small number of pQTLs (e.g., BRAC), possibly due to the data quality of protein abundance. Tumors originating from different tissues may have variations in protein extraction quality or protein measurement accuracy (). Furthermore, cancer type heterogeneity can impact pQTL identification, as tumors from different tissues exhibit distinct protein expression profiles and genetic landscapes. Addressing these limitations is necessary to ensure valid and reliable results.

Protein expression levels in tumors can impact response of cancer cells to therapeutic drugs due to their role as targets of drug action, with alterations in expression potentially modifying drug sensitivity or resistance. In GPIP, we utilized the imputed drug response and protein expression data in TCGA patients to identify the potential associations between protein expression and drug response (Fig. 2). Our results revealed that certain proteins were significantly associated with drug sensitivity or resistance, suggesting that protein expression levels could potentially be used as biomarkers to predict drug response in cancer patients. Recent studies have shown that the impact of genetic variants on drug response can be mediated through protein-protein interaction (PPI) networks (,). Integrating genetic variants and PPI to further understand the associations between protein expression and drug response may provide further insights.

The protein expression level in tumors is crucial in the context of tumor immune microenvironment and immunotherapy, as it might impact immune cell abundance and response, and potentially improve the efficacy of immunotherapy. In GPIP, we examined the association between protein expression levels and imputed immune cell abundance across multiple cancer types. Our study identified ~21,000 significant correlations between proteins and immune cell types, highlighting the potential role of protein expression levels in shaping the tumor immune microenvironment (Fig. 3). Our results offer a promising avenue for future research to understand the interplay between protein expression and the tumor immune microenvironment, leading to personalized immunotherapy strategies and better treatment outcomes for cancer patients.

In summary, GPIP is a comprehensive and multifaceted data platform designed to aid functional and clinical research on protein in cancer patients. As more relevant datasets become available, we will continually update GPIP to ensure its relevance and usefulness to the research community.

Significance:

Comprehensive characterization of the relationship between protein expression and the genetic, pharmacogenomic, and immune landscape of tumors across cancer types provides a foundation for investigating the role of protein expression in cancer development and treatment.

Researchers Produce First Map of Human Proteome, and Reveal New
Significance in The Human Proteome

HAHNE, TECHNISCHE UNIVERSITÄT MÜNCHENTwo international teams have
independently produced the first drafts of the human proteome. These curated
catalogs of the proteins expressed in most non-diseased human tissues and
organs can be used as a baseline to better understand changes that occur in
disease states. Their findings were published today (May 29) in Nature.

Both teams uncovered new complexities of the human genome, identifying novel
proteins from regions of the genome previously thought to be non-coding.

“the real breakthrough with these two projects is the comprehensive coverage of
more than 80 percent of the expected human proteome” said Hanno Steen, director
of proteomics at Boston Children’s Hospital, who was not involved in the work.

The human proteome map provides a catalog of proteins expressed in nondiseased tissues and organs to use as baseline in understanding changes that occur in disease

Given the growing importance of proteins in medical laboratory testing,

Experts are comparing this to the first complete map of the human genome

  • and this information provides for rapid advances
  • in understanding transcriptomics and metabolomics

Map of Human Proteome Expected to Advance Medical Science

“Housekeeping genes” that are expressed in all tissues and cell types

  • have been thought to be involved in basic cellular functions.

Two teams developing a Human Proteome Map

  • detected proteins encoded by 2,350 genes
  • across all human cells and tissues.

The corresponding housekeeping proteins comprised
about 75% of total protein mass.

  •  histones,
  • ribosomal proteins,
  • metabolic enzymes, and
  • cytoskeletal proteins

The two international teams produced

  • the first drafts of the human protoeome,
  • a catalog of proteins expressed in most
  • nondiseased human issues and organs.

The evidence suggests there is translation from DNA regions

  • that were not thought to be translated—including
  • more than 400 translated long, intergenic non-coding RNAs (lincRNAs)—
    found by the Küster team—and
  • 193 new proteins—uncovered by the Pandey team.

This proteome map can be used as a baseline to understand

  • changes that occur in the disease state

These studies are part of the Human Proteome Project,

  1. an international effort by the Human Proteome Organization
  2. to revolutionize our understanding of the human proteome
  3. by coordinating research at laboratories around the world directed
  4. at mapping the entire human proteome.

This new information about the human proteome

  • is expected to trigger rapid advances in medical science
  • and a better understanding of the underlying causes of human diseases.

One Study Team Was at Johns Hopkins University

  • In one study, which was headed by Ahilesh Pandey, M.D.,
    at Johns Hopkins University in Baltimore,
  • and colleague Harsha Gowda, Ph.D.,
    of the Institute of Bioinformatics in Bangalore, India,
  • the research team used an advanced form of mass spectrometry to analyze proteins
  • to create the human proteome map,

according to a report published in NIH Research Matters.

The research team examined

  1. 30 normal human tissue and cell types:
  2. 17 adult tissues,
  3. 7 fetal tissue and
  4. 6 blood cell types.

Samples from three people per tissue type

  • were processed through several steps.

The protein fragments, or peptides, were analyzed on

The amino acid sequences were

  • then compared to known sequences.

Their results were published in the May 28, 2014, issue of Nature.

The resulting draft map of the human proteome map includes

  • proteins encoded by more than 17,000 genes,
  • noted the Research Matters article.

Among these are hundreds of proteins from regions

  • previously thought to be non-coding.

This study also provided a new understanding of

  • how genes are expressed.

For example, almost 200 genes begin in locations

  • other than those predicted based on genetic sequence.

“The fact that 193 of the proteins came from DNA sequences

  • predicted to be non-coding means that
  • we don’t fully understand how cells read DNA,
  • since the sequences code for proteins

This study also produced the Human Proteome Map,

  • an interactive online portal.

This can be accessed at this link.

The study data will soon be accessible through

German’s ProteomicsDB Analyzed a Mix of Available and New Tissue Data

The other study was conducted by a team lead by  Bernhard Küster
of the Technische Universität München in Germany.

Küster and his colleagues created a

This database contains 92% of the

  • estimated 19,629 human proteins,

noted The Scientist article.

Küster’s team also used mass spectrometry

  • to analyze human tissue samples.

This team’s approach differed from Johns Hopkins’ in that

  • it compiled about 60% of the information
  • in the ProteomicsDB database
  1. by using existing raw mass spec (MS) data
  2. from databases and colleagues’ contributions.

To fill data gaps, the Küster lab generated its own
MS data after analyzing

  1. 60 human tissues,
  2. 13 body fluids, and
  3. 147 cancer cell lines.

High-resolution public data

  • was selected and computationally processed
  • for strict quality

The database for ProteomicsDB is

  • public and searchable.

It can be accessed at this link.

German Study Added New Insights to Transcription Process

Comparing the ratio of protein to mRNA levels for every protein globally,

  • the Küster lab found that the translation rate
  • is a constant feature of each mRNA transcript. 

The proteomics community has viewed

  • transcriptome and proteome data as two sides of a coin.

But this analysis shows that at least, at steady state,

  • once the ratio for an mRNA/protein pair has been calculated,
  1. protein levels can be determined
  2. just from specific mRNA levels.

Proteomics researchers in Toronto maintaining ionic balance and in Boston commented on the
importance of the findings, even a “new paradigm” because of

  • the fixed ratio of protein to mRNA

This is quite in keeping with what we have been learning

  • with respect to homeostasis.

In 2003, the Human Genome Project created a

  • draft map of the human genome—
  • all the genes in the human body.

Genomics has since driven many advances in medical science.

This was a progress from the classic discovery of Watson and Crick –

  • the classical dogma holds that
  • DNA makes RNA makes protein.
  • no constraints are place on this

But the cell is functioning in contact with other cells,

  • immersed in interstitial fluid
  • maintaining cationic and anionic balance
  • and mitochondrial energy balance and ubiquitin systems interact
  • and protein interacts with the chromatin and transcriptional RNA

So the restriction that has been discovered has credence,

  • the classical diagram has to be redrawn

Deeper Knowledge of Proteome to Improve Diagnostics and Therapeutics

In the two projects is:

  • the comprehensive coverage of more than 80% of
  • the expected human proteome,

These studies indicate that to get to

  • a deep level of proteome coverage,
  • many different tissue types must be probed.

the  studies are  complimentary.

  1. The Hopkins group provided a survey of human proteins from a single source, which allows for easy comparisons within their data.
  2. The ProteomeDB effort connected new information with existing data

A deeper knowledge of the human proteome could help

  • fill the gap between genomes and phenotypes.

As this occurs, it has the potential to transform

  • the way diagnostics and therapeutics are developed,
  •  enhancing overall biomedical research and healthcare,

it was noted in a report presented to scientific leaders at a NIH workshop

  • on advances in proteomics and its applications.

Having completed a draft map of the human proteome—
the set of all proteins in the human body

  • It opens another window to cell function.

It has been ASSUMED –

  • genes control the most basic functions of the cell,
  • including what proteins to make and when.
  • but we have assumed for too much in assigning
    full control to the genome

Researchers have identified more than 20,000 protein- coding genes.

However, scientific understanding of the proteome has

  • lagged behind that of the genome,
  • partly because of the proteome’s complexities.

The relationship between genes and proteins isn’t a simple matter of

  • one gene coding for one protein.

Stretches of DNA can be read and translated

  • into proteins in different ways.

Proteins are also more difficult to sequence than genes.

The importance of these latest studies to pathologists and Ph.D.s working

  • in molecular diagnostics laboratories is that
  • this information will expedite further research into the human proteome.

Such research is expected to lead to

  • novel methods of diagnosis and complex
  • “multi-analyte” clinical laboratory tests that
  • look for multiple proteins in a single assay.

“The prevalent view was that information transfer was from genome to transcriptome to proteome.
What these efforts show is that it’s a two-way road— proteomics can be used to annotate the genome.
The importance is that, using these datasets, we can improve the annotation of the genome and the
algorithms that predict transcription and translation,” said Steen. “The genomics field can now hugely
benefit from proteomics data.”

Wilhelm et al., “Mass-spectrometry- based draft of the human proteome,”
Nature,  http://dx.doi.doi:/10.1038/nature13319, 2014

M.S. Kim et al. “A draft map of the human proteome,”
Nature,  http://dx.doi.org:/10.1038/nature13302, 2014.

Tags

proteomicsnoncoding RNAhuman researchhuman proteome projecthuman genetics and genomics

http://www.the-scientist.com/?articles.view/articleNo/40083/title/Human-Proteome-Mapped/

 

__Patricia Kirk

__by Harrison Wein, Ph.D.

__by Anna Azvolinsky

Related Information:

Revealing The Human Proteome

Human Proteome Mapped

The human proteome – a scientific opportunity for transforming diagnostics, therapeutics, and healthcare

Reference: A draft map of the human proteome.
Kim MS, Pinto SM, Getnet D, Nirujogi RS, Manda SS, Donahue CA, Gowda H, Pandey A.
Nature. 2014 May 29;509(7502):575-81. http://dx.doi.org:/10.1038/nature13302. PMID: 24870542

Funding: NIH’s National Institute of General Medical Sciences (NIGMS), National Cancer Institute (NCI),
and National Heart, Lung, and Blood Institute (NHLBI); the Sol Goldman Pancreatic Cancer Research Center;
India’s Council of Scientific and Industrial Research; and Wellcome Trust/DBT India Alliance.

http://nihprod.cit.nih.gov/researchmatters/june2014/06092014proteome.htm

 

 

 

 

 

 

 

 

 

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