Masataka Uehara

Hypoxia-inducible factor 1 alpha in oral squamous cell carcinoma and its relation to prognosis

The aim of this study was to investigate the correlation between the expression of hypoxia-inducible factor 1 alpha (HIF-1 alpha) and proliferative activity in tumor cells, lymph node metastasis, as well as prognosis in patients with oral squamous cell carcinoma (OSCC). Fifty-seven biopsy specimens of OSCC were investigated for the expression of HIF-1 alpha and proliferating cell nuclear antigen (PCNA) by immunohistochemistry. None of the patients had received any prior treatments. The percentage of HIF-1 alpha immunopositive area (PHIA) was calculated using computer-assisted image analysis for quantitative assessment of HIF-1 alpha expression. The PCNA labeling index (LI) was evaluated as a proliferation marker. We found that the mean PHIA in all stages was 12.1% in the poor prognosis patients, and it was 6.4% in the good prognosis patients. There was a significant difference of PHIA between poor prognosis and good prognosis patients (P=0.0065). Furthermore, the mean PHIA in the patients who had no metastatic lymph nodes was 7.5%, while it was 11.7% in the patients who had metastatic lymph nodes. There was also a significant difference of PHIA between patients who had no metastatic lymph nodes and those who had metastatic lymph nodes (P=0.0487). On the other hand, significant correlation between PHIA and PCNA LI was not observed. These results provide the clinical data indicating that HIF-1 alpha may play an important role in lymph node metastasis and prognosis in patients with OSCC.

Expression of vascular endothelial growth factor in mouse tumours subjected to photodynamic therapy

The aim of this study was to define the appropriate fractionation interval between photodynamic therapy (PDT) for the enhancement of its anti-tumour effects. Tumour reoxygenation and the kinetics of tumour vascular cells following PDT were evaluated in mice by means of immunohistochemical staining for the vascular endothelial growth factor (VEGF) and the proliferating cell nuclear antigen (PCNA), respectively. The VEGF labelling indices (LIs) of the tumour cells and the PCNA LIs of the tumour vascular cells were assessed at various time intervals after PDT. The tumour cell VEGF LIs of the experimental groups at time points from 0 to 6 h after PDT were significantly higher than those of the control groups, but subsequently returned to control levels at 24 h after PDT. The vascular cell PCNA LI of the experimental group at 24 h after PDT was significantly lower than that of the control group, but returned to the control level at 48 h. These results indicated that the tumour subjected to PDT might be reoxygenated, and that the maximum damage to the tumour vasculature emerged at 24 h after PDT. We propose here that the fractionation interval between PDTs should be 24 h.

Enhancement of the photodynamic antitumor effect by streptococcal preparation OK-432 in the mouse carcinoma.

Abstract Biological response modifier antitumor effects are enhanced by the activation of the host defense mechanisms. We have investigated the antitumor effect of photodynamic therapy (PDT) and/or local administration of a biological response modifier, the streptococcal preparation OK-432, on transplanted NR-S1 mouse squamous cell carcinoma. Hematoporphyrin oligomers (20 mg/kg body weight) were used to photosensitize PDT. A pulsed Nd:YAG dye laser, tuned at 630 nm, was used as the light source. The laser power was 15 mJ cm−2 pulse−1, and the irradiation time was 40 min. The photosensitizer was injected intraperitoneally 48 h before laser irradiation. Where used, OK-432 was injected into the tumor either 3 h prior to PDT or immediately afterwards. The antitumor effects were evaluated 48 h after each protocol by (a) estimating the area of tumor necrosis (%) in hematoxylin/eosin-stained specimens, and (b) bromodeoxyuridine immunohistochemistry. Furthermore, the tumor sizes were evaluated 3, 7 and 10 days after each protocol, and the survival time after each protocol was evaluated as well. The anti-tumor effect of PDT was enhanced by administration of OK-432 3 h before PDT, whereas the administration of OK-432 immediately after PDT did not potentiate a PDT antitumor effect. Treatment with OK-432 alone had little effect on tumors. Photodynamic therapy in combination with local administration of OK-432 3 h before PDT is considered to be a useful treatment modality.

Antisense oligonucleotide against collagen-specific molecular chaperone 47-kDa heat shock protein suppresses scar formation in rat wounds

The 47-kDa heat shock protein (HSP47) is a molecular chaperone specifically targeting the processing and quality control of collagen molecules. This study was performed to investigate whether antisense therapy preventing HSP47 expression might affect the scar formation occurring during wound healing of skin. In wound healing of neonatal rat skin, the number of HSP47-positive cells and the amount of HSP47 protein consistently increased up to 7 days after surgical wounding. The increase in HSP47-positive cell number and protein content was efficiently suppressed by daily injections of HSP47-antisense deoxynucleotide (30 nmol) for 7 days. This treatment also suppressed the accumulation of collagen type I in the wound. Moreover, the disorder of collagenous fibers was relieved in the healed portion of the wounds subjected to the antisense treatment. Taken together, the authors propose that HSP47 is an important determinant in scar formation and that the antisense treatment against HSP47 gene may have a therapeutic potential to suppress the scar formation of skin.

Experimental study of combined hyperthermic and photodynamic therapy on carcinoma in the mouse

PURPOSE This study investigates the cytotoxic effect of photodynamic therapy using high-power laser irradiation on cancer cells. MATERIALS AND METHODS High- or low-power irradiation from a pulsed Nd:YAG dye laser with or without a photosensitizer was administered to an NR-S1 carcinoma in the mouse dorsum. RESULTS Photodynamic therapy with high-power laser irradiation yielded better results than conventional photodynamic therapy or hyperthermia with high-power laser irradiation. CONCLUSION Photodynamic therapy with high-power laser irradiation is more effective because it generates both a hyperthermic and a photodynamic effect.

Cell kinetics of mouse tumour subjected to photodynamic therapy—evaluation by proliferating cell nuclear antigen immunohistochemistry

Tumour reaction and tumour cell kinetics in mouse NR-S1 carcinoma subjected to photodynamic therapy (PDT) were evaluated by percentage of necrotic area as well as by proliferating cell nuclear antigen (PCNA) immunohistochemistry, and an effective PDT fractionation interval was proposed. PDT was carried out in mouse NR-S1 carcinomas using a photosensitizer (haematoporphyrin oligomers: 20 mg kg body weight) and pulsed Nd:YAG dye laser. The percentages of tumour necrotic area and PCNA labelling indices (LIs) in the tumours were assessed at intervals of 0, 0.5, 5, 2.5, 6, 24, 48, and 72 h after PDT. It was demonstrated that maximum damage and repopulation of the tumour cells emerge at 24 and 48 h, respectively, following PDT, suggesting that subsequent light treatment should be performed within 24 h to enhance the therapeutic effect of PDT.

Treatment outcome of Photofrin-based photodynamic therapy for T1 and T2 oral squamous cell carcinoma and dysplasia

BACKGROUND Photodynamic therapy (PDT) is a minimally invasive treatment modality for early and superficial malignancy or premalignancy in the head and neck regions. However, few studies have examined the use of Photofrin-mediated PDT to manage early carcinoma and dysplasia in the oral cavity. METHODS Between January 2004 and November 2008, 25 T1 to T2 patients with N0 oral squamous cell carcinoma and mucosal dysplasia in the oral cavity were treated by Porfimer sodium (Photofrin(®))-mediated PDT at Nagasaki University Hospital. Clinical responses were evaluated according to the guidelines of the Response Evaluation Criteria in Solid Tumors (RECIST). After the PDT and a 2-year follow-up period, disease specific survival rates were then calculated. RESULTS A total of 30 regions in 25 patients (18 with squamous cell carcinoma and 7 with epithelial dysplasia with hyperkeratosis in the oral cavity) were treated by PDT. Complete response was achieved in 24 of the 25 patients (96%), with a partial response found in the remaining patient. For the three patients who exhibited recurrence at 4, 5, and 15 months after PDT, salvage surgery or a second PDT was performed. Of these three patients, one died due to another disease, while one died due to local lymphatic metastasis that occurred during the follow-up period. Overall, the disease specific survival rate was 95.8%. Treatment-related edema and pain emerged within 24h after irradiation. Pain control using non-steroid anti-inflammatory drugs and opiates was required for 3-4 weeks in all patients. Complete healing was attained at 4-6 weeks after the treatment. No persistent problems related to functional or esthetic outcomes were noted.

The anti-tumor effect of photodynamic therapy evaluated by bromodeoxyuridine immunohistochemistry

The anti-tumor effect of photodynamic therapy (PDT) on mouse tumors was evaluated with bromodeoxyuridine (BrdU) immunohistochemistry. BrdU was injected into the mice intraperitoneally (40 mg/kg body weight). Immediately after injection of BrdU, PDT using a photosensitizing drug (hematoporphyrin oligomers: 20 mg/kg body weight) was carried out on the experimental group but not on the control group. BrdU labeling indices (LIs) of the tumor cells close to blood vessels and adjacent to the surrounding normal tissue were investigated. In the tumor cells close to blood vessels, the LIs of the experimental group were significantly lower than those of the control group. As for the tumor cells adjacent to the surrounding normal tissue, the LIs of the experimental group were similar to those of the control group. Thus, the effect of PDT was significant in the tumor cells close to the blood vessels, while the tumor cells adjacent to the surrounding normal tissue resisted PDT.

Lipopolysaccharide aggravates bisphosphonate-induced osteonecrosis in rats.

The pathogenesis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is highly controversial. We have previously reported the development of osteonecrosis by periodontal pathogenic stimulation in the jaw and femur of rats treated with bisphosphonate. Since the major toxicity factor of Gram-negative bacteria is lipopolysaccharide (LPS), the present study aimed to evaluate the relationship between osteonecrosis and LPS in a rat model of BRON-like lesions. Seventeen male rats were injected subcutaneously with zoledronic acid weekly for 4 weeks and divided into three groups: LPS (LPS administered into the bone marrow of the mandible and femur) and LPS plus polymyxin B (PMB) and saline groups (given neutralized LPS with PMB or saline, respectively, using the same protocol). At 4 weeks after the procedure, harvested specimens were analyzed using histomorphology (n=5 from each group) and histochemistry (n=1 each from LPS and LPS plus PMB groups). There was a significantly wider area of osteonecrosis in the LPS group as compared to the saline and LPS plus PMB groups in both the mandible (P=0.030 and P=0.009, respectively) and femur (P=0.002 and P=0.020, respectively). Our results indicate that LPS stimulation is deeply involved in the development and promotion of BRON.

Hyperthermic photodynamic therapy combined with topical administration of OK-432 in the mouse carcinoma

This study investigated the combined effect of photodynamic therapy (PDT) using high power laser irradiation (HPL), which generates both a hyperthermic and a photodynamic effect, and OK-432 on NR-S1 mouse squamous cell carcinoma. The photosensitizer (haematoporphyrin oligomers 20 mg/kg BW) was injected to the mice intraperitoneally 48 h before laser irradiation. OK-432 was injected into the tumour 3 h prior to laser irradiation. The experimental protocols consisted of HPL-PDT with or without OK-432, low power laser PDT with or without OK-432, HPL alone and OK-432 alone, and a control group. The tumour necrotic area was determined, and tumour sizes were measured 3, 7 and 10 days after each protocol. The anti-tumour effect of HPL-PDT was enhanced by preadministration with OK-432. Treatment with OK-432 alone or hyperthermic HPL irradiation presented little anti-tumour effect. HPL-PDT in combination with OK-432 topically administered 3 h before photo-irradiation is considered to be a promising therapeutic modality.