Hiromi Kudo

Impact of pan-caspase inhibition in animal models of established steatosis and non-alcoholic steatohepatitis

BACKGROUND & AIMS Non-alcoholic fatty liver disease is a progressive condition comprising steatosis, steatohepatitis, and cirrhosis. Caspase activation mediates apoptosis and the inflammatory response. Studies demonstrate increased apoptotic activity in NASH although its pathophysiological importance is uncertain. We sought to determine the effects of irreversible pan-caspase inhibition in murine models of established steatosis (high fat diet, HFD) and steatohepatitis (methionine-choline deficient diet, MCD). METHODS In one study arm, male C3H/HeN mice were fed HFD; in the other, Db/Db mice were fed MCD. Once disease was established, animals were randomised to receive caspase inhibitor (VX-166), TPGS/PEG vehicle or no additional therapy until the end of the study. Biochemical and histological indices were examined to determine NASH activity and tissue oxidative stress. Apoptotic activity and cell turnover were assessed immunohistochemically by staining for caspase-cleaved CK-18 and PCNA. RESULTS MCD and HFD significantly increased apoptosis, which was reduced by VX-166 treatment. VX-166 did not reduce steatosis but reduced histological inflammation, serum ALT levels, and oxidative stress, particularly in the MCD model. TPGS/PEG vehicle also exhibited some anti-inflammatory activity. CONCLUSIONS In both models, VX-166 inhibited apoptosis and reduced histological inflammatory infiltrate although there was a more modest impact on other indices of liver injury. In addition, TPGS/PEG vehicle also exhibited some anti-inflammatory activity, likely through the antioxidant effects of vitamin E and changes in gut flora/mucosal interactions. These data suggest that caspase inhibition may represent a valid therapeutic approach; however, further studies to assess the long-term value of more selective caspase inhibition are merited.

Quantifying hepatic steatosis – more than meets the eye

Levene A P, Kudo H, Armstrong M J, Thursz M R, Gedroyc W M, Anstee Q M & Goldin R D 
(2012) Histopathology 60, 971–981

Repeatability and reproducibility of desorption electrospray ionization-mass spectrometry (DESI-MS) for the imaging analysis of human cancer tissue: a gateway for clinical applications

In this study, we aim to demonstrate the repeatability and reproducibility of DESI-MS for the imaging analysis of human cancer tissue using a set of optimal geometric and electrospray solvent parameters. Oesophageal cancer tissue was retrieved from four quadrants of a freshly removed tumor specimen, snap frozen, cryo-sectioned and mounted on glass slides for DESI-MS image acquisition. Prior to assessing precision, optimal geometric and electrospray solvent parameters were determined to maximize the number of detected lipid species and associated Total Ion Count (TIC). The same settings were utilized for all subsequent experiments. Repeatability measurements were performed using the same instrument, by the same operator on a total of 16 tissue sections (four from each quadrant of the tumor). Reproducibility measurements were determined in a different laboratory, on a separate DESI-MS platform and by an independent operator on 4 sections of one quadrant and compared to the corresponding measurements made for the repeatability experiments. The mean ± SD CV of lipid ion intensities was found to be 22 ± 7% and 18 ± 8% as measures of repeatability and reproducibility, respectively. In conclusion, DESI-MS has acceptable levels of reproducibility for the analysis of lipids in human cancer tissue and is suitable for the purposes of clinical research and diagnostics.

Hirmi Valley liver disease: a disease associated with exposure to pyrrolizidine alkaloids and DDT.

BACKGROUND & AIMS Hirmi Valley liver disease was first reported in 2001 in Tigray, Ethiopia. 591 cases, including 228 deaths, were reported up to December 2009. The pyrrolizidine alkaloid acetyllycopsamine was detected in stored grain and residents reported adding the pesticide DDT (dichlorodiphenyldichloroethylene) directly to their food stores. We aimed to characterise the clinical features of the disease, and explore the role of these chemicals in its aetiology. METHODS 32 cases were examined and full clinical histories taken. Nine cases underwent liver biopsy in hospitals. Serum and urine samples were collected from cases and controls. Urine was analysed for acetyllycopsamine by UPLC-MS. Total DDT in serum was measured by ELISA. Hepatotoxicity of DDT and acetyllycopsamine alone or in combination was explored in C57BL/6J mice. RESULTS Clinical presentation included epigastric pain, abdominal swelling, bloody diarrhoea, hepatomegaly, splenomegaly, and ascites. Histology revealed acute injury characterised by centrilobular necrosis or chronic injury with bile ductular reaction, cytomegaly and fibrosis but no hepatic vein occlusion. Acetyllycopsamine was detected in urine samples taken in the affected area with significantly greater concentrations in 45 cases than in 43 controls (p=0.02). High levels of DDT (>125 ppb) were detected in 78% of serum samples. In mice, DDT (3 × 75 mg/kg) significantly increased the hepatotoxicity (plasma ALT, p=0.0065) of acetyllycopsamine (750 mg/kg), and in combination induced liver pathology similar to Hirmi Valley liver disease including centrilobular necrosis and cytomegaly. CONCLUSIONS This novel form of disease appears to be caused by co-exposure to acetyllycopsamine and DDT.

A Comparison of DESI-MS and LC-MS for the Lipidomic Profiling of Human Cancer Tissue

AbstractIn this study, we make a direct comparison between desorption electrospray ionization-mass spectrometry (DESI-MS) and ultraperformance liquid chromatography-electrospray ionization-mass spectrometry (UPLC-ESI-MS) platforms for the profiling of glycerophospholipid (GPL) species in esophageal cancer tissue. In particular, we studied the similarities and differences in the range of GPLs detected and the congruency of their relative abundances as detected by each analytical platform. The main differences between mass spectra of the two modalities were found to be associated with the variance in adduct formation of common GPLs, rather than the presence of different GPL species. Phosphatidylcholines as formate adducts in UPLC-ESI-MS accounted for the majority of differences in negative ion mode and alkali metal adducts of phosphatidylcholines in DESI-MS for positive ion mode. Comparison of the relative abundance of GPLs, normalized to a common peak, revealed a correlation coefficient of 0.70 (P < 0.001). The GPL profile detected by DESI-MS is congruent to UPLC-ESI-MS, which reaffirms the role of DESI-MS for lipidomic profiling and a potential premise for quantification. Graphical Abstractᇵ

Multi-Excitation Fluorescence Spectroscopy for Analysis of Non-Alcoholic Fatty Liver Disease

The increasing incidence of non‐alcoholic fatty liver diseases (NAFLD) and the consequent progression to cirrhosis is expected to become a major cause of liver transplantation. This will exacerbate the organ donor shortage and mean that ‘marginal’ fatty liver grafts are more frequently used. Autofluorescence spectroscopy is a fast, objective, and non‐destructive method to detect change in the endogenous fluorophores distribution and could prove to be a valuable tool for NAFLD diagnosis and transplant graft assessment.

The immunoreceptor NKG2D promotes tumour growth in a model of hepatocellular carcinoma

Inflammation is recognized as one of the drivers of cancer. Yet, the individual immune components that possess pro- and anti-tumorigenic functions in individual cancers remain largely unknown. NKG2D is a potent activating immunoreceptor that has emerged as an important player in inflammatory disorders besides its well-established function as tumour suppressor. Here, we provide genetic evidence of an unexpected tumour-promoting effect of NKG2D in a model of inflammation-driven liver cancer. Compared to NKG2D-deficient mice, NKG2D-sufficient mice display accelerated tumour growth associated with, an increased recruitment of memory CD8+T cells to the liver and exacerbated pro-inflammatory milieu. In addition, we show that NKG2D contributes to liver damage and consequent hepatocyte proliferation known to favour tumorigenesis. Thus, the NKG2D/NKG2D-ligand pathway provides an additional mechanism linking chronic inflammation to tumour development in hepatocellular carcinoma. Our findings expose the need to selectively target the types of cancer that could benefit from NKG2D-based immunotherapy.

Is oil red‐O staining and digital image analysis the gold standard for quantifying steatosis in the liver?

We read with great interest the article by Petta et al. The compound 25-hydroxyvitamin D3 (25[OH]D3) was reported as an independent predictor of cardiovascular disease (by a decreased expression of profibrotic markers, and an increased expression of antifibrotic markers) despite the fact that its real pathological pathway is still not clear. Incubation of the multipotent mesenchymal cell with 25(OH)D3 also resulted in antiproliferative and antiapoptotic processes. Therefore, the lower levels of 25(OH)D3 in liver with greater fibrosis is understandable. Lower cholesterol and lower 25(OH)D3 levels, along with greater steatosis, were found to be risk factors affecting sustained virological response (SVR) as seen in recent studies. The stage of fibrosis was found to be a risk factor for SVR not only in hepatitis C virus (HCV) alone, but also in patients coinfected with human immunodeficiency virus and HCV, in contrast to the results of the current article. Moreover, age, sex, and body mass index were also described as predictors for SVR in patients infected with HCV, in contrast to the current study. These challenging results could be related in the methodologic differences between the present study and recent studies, or mistakes could have happened during the sampling and/or analyzing periods. For example, SVR was reached in the half the male patients, whereas it was reached in just one-third of the females, results which are also different from the recent data. The patients in the study may also be infected with an unknown subgroup of HCV, which could explain these patients’ characteristics.

Imaging of Esophageal Lymph Node Metastases by Desorption Electrospray Ionization Mass Spectrometry

Histopathological assessment of lymph node metastases (LNM) depends on subjective analysis of cellular morphology with inter-/intraobserver variability. In this study, LNM from esophageal adenocarcinoma was objectively detected using desorption electrospray ionization-mass spectrometry imaging (DESI-MSI). Ninety lymph nodes (LN) and their primary tumor biopsies from 11 esophago-gastrectomy specimens were examined and analyzed by DESI-MSI. Images from mass spectrometry and corresponding histology were coregistered and analyzed using multivariate statistical tools. The MSIs revealed consistent lipidomic profiles of individual tissue types found within LNs. Spatial mapping of the profiles showed identical distribution patterns as per the tissue types in matched IHC images. Lipidomic profile comparisons of LNM versus the primary tumor revealed a close association in contrast to benign LN tissue types. This similarity was used for the objective prediction of LNM in mass spectrometry images utilizing the average lipidomic profile of esophageal adenocarcinoma. The multivariate statistical algorithm developed for LNM identification demonstrated a sensitivity, specificity, positive predictive value, and negative predictive value of 89.5%, 100%, 100%, and 97.2%, respectively, when compared with gold-standard IHC. DESI-MSI has the potential to be a diagnostic tool for perioperative identification of LNM and compares favorably with techniques currently used by histopathology experts. Cancer Res; 76(19); 5647-56. ©2016 AACR.

Laser-induced tissue fluorescence in radiofrequency tissue-fusion characterization

Abstract. Heat-induced tissue fusion is an important procedure in modern surgery and can greatly reduce trauma, complications, and mortality during minimally invasive surgical blood vessel anastomosis, but it may also have further benefits if applied to other tissue types such as small and large intestine anastomoses. We present a tissue-fusion characterization technology using laser-induced fluorescence spectroscopy, which provides further insight into tissue constituent variations at the molecular level. In particular, an increase of fluorescence intensity in 450- to 550-nm range for 375- and 405-nm excitation suggests that the collagen cross-linking in fused tissues increased. Our experimental and statistical analyses showed that, by using fluorescence spectral data, good fusion could be differentiated from other cases with an accuracy of more than 95%. This suggests that the fluorescence spectroscopy could be potentially used as a feedback control method in online tissue-fusion monitoring.