A multimodal contrast agent for preoperative MR Imaging and intraoperative tumor margin delineation.

We have constructed a multimodal contrast agent suitable for near-infrared, NIR, fluorescent imaging as well as magnetic resonance imaging, MRI. This class of agents may be useful for preoperative tumor localization and tumor functional evaluation and for intraoperative delineation of tumor margins. We have covalently attached dyes of the cyanine family to a previously described polymeric contrast agent, Gd-DTPA-polylysine, of an extended, uncoiled conformation. The dual modality agent is as effective in imaging tumors by MRI as the parent compound provided that the dye loading on the polymer is such that it does not eliminate all the available free-lysine groups on the parent Gd-DTPA-polylysine polymers. NIR fluorescence from preclinical subcutaneous and orthotopic mammary gland tumors could be detected with a signal to background ratio of as high as 4.5 at 12 hours post agent injection at a dye dose of 125 nmole/kg. For intraoperative delineation of tumor margins, a wide-field illumination camera system was devised giving high signal to background NIR fluorescent images of surgically exposed orthotopic mammary gland tumors. Histologic microscopy confirmed the location of the dual modality agent at the boundary of the tumor with a margin distance of about 0.3 mm from labeled tumor cells.

Cancer growth and spread are saltatory and phase-locked to the reproductive cycle through mediators of angiogenesis.

The frequency of breast cancer metastatic spread is affected by the menstrual cycle phase of its resection. Breast cancer growth, post-resection spread, and cure frequency are each modulated by the estrous cycle in C(3)HeB/FeJ mice. Tumor metastases are 2- to 3-fold more frequent when the resection is done during diestrus as compared with estrus. Tumor angiogenesis is essential for both cancer growth and lethal metastatic cancer spread. The balance between vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) modulates new blood vessel formation and blood vessel permeability. Sex hormones modulate the expression of these key angiogenesis regulators in the endometrium and uterus. We, therefore, asked whether the estrous cycle modulates the density of CD31-positive vessels within the tumor, the permeability of tumor blood vessels, levels of VEGF and bFGF immunoreactive protein in normal breast and breast cancer, and whether expression of these genes are modulated by the estrous cycle stage in C(3)HeB/FeJ mice. We find that tumor blood vessel density and blood volume do not vary throughout the cycle; however, tumor capillary permeability is regulated by the estrous cycle being highest in diestrus, the cycle stage associated with the highest cancer growth rate and the highest frequency of post-resection cancer metastasis. VEGF protein levels in breast cancer are >100-fold higher than in normal breast. VEGF protein in this mammary tumor varies with the estrus cycle with highest levels in proestrus. In a non-breast tumor, methylcholantrenene A sarcoma, from CD(2)F(1) mice, tumor VEGF protein also varies with the estrus cycle with highest levels in proestrus and diestrus. VEGF gene expression in the mammary tumor does not change significantly across the cycle, but is modulated by the cycle in normal breast tissue. bFGF protein concentration is 6-fold higher in normal breast than in breast cancer. bFGF protein pattern in both tumor and breast are similar, opposite to VEGF, and affected by oophorectomy. bFGF message is modulated by the cycle in both breast cancer and normal breast. The changes in breast cancer capillary permeability, VEGF, and bFGF that occur during each fertility cycle, in breast tissue and breast cancer, putatively in response to cyclical changes in sex hormones, might contribute, at least in part, to both the modulation of cancer growth and post-resection breast cancer spread by the fertility cycle. These fertility cycle-induced effects on tumor biology also seem to extend to non-breast cancer biology.

The transcription factor Ets-1 in breast cancer.

The proto-oncogene Ets-1 is a member of the Ets family of transcription factors which share a unique DNA binding domain, the Ets domain. Ets binding sites have been described on the promoters or enhancers of many proteinases and several Ets members transcriptionally regulate such promoters in transient cotransfection assays. Ets-1 is involved in both normal and pathological functions. Ets-1 is expressed in a variety of cells, including endothelial cells, vascular smooth muscle cells and epithelial cells. Ets-1 regulates the expression of several angiogenic and extracellular matrix remodeling factors promoting an invasive phenotype. The Ets family of transcription factors may play a role in the disease progression of breast cancer. In tumors, including breast neoplasia, Ets-1 expression is indicative of poorer prognosis. This review will summarize the role of Ets-1 in both the tumor cells, and the tumor endothelial cells as it relates to breast tumor growth and spread.

Isolation of murine aortic endothelial cells in culture and the effects of sex steroids on their growth.

The lack of commercially available primary murine endothelial cells prompted us to isolate and cultivate this cell type. We report here the effect of sex steroids on the in vitro growth of murine aortic endothelial cells. Murine aortic endothelial cells were isolated by a combination of explant outgrowth from aortic rings and enzymatic digestion. The endothelial nature of the cells was verified by uptake of acylated low-density lipoprotein and positive staining for CD-31. Murine aortic endothelial cell growth is stimulated by physiological concentrations of estrogen. Progesterone, when given simultaneously with estrogen, inhibited the stimulatory growth effect of estrogen. Murine aortic endothelial cells grown in vitro continue to express messenger ribonucleic acid for proteins related to endothelial growth. These include vascular endothelial growth factor, its receptors Flt-1 and Flk-1, and the angiogenesis-associated transcription factor, Ets-1.

Estrogen-induced Ets-1 promotes capillary formation in an in vitro tumor angiogenesis model.

We employed an in vitro angiogenesis model that simulates the in vivo milieu for tumor capillary formation to study the direct effects of estrogen. 17beta-estradiol (E2) treatment significantly stimulated capillary sprouting within 8 h in co-cultures of rat aortic endothelial cells (RAECs) and mouse mammary tumor cells. Co-cultures treated with either progesterone (P4) or E2+P4 showed minimal endothelial cell (EC) sprouting when compared to E2 treated cultures. Treatment with the E2 agonist ICI 182,780 dramatically inhibited capillary formation, demonstrating E2-specificity. Within hours, of E2 treatment ECs isolated from tumor cell/EC co-cultures demonstrated a statistically significant increase in both mRNA and protein levels of the transcription factor Ets-1. We observed increased matrix metalloproteinase (MMP) and decreased tissue inhibitor of metalloproteinase (TIMP) mRNA levels in these ECs following E2 treatment. Ets-1 upregulates expression of the vascular endothelial growth factor (VEGF) receptor, Flt-1 and we detected increased Flt-1 mRNA levels in ECs co-cultured with tumor cells following E2 treatment. Expression of Ets-1 contributes to destabilization of a quiescent EC phenotype in favor of an invasive angiogenic one, in part, by increasing expression of MMPs and integrin molecules that favor migration and invasion. Transfection of ECs with Ets-1 antisense prior to co-culture with E2 resulted in a 95% inhibition in capillary formation. We demonstrate here, for the first time that nanomolar concentrations of E2 directly and rapidly induced new capillary formation in a mammary tumor/EC co-culture system and suggest that this response may be mediated, in part, by an E2-induced increase in Ets-1 expression.

Fertility cycle influence on surgical breast cancer cure.

Cancer growth and spread is an intricate process dependent upon both tumor and host. This laboratory is interested in the role of the fertility cycle, specifically cyclic changes in steroid hormone levels, in tumor growth and metastases. Our previous studies, using a murine model, have documented that breast cancer growth rate and post-resection metastatic behavior each change reproducibly during the estrous cycle, and that post-resection cancer spread depends upon the time within the estrous cycle that an advanced transplanted cancer is resected. Twelve to thiry-two percent cure rates were seen in these studies. That early work described estrous cycle stages just prior and near to putative ovulation to be superior while those stages farther from ovulation were disadvantageous times for surgery. Data presented here confirm the role of the estrous cycle in post-resection metastatic spread. This current work validates vaginal smear determined estrous cycle stage with uterine weight. A primary, transplantable, mammary carcinoma, which metastasizes to the lungs, was resected for surgical cure in cycling C3HeB/FeJ female mice at each fertility cycle stage. A group of oophorectomized (ovx) animals was also used. In two large, independent studies resecting much earlier stage cancers than in prior studies, a 96% surgical cure frequency was documented when the tumor is resected during estrus. The second best surgical cure rate is achieved when tumors are resected during metestrus (79% overall cure rate). Cure frequency in ovx animals is intermediate. These results further support a probable role for circulating E2 and P4 levels in modulating the metastatic process. We conclude that the timing of surgical resection within the estrous cycle affects the cancer's metastatic potential and that the optimal timing of resection may also depend to some extent upon the size (stage) of the resected cancer.

Effect of resveratrol on growth of 4T1 breast cancer cells in vitro and in vivo.

In vitro, resveratrol inhibited growth of 4T1 breast cancer cells in a dose- and time-dependent manner. In vivo, however, resveratrol had no effect on time to tumor take, tumor growth, or metastasis when administered intraperitoneally daily (1, 3, or 5 mg/kg) for 23 days starting at the time of tumor inoculation. Resveratrol had no effect on body weight, organ histology, or estrous cycling of the tumor-bearing mice. Resveratrol, therefore, is a potent inhibitor of 4T1 breast cancer cells in vitro; is nontoxic to mice at 1-5 mg/kg; and has no growth-inhibitory effect on 4T1 breast cancer in vivo.