Differential association of STK11 and TP53 with KRAS mutation-associated gene expression, proliferation and immune surveillance in lung adenocarcinoma.

While mutations in the KRAS oncogene are among the most prevalent in human cancer, there are few successful treatments to target these tumors. It is also likely that heterogeneity in KRAS-mutant tumor biology significantly contributes to the response to therapy. We hypothesized that the presence of commonly co-occurring mutations in STK11 and TP53 tumor suppressors may represent a significant source of heterogeneity in KRAS-mutant tumors. To address this, we utilized a large cohort of resected tumors from 442 lung adenocarcinoma patients with data including annotation of prevalent driver mutations (KRAS and EGFR) and tumor suppressor mutations (STK11 and TP53), microarray-based gene expression and clinical covariates, including overall survival (OS). Specifically, we determined impact of STK11 and TP53 mutations on a new KRAS mutation-associated gene expression signature as well as previously defined signatures of tumor cell proliferation and immune surveillance responses. Interestingly, STK11, but not TP53 mutations, were associated with highly elevated expression of KRAS mutation-associated genes. Mutations in TP53 and STK11 also impacted tumor biology regardless of KRAS status, with TP53 strongly associated with enhanced proliferation and STK11 with suppression of immune surveillance. These findings illustrate the remarkably distinct ways through which tumor suppressor mutations may contribute to heterogeneity in KRAS-mutant tumor biology. In addition, these studies point to novel associations between gene mutations and immune surveillance that could impact the response to immunotherapy.

Successful treatment of uterine torsion in a cat with severe metabolic and haemostatic complications.

A peri-parturient fifteen-month-old female Maine Coon cat was presented with extreme weakness and depression, profound hypovolaemia and hypothermia. Severe hyperkalaemia, hyponatraemia and anaemia were detected. Disseminated intravascular coagulation was suspected due to marked prolongation of activated partial thromboplastin time. Uterine torsion was diagnosed at exploratory laparotomy. The cat made a full recovery following ovariohysterectomy and intensive supportive therapy.

Extent of laminin-5 assembly and secretion effect junctional epidermolysis bullosa phenotype.

Junctional epidermolysis bullosa (JEB) is an autosomal recessive skin blistering disease with both lethal and nonlethal forms, with most patients shown to have defects in laminin-5. We analyzed the location of mutations, gene expression levels, and protein chain assembly of the laminin-5 heterotrimer in six JEB patients to determine how the type of genetic lesion influences the pathophysiology of JEB. Mutations within laminin-5 genes were diversely located, with the most severe forms of JEB correlating best with premature termination codons, rather than mapping to any particular protein domain. In all six JEB patients, the laminin-5 assembly intermediates we observed were as predicted by our previous work indicating that the alpha3beta3gamma2 heterotrimer assembles intracellularly via a beta3gamma2 heterodimer intermediate. Since assembly precedes secretion, mutations that disrupt protein-protein interactions needed for assembly are predicted to limit the secretion of laminin-5, and likely to interfere with function. However, our data indicate that typically the most severe mutations diminish mRNA stability, and serve as functional null alleles that block chain assembly by resulting in either a deficiency (in the nonlethal mitis variety) or a complete absence (in lethal Herlitz-JEB) of one of the chains needed for laminin-5 heterotrimer assembly.

Human leukocyte antigen-DQB1*03 alleles are associated with alopecia areata.

Alopecia areata (AA) is characterized by hair loss in patches (patchy AA), over the entire scalp (AT, totalis), or universally (AU). An autoimmune mechanism has been hypothesized, because the inflammatory infiltrate targeted to the hair follicles includes activated T cells. To investigate whether or not genetic polymorphism of the human leukocyte antigen (HLA) region contributes to disease susceptibility, we used sequence-specific oligonucleotides and amplified genomic DNA to define HLA-DQA1, -DQB1, and -DPB1 alleles in a cohort of 85 white patients. The frequency of DQB1*0301 was significantly increased to 41% in all patients, and to 47% in AT/AU patients relative to controls (27%). Analyzed together, DQB1*03 alleles (DQB1*0301-*0303) were increased to 80% (all patients) and to 92% (AT/AU) (odds ratio = 12.14, p = 0.00003, corrected). This striking association implicates the DQB1*03 alleles in the pathogenesis of AA. DQB1*06 was decreased relative to controls (56%) in all patients (32%, odds ratio = 0.37, p = 0.0045, corrected). An increase was observed in the HLA-DRB1*11(DR5) allele DRB1*1104, which may result from linkage disequilibrium with DQB1 alleles. Sequence comparison among the allele products associated with AA indicates that the DQB1*03 alleles carry a unique proline at position 55 that is not present in alleles that are neutral or negatively associated with the disease. This highly significant association may exert considerable control over immune responsiveness and the initiation or persistence of a T-cell autoimmune response against the hair follicle.

Localization of the gene whose mutations underlie Hailey-Hailey disease to chromosome 3q.

Hailey-Hailey disease (familial benign chronic pemphigus) is an autosomal dominant skin disease characterized by impaired keratinocyte cohesion and consequent blister formation. In the present study we have used linkage analysis to map the gene for this disease to a region of chromosome 3q between D3S1589 and D3S1316. The maximum combined two point lod score in four families studied was 14.60 at theta = 0 at the D3S1290 microsatellite repeat. These findings suggest the presence of a gene not previously known to be involved in keratinocyte cohesion at this site.

Hailey-Hailey disease is not allelic to Darier's disease.

Hailey-Hailey (Familial Benign Chronic Pemphigus) Disease is a rare autosomal dominant disorder characterized by blisters caused by suprabasal epidermal acantholysis. Another autosomal dominant skin disease, Darier's disease, has clinical and histologic features which overlap those of Hailey-Hailey disease and recently has been mapped to chromosome 12q23-q24.1. We have used linkage analysis to test whether or not a mutation in this region might also underlie Hailey-Hailey disease. This analysis, using polymorphic loci tightly linked to Darier's disease, excluded this region as the site for the disease-causing mutation in two kindreds affected with Hailey-Hailey disease.

Studies on the mechanism of immunologic tolerance induction by murine dendritic epidermal Thy-1+ cell lines.

We are investigating the functions of the Thy-1+ dendritic cells present in murine epidermis. Dendritic epidermal Thy-1+ cell (DETC) lines conjugated in vitro with hapten induce specific immunologic tolerance upon intravenous (i.v.) or subcutaneous injection into the footpad of normal mice. In these studies, we demonstrate that hapten-conjugated cells of other long-term, interleukin-2 (IL-2)-dependent, T cell lines are unable to induce tolerance upon footpad injection, indicating that the ability of DETC lines to induce tolerance is not a function of long-term cell culture or IL-2 dependence. Suppressor T cells were not found in mice made tolerant by footpad injection of hapten-conjugated cells of the DETC line AU16, although they could be demonstrated in mice made tolerant by i.v. injection. Studies of lymphocyte proliferation in vitro suggested that hapten-conjugated AU16 cells may induce tolerance by inhibiting the proliferation of activated T lymphocytes.

Multivariate statistical analysis of electron micrographs of a mammalian transcription initiation complex.

We describe the appearance of the murine ribosomal protein (rp) L32 gene transcription initiation complex as determined by electron image analysis. Using a fractionated nuclear extract enriched for transcription factors necessary for rpL32 gene transcription in vitro and a DNA fragment containing the rpL32 gene promoter, the transcription initiation complex was prepared and viewed by standard transmission electron microscopy. Image analysis demonstrated that the complex was a multilobed structure.

Visualization of a mammalian transcription initiation complex.

Various proteins required for the initiation of eukaryotic gene transcription by RNA polymerase II have been identified and characterized, but little is known about their organization into a functional unit. Here, we describe the appearance of the murine ribosomal protein (rp) L32 gene transcription initiation complex as determined by transmission electron microscopy. Using a fractionated nuclear extract enriched for transcription factors necessary for rpL32 gene transcription in vitro and a DNA fragment containing the rpL32 gene promoter, the transcription initiation complex was imaged by standard transmission electron microscopy. Quantitative image analysis demonstrated that the complex is a multilobed structure whose two-dimensional projections are approximately 24 x 34 nm in size. Looping of the DNA seen in these images suggests that the proteins residing at the promoter region associate with proteins several hundred base pairs distant to the RNA start site, with bending of the DNA allowing these interactions to occur.

Murine Thy-1+ dendritic epidermal cells induce immunologic tolerance in vivo.

To study the potential immunologic functions of murine Thy-1+ dendritic epidermal cells (Tdec), we used long term, IL-2-dependent, Tdec lines derived from the skin of C3H mice. Cells of the Tdec lines AU16 or AU4 were conjugated in vitro with the hapten FITC and injected s.c. into the footpad (ifp.) or i.v. into syngeneic recipient mice to assess their ability to induce or inhibit contact hypersensitivity (CHS). FITC-conjugated Tdec were unable to induce CHS after ifp. or i.v. injection. Furthermore, when mice were sensitized epicutaneously with FITC after the injection of FITC-conjugated Tdec, they were unable to mount a CHS response. These results indicated that hapten-conjugated Tdec are capable of inducing tolerance upon ifp. or i.v. injection. In contrast, ifp. injection of normal lymphocytes conjugated with FITC in vitro produced no impairment of the CHS response to FITC, although i.v. injection of these cells, as with that of FITC-conjugated Tdec, induced down-regulation of CHS. The immunologic tolerance induced by FITC-conjugated Tdec was Ag specific, but not H-2 restricted. Immunization with unconjugated Tdec either ifp. or i.v. did not induce tolerance, indicating that unconjugated Tdec by themselves are not suppressive. In addition, Tdec were unable to mediate a local graft-vs-host reaction in an F1 host. These results demonstrate that Tdec can induce immunologic tolerance and suggest that these cells may play a role in the down-regulation of cutaneous immune responses.

Anaesthetic records in Great Britain and Ireland.

A survey of anaesthetists and their use of anaesthetic records was carried out in Great Britain and Ireland. An analysis of 206 different record sheets from 175 hospitals or groups showed that, although many features were similar, important aspects were omitted in some, while others had too many options which were not necessarily relevant to the administration of an anaesthetic. No attempt has been made to offer an ideal design for an anaesthetic record, but the information may assist those anaesthetists wishing to change the current practice in their hospital or group.