Primary colorectal diffuse large B-cell lymphoma: A report of eighteen cases in a tertiary care center.

Primary colorectal diffuse large B-cell lymphoma (DLBCL) is very rare colon malignancy. It is important to know the main demographic and clinical characteristics of these patients. We conducted a retrospective analysis of 18 patients diagnosed with primary colorectal DLBCL during a 17-year period at the National Cancer Institute of Brazil (INCA) between 2000 and 2018. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) levels, treatment modality and follow-up status were obtained from medical records. Survival was estimated from the date of diagnosis until death. There were 11 male and seven female patients in our cohort, the median age at diagnosis was 59.5 years and four patients were HIV positive. Tumor was mainly localized in the right colon. Patients were treated with chemotherapy (CT) and/or surgical resection. Eleven patients died during a median follow-up of 59 months and the median survival time was 10 months. Six or more cycles of CT (HR=0.19; CI 95% 0.054-0.660, p = 0.009), LDH levels below 350 U/L (HR=0.229; CI 95% 0.060-0.876, p = 0.031) and surgical resection (HR=0.23; CI 95% 0.065-0.828, p = 0.030) were associated with reduced risk of death in univariate analysis. Patient's age and DLBCL right colon localization should be considered at diagnosis to distinguish between DLBCL and other diseases for differential diagnosis. Six cycles of CT, LDH levels below 350 U/L and surgical resection were associated with better survival. Our results are consistent with previous publications and address the importance of correct colorectal DLBCL diagnosis and treatment.

Primary diffuse large B-cell lymphoma of the head and neck in a Brazilian single-center study.

OBJECTIVES: Lymphomas represent around 10% of head and neck neoplasms, among which the diffuse large B-cell lymphoma (DLBCL) is the most common histologic subtype. In the present study, we characterized demographic parameters, anatomical sites, and survival rates of patients in a Brazilian cancer center. MATERIALS AND METHODS: Single-center retrospective epidemiological study of 243 head and neck DLBCL patients. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) activity, and treatment modality were obtained from electronic medical records. RESULTS: The most common primary head and neck tumor location in patients with DLBCL was Waldeyer's ring. Interestingly, age above 80 years, male gender, high LDH levels, and HIV positivity were significantly associated with shorter overall survival (OS) rates and increased risk of death. We further demonstrated that treatment had a protective effect, improving OS, and reducing risk of death. Notably, we found no benefit of combination of chemotherapy and radiotherapy versus isolated treatment modalities. CONCLUSION: The study showed that primary head and neck DLBCL is more incident in middle age and elderly patients with a small male patients' majority in a Brazilian population. Moreover, we observed a 3-year OS rate of almost 60% and multivariate analysis showed that treatment was the only protective factor.

Effects of long-term exposure to MST-312 on lung cancer cells tumorigenesis: Role of SHH/GLI-1 axis.

Replicative immortality is a key feature of cancer cells and it is maintained by the expression of telomerase, a promising target of novel therapies. Long-term telomerase inhibition can induce resistance, but the mechanisms underlying this process remain unclear. The Sonic hedgehog pathway (SHH) is an embryogenic pathway involved in tumorigenesis and modulates the transcription of telomerase. We evaluated the effects of long-term treatment of the telomerase inhibitor MST-312 in morphology, proliferation, resistance, and in the SHH pathway molecules expression levels in lung cancer cells. Cells treated for 12 weeks with MST-312 showed changes in morphology, such as spindle-shaped cells, and a shift in the distribution of F-ACTIN from cortical to diffuse. Treatment also significantly reduced cells' efficiency to form spheroids and their clonogenic potential, independently of the cell cycle and telomeric DNA content. Moreover, GLI-1 expression levels were significantly reduced after 12 weeks of MST-312 treatment, indicating a possible inhibition of this signaling axis in the SHH pathway, without hindering NANOG and OCT4 expression. Here, we described a novel implication of long-term treatment with MST-312 functionally and molecularly, shedding new light on the molecular mechanisms of this drug in vitro.

11a-N-Tosyl-5-deoxi-pterocarpan, LQB-223, a novel compound with potent antineoplastic activity toward breast cancer cells with different phenotypes.

UNLABELLED: Multidrug resistance is the major obstacle for successful treatment of breast cancer, prompting the investigation of novel anticancer compounds. PURPOSE: In this study, we tested whether LQB-223, an 11a-N-Tosyl-5-deoxi-pterocarpan newly synthesized compound, could be effective toward breast cancer cells. METHODS: Human breast cell lines MCF-7, MDA-MB-231, HB4a and MCF-7 Dox(R) were used as models for this study. Cell culture, MTT and clonogenic assay, flow cytometry and Western blotting were performed. RESULTS: The LQB-223 decreased cell viability, inhibited colony formation and induced an expressive G2/M arrest in breast cancer cells. There was an induction in p53 and p21(Cip1) protein levels following treatment of wild-type p53 MCF-7 cells, which was not observed in the mutant p53 MDA-MB-231 cell line, providing evidence that the compound might act to modulate the cell cycle regardless of p53 status. In addition, LQB-223 resulted in decreased procaspase levels and increased annexin V staining, suggesting that the apoptotic cascade is also triggered. Importantly, LQB-223 treatment was shown to be less cytotoxic to non-neoplastic breast cells than docetaxel and doxorubicin. Strikingly, exposure of doxorubicin-resistant MCF-7-Dox(R) cells to LQB-223 resulted in suppression of cell viability and proliferation in levels comparable to MCF-7. Of note, MCF-7-Dox(R) cells have an elevated expression of the P-glycoprotein efflux pump when compared to MCF-7. CONCLUSION: Together, these results show that LQB-223 mediates cytotoxic effects in sensitive and resistant breast cancer cells, while presenting low toxicity to non-neoplastic cells. The new compound might represent a potential strategy to induce toxicity in breast cancer cells, especially chemoresistant cells.

XIAP and P-glycoprotein co-expression is related to imatinib resistance in chronic myeloid leukemia cells.

P-glycoprotein (Pgp) and XIAP co-expression has been discussed in the process of the acquisition of multidrug resistance (MDR) in cancer. Here, we evaluated XIAP and Pgp expression in chronic myeloid leukemia (CML) samples, showing a positive correlation between them. Furthermore, we evaluated the effects of imatinib in XIAP and Pgp expression using CML cell lines K562 (Pgp(-)) and K562-Lucena (Pgp(+)). Imatinib increased XIAP and Pgp expression in K562-Lucena cells, while in K562 cells a downregulation of these proteins was observed, suggesting that imatinib induces an increment of MDR phenotype of CML cells that previously exhibit high levels of Pgp/XIAP co-expression.

Análise da expressão e atividade das moléculas de influxo e de efluxo de drogas em células da leucemia mielóide crônica / Analysis of the expression and activity of drug influx and efflux molecules in chronic myeloid leukemia cells

"A leucemia mielóide crônica (LMC) é caracterizada pela presença da translocação t(9:22) que codifica a proteína quimérica oncogênica BCR-ABL. Imatinibe é uma droga alvo-específica que inibe a atividade tirosina quinase (TK) da proteína BCR-ABL. Entretanto, os níveis intracelulares do imatinibe podem ser alterados pelas proteínas transportadoras de efluxo de drogas: glicoproteína P (Pgp), proteína da resistência em câncer de mama (BCRP) e proteína relacionada à resistência à múltiplas drogas (MRP1), assim como a proteína transportadora de influxo de drogas (OCT1). O objetivo do presente estudo foi analisar a participação dessas proteínas, isoladamente ou em associação, na resistência ao imatinibe em linhagens celulares e células de pacientes com LMC. Para análise da atividade das proteínas transportadoras de efluxo, foi utilizado o fluorocromo rodamina-123 associado ao modulador ciclosporina-A (Rho+CSA) e o pheophorbide A associado ao fumitremorgin C (PhA+FTC), ambos através de citometria de fluxo. A análise dos RNAm dos genes ABCB1, ABCG2 e SLC22A1 que codificam as proteínas Pgp, BCRP e OCT1, respectivamente, foi realizada por PCR em tempo real. A inibição da TK BCR-ABL foi mensurada através dos níveis de fosforilação de CrkL (pCrkL), seu principal alvo de ativação. Observamos uma maior positividade para o ensaio Rho+CSA nas amostras que expressavam Pgp comparada com as que expressavam MRP1, sugerindo menor atividade dessa proteína em pacientes com LMC, ou ainda que tal ensaio possa ser menos específico para a atividade da MRP1. O ensaio PhA+FTC foi capaz de identificar a atividade da proteína BCRP em linhagens celulares e células de pacientes. Níveis reduzidos dos RNAm ABCB1 e SLC22A1, mas não do RNAm ABCG2, foram observados quando comparados com as amostras de indivíduos saudáveis. Não houve correlação entre os níveis da proteína Pgp e do RNAm ABCB1. A expressão de Pgp foi detectada na maioria das amostras de LMC, independente da fase da doença, e não foi associada com o prognóstico desfavorável. Variações nos níveis de expressão da Pgp foram observadas durante a evolução da LMC e relacionadas com o tratamento prévio. O imatinibe foi capaz de aumentar a expressão da Pgp, assim como os níveis do RNAm ABCB1 na linhagem K562-Lucena 1, Pgp+. Além disso, observamos uma maior redução de pCrkL e um maior percentual de morte celular nas células K562, Pgp-, quando comparadas à K562-Lucena 1, evidenciando um possível papel do imatinibe como substrato para a Pgp. Este fármaco também demonstrou ter potencial para funcionar como agente modulador da bomba de efluxo, uma vez que impediu o exporte de Rho das células K562-Lucena 1. Amostras de pacientes resistentes ao imatinibe exibiram altos níveis de atividade das proteínas transportadoras de efluxo de drogas (ensaio Rho+CSA). Nossos dados mostram que a atividade e/ou expressão dos transportadores de efluxo e influxo de drogas encontram-se alterados na maioria dos pacientes com LMC, porém não há correlação com a resposta ao imatinibe e o prognóstico na LMC. Entretanto, o conjunto dos resultados sugere um papel para a Pgp na resistência in vitro ao imatinibe"(AU)

"Chronic myeloid leukemia (CML) is characterized by the presence of the t(9:22) encoding the BCR-ABL chimeric oncogenic protein. Imatinib is a target specific drug that inhibits the activity of the tyrosine kinase (TK) protein BCR-ABL. However, imatinib intracellular concentration may be altered by transporter proteins. It was described that efflux proteins, P-glycoprotein (Pgp), breast cancer resistance protein (BCRP) and multidrug resistance related protein (MRP1), and the influx protein, the organic cation transporter protein (OCT1) may contribute for imatinib clinical resistance. The aim of this study was to evaluate the role of these proteins in imatinib resistance in cell lines and leukemic cells from CML patients. To analyze the activity of the efflux transporter proteins, fluorochrome rhodamine-123 associated with the modulator cyclosporin A (Rho+CSA) and pheophorbide A associated with fumitremorgin C (PhA+FTC) were used by flow cytometry. Analysis of ABCG1, ABCG2 and SLC22A1 genes, that encode the Pgp, BCRP and OCT1 proteins, respectively, was performed by real time PCR. The inhibition of BCR-ABL TK was measured by the levels of CrkL phosphorylation (pCrkL), its main target of activation. We observed a higher positivity for Rho+CSA assay in samples expressing Pgp, when compared with the ones expressing MRP1. These results suggest that patients with CML have lower activity of this protein, or this assay might be less specific to indicate the activity of MRP1. The PhA+FTC assay was able to identify BCRP activity in cell lines and cells from patients. Reduced levels of ABCB1 and SLC22A1, but not ABCG2 mRNA were observed when compared with samples from healthy individuals. There was no correlation between the levels of Pgp protein and ABCB1 mRNA. Pgp expression was detected in most samples of CML, regardless of disease stage and was not associated with poor prognosis. Changes in Pgp expression levels have been observed during the development of CML and were related to pretreatment. Imatinib was able to increase Pgp expression as well as ABCB1 mRNA levels in Pgp+ K562Lucena 1 cells. Moreover, we observed a greater pCrkL reduction and a higher percentage of cell death in Pgp- K562 cells compared to K562-Lucena 1, indicating a possible role of imatinib as a Pgp substrate. This drug has also been shown to have potential as an efflux pump modulating agent, once efflux of Rho was prevented in K562-Lucena 1. Imatinib resistant patient samples exhibited high levels of efflux transporter proteins activity (Rho+CSA assay). Our data show that the activity and / or expression of influx and efflux transporters of drugs are altered in most patients with CML, but no correlation with prognosis and response to imatinib in CML was observed. However, our results suggest a role for Pgp in imatinib resistance"(AU)

Survivin overexpression correlates with an apoptosis-resistant phenotype in chronic myeloid leukemia cells.

Survivin is a member of the inhibitor of apoptosis protein family (IAP) that acts in both inhibition of apoptosis and regulation of the cell cycle. Despite the fact that survivin is overexpressed in almost all human malignancies, its expression is undetectable in most normal adult tissues, which is what makes it a potential target for anticancer interventions. The aim of this work was to investigate whether survivin is involved in resistance to idarubicin (ida), a drug commonly used in leukemia treatment. Cytotoxic assays using MTT showed that 1 µM of ida could inhibit 50% of cell viability in K562, a chronic myeloid leukemia cell line. Western blotting analysis revealed that survivin expression was increased in the cell line after treatment with ida 0.5 and 1 µM concentrations, protecting cells from ida-induced apoptosis. However, the highest ida concentrations tested were able to inhibit survivin levels and induce apoptosis in K562 cells, as evaluated by morphology and caspase-3 and -9 activation. These results indicate that survivin expression is involved in ida resistance in K562 leukemic cells. Flow cytometry analysis of the cell cycle showed that ida induced G2/M arrest in these cells and there was a statistically significant positive correlation between survivin expression and the percentage of cells in G2/M phase. This work supports the idea that survivin may contribute to an apoptosis-resistant phenotype by inhibiting ida-induced apoptosis and preventing cells from progressing in the cell cycle.

p53 flow cytometry evaluation in leukemias: correlation to factors affecting clinical outcome.

p53 is a cell cycle checkpoint control protein that assesses DNA damage and acts as a transcription factor regulating genes, which control cell growth, DNA repair, and apoptosis. p53 mutations have been found in a wide variety of different cancers including flow cytometric assessment of p53 protein expression using anti-p53 monoclonal antibodies. We studied p53 protein expression by flow cytometry (FC) assay in 223 blood and/or bone marrow samples from 72 patients with chronic myeloid leukemia (CML): 54 in chronic phase (CML-CP), 7 in accelerated phase (CML-AP), and 11 in blastic phase (CML-BP); 64 patients with chronic lymphoid leukemia (CLL): (34 at diagnosis, 21 in previously treated, and 9 with Richter's syndrome); 44 patients with acute lymphoid leukemia (ALL): 36 at diagnosis and 8 in relapse; and 43 acute myeloid leukemia (AML): 27 de novo, 7 in relapse, and 9 secondary. p53 protein expression was observed in 64 of 223 patient's samples: 14/64 (21.9%) CLL, 13/44 (29.5%) ALL, 19/43 (44.2%) AML, and 17/72 (23.6%) CML. Highest levels were detected in the advanced phases of CLL, ALL, and CML. In addition, in patients with AML, high levels of p53 expression were detected in secondary and relapse disease and also in de novo AML cases. Our results demonstrated that p53 expression levels are strongly associated with advanced disease. On the basis of these results, we concluded that FC can be a reliable approach to study p53 protein expression in leukemic patients.

Insights into apoptosis mechanisms induced by DNA-damaging agents in Burkitt's lymphoma cells.

p53 protein induces cell cycle arrest, DNA repair, or apoptosis of damaged cells. Loss of wild-type p53 (wt-p53) function was shown to be associated with upregulation of survivin and resistance to therapy. Here we investigated the effects of DNA-damage agents in inducing apoptosis and cell cycle arrest, and modulation of survivin levels in two Burkitt's lymphoma (BL) cell lines with different p53 mutations. Our results showed that BL cell lines have variable response to DNA-damaging agents that cannot be correlated exclusively with p53 mutation or survivin expression suggesting that p53-independent transactivation may play a role in apoptosis induced by DNA-damaging agents.

Coexpressão da proteína p53 e proteínas relacionadas a resistência a múltiplas drogas em diferentes tipos de leucemias: associação predominante nos estágios avançados da doença / Coexpression of p53 protein and multidrug resistance proteins in diferents types of leukemias: the predominant association in advanced status of disease

Um dos mais bem caracterizados mecanismos de resistência às drogas (MDR) nas leucemias são os mediados pela glicoproteína P (PGP) e proteína relacionada a múltiplas drogas (MRP). Diversos relatos têm demonstrado que a superexpressão dessas proteínas podem ser medianas pela superexpressão da proteína p53 inativada. O objetivo deste estudo foi investigar a co-expressão da p53, PGP e MRP em diferentes tipos de leucemias pela citometria de fluxo. Analisou-se amostras de 223 pacientes leucêmicos: 64 leucemia linfocítica crônica (LLC), 43 leucemia mielóide aguda (LMA), 44 leucemia linfoblástica aguda (LLA), e 72 leucemia mielóide crônica (LMC). A p53 foi observada em 23,6% na LMC, 21,8% na LLC, 44,2% na LMA e 29,4% na LLA. A Pgp em 46,4% na LMC, 47,5% LLC, 62,8% LMA e 20% LLA e a MRP em 31,9% na LMC, 40,6% na LLC, 44,2% na LMA e 40,1% na LLA. Observou-s co-expressão estatisticamente significativa entre p53 e Pgp na LMC (p=0,0066) e na LMA (p=0,0013) e p53 e MRP na LMC (p=0,000066), na LLC (p=0,0079) e LMA (0,00044), sendo observado predomínio dessas associações nos estágios avançados dessas doenças. Estes resultados demonstraram que as pesquisas desses marcadores possam servir como indicadores de evolução clínica e prognóstico para estas leucemias.

Modulation of reactive oxygen species by antioxidants in chronic myeloid leukemia cells enhances imatinib sensitivity through survivin downregulation.

Survivin, a member of the inhibitor of apoptosis protein family and a target for new drugs, is modulated by reactive oxygen species in several types of neoplasms including leukemias. The aim of this study is to find mechanisms to enhance sensitivity to imatinib in imatinib-responsive cells. In this study, we demonstrated through fluorescein isothiocyanate-labeled annexin V for apoptotic cells detection and western blotting that by inhibiting catalase activity, imatinib apoptosis induction was significantly enhanced (P<0.05) through diminishing survivin expression in K562 cells. These findings might be of clinical relevance and might help improve the chemotherapeutic use of imatinib mesylate.

Bisphosphonates induce apoptosis in CLL cells independently of MDR phenotype.

PURPOSE: The anti-tumoral activity of bisphosphonates (BPs) has been reported in leukemia. In this study, we attempted to evaluate the apoptotic effects of the BPs pamidronate (PAM) and zoledronic acid (ZOL) in chronic lymphocytic leukemia (CLL) samples, and to correlate it with clinical parameters and multidrug resistance (MDR) phenotype (P-glycoprotein and multidrug resistance-related protein expression and/or their functional activity). RESULTS: Both BPs were able to induce apoptosis significantly. No correlation was observed between BP-induced apoptosis and clinical parameters or MDR phenotype. CONCLUSION: Our data suggest that concurrent or sequential administration of BPs with conventional chemotherapeutic drugs may have significant therapeutic potential for CLL patients.

Uso simultâneo do método do polimorfismo conformacional de fita simples e da citometria de fluxo no aumento da eficácia da detecção de anormalidades do gene e da proteína p53 na leucemia mielóide crônica / Simultaneous use of the single strand conformation polymorphism method and flow cytometry for increasing the detection efficacy of abnormalities in the gene and p53 protein in chronic myeloid leukemia

A proteína p53 desempenha um importante papel no controle do ciclo de celular e reparo no DNA danificado. Em pacientes com leucemia de mielóide crônica (LMC) as mutações neste gene são encontradas em até 30% dos casos, especialmente na crise blástica (LMC-CB), sendo a detecção de alterações nesse gene ou proteína importantes na avaliação da evolução clínica da LMC. O sequenciamento de DNA é descrito como o método capaz de identificar as mutações do gene TP53, sendo, no entanto uma técnica complexa e dispendiosa, o que dificulta seu emprego em larga escala, sendo, atualmente, proposto a pesquisa da proteína p53 por métodos imunológicos e a técnica da reação em cadeia da polimerase seguida pelo estudo do polimorfismo conformacional de fita simples (PCR/SSCP). Métodos: Analisaram-se amostras de 72 pacientes com LMC: 54 de LMC em fase crônica (33 fase inicial ou LMC-FCi e 21 em fase crônica tardia ou LMC-FCtd), 7 em fase acelerada ou LMC-Ac e 11 em crise de blástica (LMC-CB). Foram realizados PCR para os exons 5-9 para posterior estudo pelo SSCP e a expressão de proteína de p53 foi feita por citometria de fluxo. Resultados: Na análise do PCR-SSCP, alterações de mobilidade eletroforética indicativa de mutação do gene de TP53 foi observado em 11/72 pacientes e a expressão da proteína p53 em 17/72 pacientes. O SSCP anormal foi visto em dois casos de LMC-FCi (exon 7), quatro LMC-FCt (um exon 7, um exon 8 e dois exons 8-9), um na LMC-FAc (exon 8) e quatro na LMC-CB (dois no exon 5, um no exon 6 e um no exon 8-9). Neste grupo, a proteína de p53 estava expressa sete casos (todas LMC-CB e AC e 2 LMC-FCtd), havendo correlação estatisticamente significativa entre os resultados dos dois métodos. Conclusões: Estes resultados sugerem que os dois métodos conjuntamente empregados podem aumentar a sensibilidade na detecção de anormalidades do gene e proteína p53 nos pacientes com LMC. A presença de SSCP anormal associado à expressão da proteína de p53 nas fases avançadas desta doença na maioria de casos, sugere que estes exames possam se empregados como indicadores de progressão para a LMC.

The p53 protein play an important role in the control of the cell cycle and DNA repair. In patients with chronic myeloid leukemia (CML) mutation in this gene were found in up to 30%, especially among those in blast crisis. At present, the only widely available technology that reliable detects and defines all mutations is DNA sequencing. However, the routine sequencing of the entire TP53 gene in all cases suggestive of mutation in the laboratorial routine is prohibitively costly, complex, and time consuming. To screen for TP53 abnormalities in CML patients, both p53 protein expression bay immunologic methods and single strand conformation polymorphism of polymerase chain reaction products (SSCP-PCR) is proposed. Methods: We report the results of an analysis of 72 samples from CML patients:54 in chronic phase :33 in initial phase (ICP-CML) and 21 in late phase (LCP-CML), 7 in accelerated phase (AP-CML) and 11in blast crisis (BC-CML). DNA structure for 5-9 exons of the TP53 gene were analyzed by PCR-SSCP and p53 protein expression by flow cytometry (CF). Results: By PCR-SSCP analysis, shifts in eletrophoretic mobility of the TP53 gene were detected in 11 out of CML patients and p53 protein expression in 17 out of 72 CML patients. The abnormal SSCP pattern were showed in two cases of ICP-CML (exon 7), four LCP-CML (one exon 7 and exon 8 and two exons 8-9), one in AP-CML (exon 8) and four in BC-CML (two in exon 5, one in exon 6 and one in exon 8-9). In this group, the p53 protein were express in 17 cases (all CB and AC of CML patients and 2 out of 5 LCP samples of CML patients) and the statistical analysis by qui-square test showed correlation between this two tests. Conclusions: These results suggest that the two methods together can increase the sensibility of screening for p53 abnormalities in CML patients. The presence of abnormal SSCP associated to the p53 protein expression in advanced phases of this disease in the most of cases, suggesting that these tests can be used as an indicator of progression of CML.

Detecção da proteína p53 em células leucêmicas por citometria de fluxo e imunocitoquímica / Detection of p53 protein in leukemic cells by flow cytometry and immunocytochemistry

Introdução: A proteína p53 desempenha uma função crucial no controle do ciclo celular, reparo do DNA e na indução de apoptose em células geneticamente instáveis. A imunocitoquímica (ICQ) é um dos métodos preconizados para detecção e visualização dessa proteína no núcleo das células, sendo, no entanto um método demorado e trabalhoso o que dificulta a sua aplicação na rotina laboratorial. Atualmente, a citometria de fluxo (CF) também tem sido empregada na detecção da proteína p53 mutada ou estabilizada tendo a vantagem da praticidade e rapidez de execução. Objetivos e Metodologia: Comparar os resultados obtidos pela CF e ICQ na detecção da proteína p53 em células leucêmicas. Empregamos amostras de 10 pacientes com leucemia linfóide aguda (LLA) 10 com leucemia linfóide crônica (LLC), tendo sido também empregadas, células de linhagens leucêmicas humanas que serviram como controle de expressão positiva e negativa para ambos os métodos além de linfócitos de 40 doadores de sangue. A CF e ICQ foram realizadas após a marcação com anticorpo monoclonal anti-p53 por técnicas convencionais. Resultados: Observamos concordância nos resultados da maioria das amostras dos pacientes e em todas as amostras das linhagens elulares tendo sido, no entanto constatados níveis de expressão mais elevados nas análises obtidos pela CF quando comparados com a ICQ, refletindo em uma maior sensibilidade desse método. Conclusão: Apesar da ICQ ser considerada uma técnica adequada para a detecção da p53, nossos resultados indicam que a CF pode ser empregada satisfatoriamente na detecção dessa proteína em amostras de células leucêmicas.

Introduction: The p53 protein plays a crucial role in the cell cycle control, DNA damage repair and induction of apoptosis in genetically unstable cells. The immunocytochemistry (ICQ) is one of the most common methodology for detection and visualization of this protein in the nucleus of the cells, but this technique is time-consuming and difficult to apply in the clinical setting. Nowadays the assessment of p53 protein expression by flow cytometry (FC) assays are easier to perform and provide reliable estimates of the prolonged half-life of mutant or inactivated wild-type p53 protein. Objectives and Methodology: Compare the results of p53 detection by FC and ICQ in leukemic cells. We used samples from 10 patients with acute lymphoid leukemia (ALL), 10 with chronic lymphoid leukemia (CLL). To positive and negative controls of p53 expression in both methods we also employed leukemic cells from human leukemic cell lines an lymphocytes from 40 healthy donors were also used as control for negative labeling in FC. The FC and ICQ were performed after labeling with p53 monoclonal antibody by the usual protocol. Results: We verified an agreement in the results in the majority of the leukemic cells from patients and in all human leukemic cell line samples. Conclusion: Despite of ICQ is considered a good methodology for p53 detection in leukemic cells; our results show that FC can be satisfactorily used for detection of this protein in leukemic cells.

Coexpression of p53 protein and MDR functional phenotype in leukemias: the predominant association in chronic myeloid leukemia.

BACKGROUND: One of the best characterized resistance mechanisms of leukemias is multidrug resistance (MDR) mediated by P-glycoprotein (Pgp) and multidrug-resistant related protein (MRP). In addition to Pgp and MRP, p53 mutation or inactivation might play a relevant role in therapeutic failure. Some studies have demonstrated that Pgp and MRP may be activated in association with overexpression of mutant or inactivated p53 protein. The aim of this study was to investigate the association between p53 expression and MDR functional phenotype analyzed by flow cytometry (FCM). METHODS: Rhodamine-123 assay analyzed by FCM was used to detect the MDR phenotype that was positive in 18 out of 41 (43.9%) cases of chronic myeloid leukemia (CML), 16 out of 28 (57.1%) chronic lymphoid leukemia (CLL) cases, 11 out of 28 (39.3%) acute myeloid leukemia (AML) cases, and four out of 22 (18.2%) acute lymphoid leukemia (ALL) cases. RESULTS: Variable levels of p53 expression were observed in leukemic cells: 12 out of 41 (29.2%) in CML, nine out of 28 (32.1%) in CLL, 15 out of 28 (53.6%) in AML, and eight out of 22 (36.4%) in ALL samples. CONCLUSIONS: In our study, no significant association between p53 expression and MDR functional phenotype was observed in ALL, CLL, and AML. On the other hand, a significant association (P = 0.0003) of the coexpression was observed in CML. The p53 overexpression was more frequently seen in the accelerated phase and the blastic phase of this disease. Our results suggest that an MDR functional phenotype could be associated with p53 mutation in the advanced stage of leukemias.

Detecção da proteína p53 em células leucêmicas por citometria de fluxo e Western blot / Detection of p53 protein in leukemic cells by flow cytometry and Western blot

Introdução: A proteína p53 desempenha uma função crucial no controle do ciclo celular, reparo do DNA e naindução de apoptose em células geneticamente instáveis. O Western blot (WB) é o método preconizado paradetecção dessa proteína, no entanto é técnica demorada e trabalhosa. Atualmente, a citometria de fluxo (CF)também tem sido empregada na detecção da proteína p53 tendo a vantagem da praticidade. Objetivos e Metodologia:Comparar os resultados obtidos pela CF e WB na detecção da proteína p53 em células leucêmicas. Empregamosamostras de 3 pacientes com leucemia linfóide aguda (LLA), 5 com leucemia mielóide aguda (LMA), 6 comleucemia mielóide crônica (LMC) e 8 com leucemia linfóide crônica (LLC). Os controles positivos (5) e negativos(4), para os dois métodos, foram linhagens de células leucêmicas. Juntamente com o controle de marcação negativa,na técnica de CF, utilizamos linfócitos de 40 doadores de sangue. A análise pela CF foi realizada após a marcaçãocom anticorpo monoclonal anti-p53 e o WB por técnica convencional. Resultados e Conclusões: Observamosconcordância nos resultados em 82 por cento das amostras leucêmicas e em 100 por cento nas linhagens celulares. CF+/WB+foram observados em pacientes com evolução desfavorável tais como na LLC / Síndrome de Richter, LMC emcrise blástica e na maioria das LMA. Apesar do WB ser considerado um método padrão para a detecção da p53,nossos resultados indicam que a CF pode ser empregada satisfatoriamente na detecção dessa proteína em amostrasleucêmicas.

Citometria de fluxo, imunocitoquimica e western blot na detecção da expressão da proteína p53 em células tumorais: uma análise comparativa / Flow cytometry, immunocytochemistry and western blot in measurement of p53 protein expression in tumor cells: a comparative analysis

Introdução e objetivos: p53 é a proteína cuja função é crucial no controle do ciclo celular, reparo do DNA e indução de apoptose de células geneticamente instáveis. O Western Blot (WB) e a imunocitoquímica (ICQ) são atualmente os métodos de detecção mais empregados da proteína p53, se tratando, porém de técnicas de execução demorada e trabalhosa. O objetivo deste trabalho foi desenvolver uma metodologia rápida para detecção e quantificação da proteína p53 em células tumorais através da citometria de fluxo (CF). Material e métodos:Empregou-se 14 linhagens de células tumorais humanas: Namalva, Raji e Daudi (linfoma de Burkitt), C91 e MT-2 (leucemia de células T do adulto), Jurkat (leucemia linfoblástica de células T), HL-60 (leucemia promielocítica), HT-29 (adenocarcinoma de colon), GLC-4 (carcinoma de pulmão), MCF-7 (carcinoma de mama), H460 e H460/bcl-2 (carcinoma de células não pequenas de pulmão), k562 e lucena (leucemia mielóide crônica em crise blástica) e C6 (astrocitoma originária de rato). Paralelamente, linfócitos provenientes de 36 indivíduos sadios serviram como controle da reação negativa. A iCQ foi realizada pelo método da imunoperoxidase indireta, a CF por marcação direta com anticorpo monoclonal anti-p53 diretamente conjugado ao isotiocianato de fluoresceína após permeabilização celular e o WB através do método padrão. A quantificação antigênica foi realizada através da média de intensidade de fluorescência na CF e densitometria no WB. Resultados: Observou-se uma correlação direta entre os resultados da CF, WB e ICQ, com expressão positiva nas linhagens Namalva, Raji, HT-29, GLC-4, MT-2, C91pl, MCF-7, H460 e H460/bcl-2 e negativa nas demais linhagens e em todas as células do grupo controle. A ICQ foi eficaz na demonstração da presença da p53 no núcleo da célula e a CF e WB permitiram também a quantificação antigênica, evidenciando células com variados níveis de expressão antigênica. A CF quando comparada ao WB apresentou maior sensibilidade. Conclusões: Nossos resultados mostraram que a proteína p53 pode ser detectada em células tumorais através da CF. Esta metodologia é eficaz, sensível e prática, podendo ser empregada rotineiramente em estudos de expressão da proteína p53 em células tumorais.