Complete response to multidisciplinary therapy in a patient with primary gastric choriocarcinoma

Primary gastric choriocarcinoma is a rapidly growing neoplasm with an average survival of several months in untreated patients.Gastrectomy with lymph node dissection followed by chemotherapy is the treatment of choice.Regimens used for gastric adenocarcinoma are usually selected.However,median survival remains less than six months.In this case report,we describe a case of primary gastric choriocarcinoma with a clinical complete response to multidisciplinary treatment including surgery,chemotherapy,and radiofrequency ablation(RFA).The patient was originally referred for general malaise.Esophagogastroduodenoscopy demonstrated a large tumor occupying the fornix,and total gastrectomy with lymph node dissection was performed.Seven days later,multiple liver metastatic recurrences with high serum levels of beta-human chorionic gonadotropin(β-hCG) were recognized.Chemotherapy with a gonadal choriocarcinoma regimen consisting of etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine(EMA/CO),was initiated.After three cycles,serum β-hCG decreased markedly and the tumors disappeared.Six months later,multiple lung metastatic recurrences were found.After one cycle of EMA/CO,only one nodule remained.Computed tomography-guided RFA was performed for this oligometastatic tumor.The patient has been alive with no evidence of disease for 10 years after the initial diagnosis.To the best of our knowledge,this patient with recurrent primary gastric choriocarcinoma has achieved the longest survival.The present case is the first report of choriocarcinoma metastatic to the lung successfully treated with RFA.From our retrospective analysis of recurrent or unresectable primary gastric choriocarcinoma,we propose that gonadal choriocarcinoma regimens can be considered as first-line for primary gastric choriocarcinoma.

Combination Therapy of Actinomycin D and Cisplatin Achieved Stronger Cytotoxicity via Increasing PUMA Expression on KB Cells

Aim To study the synergistic effect and mechanism of actinomycin D to the anti-cancer activity of cispl- atin on KB cells. Methods Cytotoxicity of actinomycin D on KB cells was evaluated by MTT and LDH Assay. Apoptosis was detected by Flow cytometry （FCM）. Expression of p53, PUMA, Bax, Bcl-2 and Bcl-xl was detected by WB （Western blot） or IF （immunofluorescence staining）. The translocation of PUMA, Bax, Bcl-2 and Bcl-xl was detected by confocal microscope. PUMA knockdown was achieved by PUMA siRNA. Results Actinomycin D synergistically enhanced the cytotoxicity of cisplatin on KB cells. Time-dependent increasing of PUMA and p53 in- duced by actinomycin D was accompanied by the translocation of PUMA and Bax/Bcl-xl in KB cells. Knockdown of PUMA effectively blocked the synergistic effect of actinomycin D to cisplatin. Conclusion Actinomycin D effi- ciently enhanced the anti-cancer activity of cisplatin on KB cells. Up-regulation of PUMA by actinomycin D is like- ly responsible for the observed synergistic effect between the two drugs. Combination of actinomycin D and cisplatin may lead to an effective cancer treatment strategy.

Actinomycin D synergistically enhances the efficacy of CDDP by activating P53-PUMA pathway via downregulating P53-MDM2 complex on KB cells

OBJECTIVE Low dose of actinomycin D(LDAct D)was reported as a potent P53 activator and protected normal proliferating cells during anti-mitotic chemotherapy.However,the mechanism of LDAct D on P53 activation is still undetermined.In this study,the mechanism of LDAct D on the synergistic antitumor effect for cisplatin(CDDP)and P53 reactivation in KB cells was studied in detail.METHODS Cell viability was determined by MTT and LDH release.Apoptosis was determined by AnnexinⅤ-FITC/PI staining.Mitochondrial membrane potential(MMP)was detected by JC-1 stain-ing.Expression of P53,PARP,BAX,BCL-XL,PUMA,MDM2 and MDMX was detected by Western blotting(WB)and/or immunofluorescence(IF).P53-MDM2 complex was detected by ELISA.Molecular docking of receptor MDM2 and MDMX with actinomycin D(ACTD)was analyzed by Discovery Studio.RESULTS Compared with CDDP alone,P53 expression and the cytotoxicity on KB cells was significantly increased by the combination therapy.P53 regulatory proteins were increased while MMP was decreased.Meanwhile,knockdown of PUMA(P53 upregulated modulator of apoptosis)efficiently blocked the synergistic effect of LDAct D to CDDP.P53 activation was found to be accompanied with the increase of MDMX but not MDM2.Meanwhile,MDM2-P53 complex in KB cells was significantly decreased by LDAct D.Docking of both receptor MDM2 and MDMX with ACTD exhibited well established bonds with nearby amino acid residues.CONCLUSION LDAct D was probably an inhibitor of both MDM2 and MDMX.The synergistic effects of LDAct D for CDDP on KB cells depended on its effect on reactivating P53 and PUMA mediated mitochondrial apoptosis.

Effects of glucocorticoid dexamethasone on serum nitric oxide synthase activity and nitric oxide levels in a rat model of lung disease-induced brain injury

In this study, we investigated the effects of dexamethasone, pertussis toxin （a Gi protein inhibitor） and actinomycin （a transcription inhibitor） on serum nitric oxide synthase activity and nitric oxide content in a rat model of lung disease-induced brain injury. High-dose dexamethasone （13 mg/kg） and dexamethasone ＋ actinomycin reduced lung water content, increased serum nitric oxide synthase activity and nitric oxide content, diminished inflammatory cell infiltration in pulmonary alveolar interstitium, attenuated meningeal vascular hyperemia, reduced glial cell infiltration, and decreased cerebral edema. These results demonstrate that high-dose glucocorticoid treatment can reduce the severity of lung disease-induced brain injury by increasing nitric oxide synthase activity and nitric oxide levels.

EMA/CO Regimen Chemotherapy for Gestational Trophoblastic Tumor

Objective To evaluate the efficacy and safety of etoposide, methotrexate, actinomycin D, vincristine and cyclophosphamide (EMA/CO) therapy for gestational trophoblastic tumor (GTT). Methods Medical records of all patients with low risk, middle risk and high risk GTT receiving EMA/CO regimen chemotherapy were analyzed retrospectively. Results\ Twenty one low risk and fourteen middle risk GTT received EMA/CO with 100% remission, six patients with high risk GTT received EMA/CO with 83% complete response and with 17% partial response; Gastrointestinal, hematologic and hepatic toxicity, as well as shed of hair is predictable, mild and reversible. Conclusion\ At present EMA/CO chemotherapy is the choice of our treatment for patients with high, middle and low risk GTT.\;

Multidisciplinary treatment of life-threatening hemoptysis and paraplegia of choriocarcinoma with pulmonary,hepatic and spinal metastases:A case report

BACKGROUND Although choriocarcinoma is thought to be a malignancy curable by chemotherapy,there remain difficult and challenging problems in cases with high prognostic scores or extensive metastases,for which the treatment is limited.Particularly,chemotherapy in combination with other treatments offers promising therapeutic potential for these cases.CASE SUMMARY We present the case of a 40-year-old female patient who suffered from lifethreatening hemoptysis and paraplegia due to choriocarcinoma with pulmonary,hepatic and spinal metastases.The patient successfully recovered after multidisciplinary treatment consisting of 21 cycles of intravenous chemotherapy,radiofrequency ablation of multiple hepatic metastases,intensity-modulated radiation therapy for spinal metastases and routine physiotherapy.To our knowledge,it is the first reported case of recovery from pulmonary,hepatic and spinal metastases of choriocarcinoma with no specific primary site.Moreover,this is the first reported clinical attempt on 5-d actinomycin D as primary chemotherapy in ultrahigh-risk gestational trophoblastic neoplasia.CONCLUSION The case supports the opinion that the individualized treatment of choriocarcinoma by a multidisciplinary approach can accomplish optimal therapeutic effects.

Binding of Hoechst with nucleic acids using fluorescence spectroscopy

It has been shown that polarity of environment around Hoechst 33342 is almost unchanged while sorption of this fluorescent dye on a surface of the hairpin oligonucleotide HP1, t-RNA and DNA. At small concentrations, this dye, adsorbed on the surface of DNA, RNA or HP1, does not show any specificity to certain nucleotides. In the case of unwound sites of DNA or HP1, it can bind inside, but without the intercalation stacking with nucleotides. The energy transfer from nucleotide chromophores to Hoechst is absent due to their remoteness and also “bad” (non-stacking) orientation. The mutual fluorescence quenching of Hoechst by actinomycin D (AMD) and, vice versa, of 7-amino-actinomycin D (7AAMD) by Hoechst in DNA and HP1 is observed. It is due to dynamic deactivation and mutual replacing in binding sites.

Identification and application of a strong bidirectional acmN2p promoter from actinomycin D-producing streptomycetes

Natural product biosynthesis is controlled at multiple levels.Characterization of naturally occurring promoters has facilitated the study of the synthetic biology of natural products.Herein,we report the discovery of two highyield actinomycin D(ActD)-producing streptomycetes and the identification of a strong bidirectional acmN2p promoter from the ActD gene clusters and its application in heterologous expression of three core genes involved in the bacterial alkaloid bohemamine biosynthesis,providing a good example for identification of new promoters for synthetic biological applications.

EPR study on the photosensitized generation of reactive oxygen species by actinomycin D

Actinomycin D (AMD) is an anticancer antibiotic that can bind selectively to both double-stranded and single-stranded DNA, and this binding greatly enhances DNA photosensitization. Using electron paramagnetic resonance (EPR) in combination with spin trapping techniques, a systematic study was carried out on the reactive oxygen species generated in the photosensitization process of AMD. It was found that 1O2 and $O_2^{ - \cdot } $ are important reactive intermediates either in solution or in DNA complexes, and the generation of these species is in competition. This finding suggests that the photodynamic action of AMD proceeds via two pathways: energy transfer (type I mechanism) and electron transfer (type II mechanism). 1O2 is the main product formed via energy transfer reaction in solution while electron transfer between the excited states of AMD and DNA becomes the predominant pathway in DNA complexes.

Parental RNA is Significantly Degraded During Arabidopsis Seed Germination

Germination is the first and maybe the foremost growth stage in the life cycle of a plant. Herein, we report that initiation of germination in the Arabidopsis Columbia ecotype was accompanied by a sharp decrease in the amount of extractable total RNA. At the beginning of our germination experiment, we were usually able to obtain 35-40 IJg total RNA from 100 mg dry seeds. However, after 3 d of cold stratification, we could only obtain less than 5 μg total RNA from the same amount of starting material. Young seedlings contained approximately 100 μg total RNA per 100 mg fresh tissue. Further studies showed that inhibition of de novo RNA synthesis by actinomycin D prevented the degradation of parental RNA and, in the meantime, significantly delayed the germination process. Several ribonuclease-like genes that were highly expressed in dry seeds, and especially during the cold stratification period, were discovered. We propose that these enzymes are involved in the regulation of parental RNA degradation. These results indicate that parental RNA metabolism may be an important process for Arabidopsis seed germination.

Antiapoptotic activity of 30 kDa lipoproteins family from fat body tissue of silkworm, Bombyx moil

The family of 30kDa lipoproteins （LP1-5） is abundant in silkworm pupa fat body （FB） and hemolymph. One of its members, the 29 kDa protein decreased in concentration from peripheral （PP） FB tissue but was sustained in perivisceral （PV） FB tissue at the time of apoptosis. This study investigated the correlation of the 30kDa proteins with FB apoptosis. Two protein fractions were purified, a 29 and a 30/31 kDa protein fraction, and they were used to test for activity against actinomycin D-induced apoptosis in the FB tissues. Concentrations as little as 50/zg/mL of the 29 kDa protein fraction efficiently inhibited apoptosis. Less antiapoptotie activity was detected for the higher MW fraction; DNA fragmentation was observed in FB tissue treated with 50 #g/mL of the 30/31 kDa fraction. The viability of the cells in the 29 kDa protein-supplemented culture was 40% higher than in the 31 kDa protein-supplemented culture. However, the 30 kDa lipoproteins were not able to prevent scheduled FB degeneration during silkworm metamorphosis. Thus, it is hypothesized that the antiapoptotic 29 kDa protein needs to be proteolytically degraded by a regulatory mechanism to allow programmed cell death of FB tissue.

Super-sensitive bifunctional nanoprobe: Self-assembly of peptide-driven nanoparticles demonstrating tumor fluorescence imaging and therapy

The development of nanomedicine has recently achieved several breakthroughs in the field of cancer treatment;however,biocompatibility and targeted penetration of these nanomaterials remain as limitations,which lead to serious side effects and significantly narrow the scope of their application.The self-assembly of intermediate filaments with arginine-glycine-aspartate(RGD)peptide(RGDIFP)was triggered by the hydrophobic cationic molecule 7-amino actinomycin D(7-AAD)to synthesize a bifunctional nanoparticle that could serve as a fluorescent imaging probe to visualize tumor treatment.The designed RGD-IFP peptide possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method.This fluorescent nanoprobe with RGD peptide could be targeted for delivery into tumor cells and released in acidic environments such as endosomes/lysosomes,ultimately inducing cytotoxicity by arresting tumor cell cycling with inserted DNA.It is noteworthy that the RGD-IFP/7-AAD nanoprobe tail-vein injection approach demonstrated not only high tumor-targeted imaging potential,but also potent antitumor therapeutic effects in vivo.The proposed strategy may be used in peptide-driven bifunctional nanoparticles for precise imaging and cancer therapy.