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I. Gupta, Gheyath K Nasrallah, Anju Sharma, A. Jabeen, M. Smatti, Hamda A. Al-Thawadi, A. Sultan, Moussa Alkhalaf et al.

I. Gupta, S. Vranić, Hamda A. Al-Thawadi, A. Al Moustafa

Simple Summary Fascin, an actin-binding protein, is upregulated in different types of human cancers. It is reportedly responsible for increasing the invasive and metastatic ability of cancer cells by reducing cell–cell adhesions. This review provides a brief overview of fascin and its interactions with other genes and oncoviruses to induce the onset and progression of cancer. Abstract Fascin is an actin-binding protein that is encoded by the FSCN1 gene (located on chromosome 7). It triggers membrane projections and stimulates cell motility in cancer cells. Fascin overexpression has been described in different types of human cancers in which its expression correlated with tumor growth, migration, invasion, and metastasis. Moreover, overexpression of fascin was found in oncovirus-infected cells, such as human papillomaviruses (HPVs) and Epstein-Barr virus (EBV), disrupting the cell–cell adhesion and enhancing cancer progression. Based on these findings, several studies reported fascin as a potential biomarker and a therapeutic target in various cancers. This review provides a brief overview of the FSCN1 role in various cancers with emphasis on gynecological malignancies. We also discuss fascin interactions with other genes and oncoviruses through which it might induce cancer development and progression.

Amr Ouda, A. Elsabagh, Ibrahim Elmakaty, I. Gupta, S. Vranić, Hamda A. Al-Thawadi, A. Al Moustafa

Recurrent Respiratory Papillomatosis (RRP) is a rare but severe manifestation of human papillomavirus (HPV). As our knowledge about HPV infections has expanded, it has become possible to understand the course of RRP disease and unravel plausible efficient methods to manage the disease. However, the surge in reports on HPV has not been accompanied by a similar increase in research about RRP specifically. In this paper, we review the clinical manifestation and typical presentation of the illness. In addition, the pathogenesis and progression of the disease are described. On the other hand, we discuss the types of treatments currently available and future treatment strategies. The role of vaccination in both the prevention and treatment of RRP will also be reviewed. We believe this review is essential to update the general knowledge on RRP with the latest information available to date to enhance our understanding of RRP and its management.

V. López-Ozuna, I. Gupta, Ryan Chen Kiow, E. Matanes, A. Yasmeen, S. Vranić, A. Al Moustafa

Background: Water-pipe smoking (WPS), a predominant method of tobacco consumption, is common amongst young females in the Middle East. WPS smoke consists of toxins analogous to the ones that exist in cigarette smoke and frequently correlates with the onset of several types of human cancers including breast. However, the potential target genes and their underlying mechanisms in the initiation and/ or progression of human cancers, especially breast, due to WPS exposure are still unknown. Materials and Methods: In this investigation, we explored the effect of WPS chronic exposure on human normal mammary epithelial cells and analyzed alterations in the differentially ex-pressed gene (DEG) targets using the NanoString nCounter PanCancer Pathways Panel consisting of 770 gene transcripts and a quantitative real-time polymerase chain reaction (PCR) analysis. Results: Our NanoString analysis identified 13 genes dysregulated under the effect of WPS exposure involved in regulating signal transduction, cell cycle, cell motility, proliferation and migration/invasion as well as the inflammatory response. We further performed an in silico analysis to investigate the effect of the identified genes in the prognosis of breast cancer patients and reported those DEGs that directly correlated with smoking and were upregulated in breast cancer in comparison with normal tissue. Moreover, the Kaplan–Meier curve analysis showed a significant correlation be-tween WPS-dysregulated genes (MX1, CCL8, GNGT1 and MMP9) and relapse-free survival in breast cancer patients. Conclusions: Our data clearly suggest that exposure to WPS can alter the expression of key regulator genes involved in the pathogenesis of breast cancer, thereby affecting the breast cancer prognosis.

Hadeel Kheraldine, I. Gupta, F. Cyprian, S. Vranić, A. Al Moustafa

Introduction: Both Dasatinib (DA), a tyrosine kinase inhibitor that is used for targeted cancer therapy, and programmed death-ligand 1 (PD-1/PD-L1) inhibitor that is an immune checkpoint therapy, play a vital role in the management of several types of solid tumors, including breast. Nevertheless, the combined outcome of DA and PD-1/PD-L1 inhibitors in human carcinomas has not been explored yet. Materials and methods: We herein compared the individual impact of DA and PD-1/PD-L1 inhibitors (BMS-202) with their combination on two human HER2-positive breast cancer cell lines, SKBR3 and ZR75. Results: Our data revealed that the combination of DA and BMS-202 significantly inhibits cell proliferation in both cell lines as compared to mono treatment and/or untreated cells. Moreover, we observed that combination treatment prevents the progression of “epithelial-mesenchymal transition” (EMT), which is a hallmark of cell invasion and cancer progression. Our data reveal that DA and BMS-202 together dramatically inhibit cell invasion of SKBR3 and ZR75 cells; this is accompanied by the up-regulation of E-cadherin and its restoration along with b-catenin on the cell membrane and its undercoat, respectively, in addition to the downregulation of vimentin, which are major markers of EMT. Additionally, we found that the synergistic treatment of DA and BMS-202 inhibits colony formation of both cell lines in comparison with their matched control. Conclusion: Our findings implicate that, in comparison to monotreatment, combination of DA and BMS-202 could have a significant impact on the management of HER2-positive breast cancer via HER2 inactivation and specifically b-catenin signaling pathways.

I. Gupta, M. Ulamec, M. Perić-Balja, S. Ramić, A. Al Moustafa, S. Vranić, Halema F Al-Farsi

ABSTRACT Breast cancer, the most frequent disease amongst women worldwide, accounts for the highest cancer-related mortality rate. Triple-negative breast cancer (TNBC) subtype encompasses ~15% of all breast cancers and lack estrogen, progesterone, and HER2 receptors. Although risk factors for breast cancer are well-known, factors underpinning breast cancer onset and progression remain unknown. Recent studies suggest the plausible role of oncoviruses including human papillomaviruses (HPVs), Epstein-Barr virus (EBV), and mouse mammary tumor virus (MMTV) in breast cancer pathogenesis. However, the role of these oncoviruses in TNBC is still unclear. In the current study, we explored the status of high-risk HPVs, EBV, and MMTV in a well-defined TNBC cohort from Croatia in comparison to 16 normal/non TNBC samples (controls) using polymerase chain reaction assay. We found high-risk HPVs and EBV present in 37/70 (53%) and 25/70 (36%) of the cases, respectively. The most common HPV types are 52, 45, 31, 58 and 68. We found 16% of the samples positive for co-presence of high-risk HPVs and EBV. Moreover, our data revealed that 5/70 (7%) samples are positive for MMTV. In addition, only 2/70 (3%) samples had co-presence of HPVs, EBV, and MMTV without any significant association with the clinicopathological variables. While, 6/16 (37.5%) controls were positive for HPV (p = .4), EBV was absent in all controls (0/16, 0%) (p = .01). In addition, we did not find the co-presence of the oncoviruses in the controls (p > .05). Nevertheless, further investigations are essential to understand the underlying mechanisms of multiple-oncogenic viruses’ interaction in breast carcinogenesis, especially TNBC.

N. Mahmoud, Z. Zakaria, Hadeel Kheraldine, I. Gupta, S. Vranić, M. Al-Asmakh, A. Al Moustafa

Gold nanorods have been implicated in several biomedical applications. Herein, the effect of two surface-modified gold nanorods on the early stages of embryogenesis and angiogenesis was investigated using avian embryos at three days and their chorioallantoic membrane (CAM) at five days of incubation. We found that gold nanorods (GNR) modified with PEGylated phospholipid moiety show a high mortality rate in embryos after four days of exposure compared to GNR modified with PEGylated cholesterol moiety. Meanwhile, our data revealed that surface modified-GNR significantly inhibit the formation of new blood vessels in the treated CAM model after 48 h of exposure. Moreover, we report that surface-modified GNR significantly deregulate the expression of several genes implicated in cell proliferation, invasion, apoptosis, cellular energy metabolism, and angiogenesis. On the other hand, our data point out that GNR treatments can modulate the expression patterns of JNK1/2/3, NF-KB/p38, and MAPK, which could be the main molecular pathways of the nanorods in our experimental models.

Abstract Rationale: Peutz-Jeghers syndrome (PJS), a rare autosomal dominant disorder, is characterized by mucocutaneous pigmentations, hamartomatous polyps in the gastrointestinal tract, and a high risk of developing various malignancies. To the best of our knowledge, only 1 case of appendiceal carcinoid associated with PJS has been previously reported in the pediatric population. Patient concerns: We report a 7-year-old girl who was admitted for severe, intermittent abdominal pain and cramps, nausea, and vomiting. Multiple brown melanotic macules on the lips, buccal mucosa, and the tongue were noted. Diagnosis: A plain abdominal X-ray in a standing position revealed dilated intestinal loops with multiple air-fluid levels. A computed tomography scan of the abdomen showing a “coffee bean” appearance of the jejunal loop with a transition point to the duodenal loop. Axial-contrast-enhanced computed tomography scan of the abdomen showing dilated jejunum loops, filled with fluid with the swirled appearance of mesentery typical for volvulus. The diagnosis of PJS was based on clinical findings along with the histopathologic confirmation of the hamartomatous polyps. Interventions: An emergency laparotomy was performed, revealing a jejunojejunal intussusception starting 40 cm from the duodenojejunal flexure. Jejunotomy revealed that a lead-point intussusception was a necrotic hamartomatous polyp. After resecting the involved jejunal necrotic segment, including the polyp, end-to-end jejuno-jejunal anastomosis was performed. Further exploration revealed the presence of a jejunal mass 80 cm from the duodenojejunal flexure identified as another hamartomatous pedunculated polyp. The polyp was resected, and the enterotomy was then closed transversely. The grossly normal appendix was also removed. Outcomes: Clinical findings along with the histopathologically confirmed hamartomatous polyps were consistent with PJS. An appendiceal carcinoid (well-differentiated neuroendocrine tumor, European Neuroendocrine Tumor Society stage pT2) was incidentally detected during histological examination of the appendix. The patient and parents were counseled accordingly, focusing on active surveillance and control of symptoms. Two additional hamartomatous polyps (gastric and jejunal) were detected endoscopically and resected in the fourth postoperative week. A regular, 1-year follow-up and surveillance revealed no complications or recurrences. Lessons: Unusual neoplasms can occasionally be encountered in well-defined syndromes such as PJS. Therefore, active follow-up and surveillance are mandatory for all patients with PJS.

W. Luo, T. Stevens, P. Stafford, M. Miettinen, Z. Gatalica, S. Vranić

Nuclear protein of testis (NUT), a protein product of the NUTM1 gene (located on the long arm of chromosome 15) with highly restricted physiologic expression in post-meiotic spermatids, is the oncogenic driver of a group of emerging neoplasms when fused with genes involved in transcription regulation. Although initially identified in a group of lethal midline carcinomas in which NUT forms fusion proteins with bromodomain proteins, NUTM1-rearrangement has since been identified in tumors at non-midline locations, with non-bromodomain partners and with varied morphology. The histologic features of these tumors have also expanded to include sarcoma, skin adnexal tumors, and hematologic malignancies that harbor various fusion partners and are associated with markedly different clinical courses varying from benign to malignant. Most of these tumors have nondescript primitive morphology and therefore should be routinely considered in any undifferentiated neoplasm. The diagnosis is facilitated by the immunohistochemical use of the monoclonal C52 antibody, fluorescence in situ hybridization (FISH), and, recently, RNA-sequencing. The pathogenesis is believed to be altered expression of oncogenes or tumor suppressor genes by NUT-mediated genome-wide histone modification. NUTM1-rearranged neoplasms respond poorly to classical chemotherapy and radiation therapy. Targeted therapies such as bromodomain and extraterminal domain inhibitor (BETi) therapy are being developed. This current review provides an update on NUTM1-rearranged neoplasms, focusing on the correlation between basic sciences and clinical aspects.

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