tacrolimus and Adenocarcinoma

Familial adenomatous polyposis (FAP) was found to be completely reversed in a patient treated with mycophenolate mofetil (MMF) and tacrolimus following kidney transplantation. In this preliminary study, we assessed whether MMF and tacrolimus alone or in combination interfere with the cell cycle and proliferation in a human colonic adenocarcinoma cell line and in the colonic polyps of the patient with FAP.. Human colonic adenocarcinoma HT-29 cells were treated with tacrolimus and MMF alone and in combination at different concentrations. Cell viability and proliferation were assessed using the MTT assay. Cell-cycle distribution was analyzed by flow cytometry. Expression of Ki-67, a marker of mitotic activity, was evaluated in the patient's colonic polyps before and under drug treatment.. MMF in combination with tacrolimus induced S-phase cell-cycle arrest and markedly inhibited HT-29 cell proliferation. Ki-67 expression in the patient's colonic polyps was significantly reduced following combined tacrolimus and MMF treatment.. MMF and tacrolimus synergistically inhibited proliferation of a human colonic adenocarcinoma cell line and interfered with the expansion of colonic crypt proliferation in the polyp from a patient with FAP. The results confirm our clinical observation and indicate the possibility of novel approach to therapy of colorectal neoplasia.

Topics: Adenocarcinoma; Adenomatous Polyposis Coli; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Carcinogenesis; Cell Cycle Checkpoints; Cell Proliferation; Colon; Colonic Neoplasms; Drug Synergism; HT29 Cells; Humans; Immunosuppressive Agents; Ki-67 Antigen; Mycophenolic Acid; Tacrolimus

Topics: Adenocarcinoma; Aged; Colonic Neoplasms; Colostomy; Dermatitis; Diagnosis, Differential; Humans; Male; Postoperative Complications; Prednisone; Pyoderma Gangrenosum; Skin Neoplasms; Skin Ulcer; Surgical Stomas; Tacrolimus

Patients who undergo organ transplantation are now known to be at increased risk of the development of de novo malignant tumors. This is primarily a consequence of immunosuppression, which may promote tumor development and progression by a variety of mechanisms. It was also reported recently that the relative ratio of lung tumors developing in orthotopic liver transplantation patients was 3.7 times greater than in the general population. We report a case of de novo lung cancer diagnosed in a 65-year-old man 32 months after he underwent liver transplantation for hepatocellular carcinoma secondary to hepatitis C virus cirrhosis. He had received tacrolimus as immunosuppressive therapy after the liver transplantation. The tumor was resected, and he remains well almost 3 years later. Previous reports provide evidence that immunosuppressive therapy is a risk factor for de novo lung cancer; thus, it is important to reduce immunosuppression for orthotropic liver transplantation patients, and to screen them carefully to detect the tumor at an early stage.

Topics: Adenocarcinoma; Aged; Carcinoma, Hepatocellular; Hepatitis C, Chronic; Humans; Immunocompromised Host; Immunosuppression Therapy; Immunosuppressive Agents; Liver Neoplasms; Liver Transplantation; Lung Neoplasms; Male; Neoplasms, Second Primary; Tacrolimus

A 53-year-old man who underwent successful kidney transplantation for stage 5 chronic kidney disease presented to our clinic with intermittent painless gross hematuria. Urachal adenocarcinoma, stage III A by Sheldon system, was diagnosed after serial histopathologic and radiological studies. The patient was treated with extended partial cystectomy, en bloc resection of urachus and umbilicus, pelvic lymphadenectomy, and ileocystoplasty. There were no complications seen in this patient. Neither urachal adenocarcinoma recurrence, metastasis, nor de novo uroileal cancer developed during 48-month follow-up. His reconstructed bladder functioned efficiently, without compromising the transplanted kidney function. Our case demonstrated that conservative surgery and augmentation ileocystoplasty could be offered to kidney transplant recipients with localized urachal carcinoma.

Topics: Adenocarcinoma; Hematuria; Humans; Immunosuppressive Agents; Kidney Failure, Chronic; Kidney Neoplasms; Kidney Transplantation; Magnetic Resonance Imaging; Male; Middle Aged; Mycophenolic Acid; Neoplasm Staging; Prednisolone; Tacrolimus; Urachus

Malignancy is a dreaded complication following organ transplantation. Immunosuppressive therapy-induced impairment of the host immune system is the prevailing hypothesis for the high incidence and aggressive progression of post-transplant neoplasm. We summarize our observations supporting an autonomous cellular mechanism for cyclosporine and tacrolimus associated metastases. Cyclosporine conferred tumor invasiveness by a direct effect on the tumor cells and promoted metastases in T-, B-, and NK cell deficient SCID- beige mice, and anti-TGF-beta antibodies reduced metastases. Tacrolimus, another calcineurin inhibitor widely used in transplantation, induced TGF-beta secretion by tumor cells and promoted metastases in the SCID- beige mice. The immunosuppressive macrolide rapamycin reversed an invasive phenotype to a non-invasive one, reduced circulating levels of TGF-beta1 and prevented tumor growth and metastases in the immocompetant BALB/c mice and in the SCID-beige mice. Our studies, in addition to demonstrating a cell autonomous mechanism for tumor progression, advance TGF-beta blockade as an anti-tumor strategy.

Topics: Adenocarcinoma; Animals; Antineoplastic Agents; Cell Line, Tumor; Cyclosporine; Humans; Immunosuppressive Agents; Kidney Neoplasms; Lung Neoplasms; Mice; Mice, Inbred BALB C; Mice, Inbred DBA; Mice, SCID; Neoplasm Invasiveness; Neoplasms; Organ Transplantation; Phenotype; Sirolimus; Tacrolimus

While most BK virus infections are asymptomatic, immunosuppression has been associated with BK virus reactivation and impaired graft function or ureteric ulceration in renal transplant patients and hemorrhagic cystitis in bone marrow transplant patients. Oncogenicity is also postulated and this is the first report of a child with a carcinoma of the donor renal pelvis following BK virus allograft nephropathy. Removal of the primary tumor and cessation of immunosuppression led to regression of secondary tumors and a return to health.

Topics: Adenocarcinoma; BK Virus; Child; Genetic Diseases, X-Linked; Humans; Immunocompromised Host; Immunosuppressive Agents; Kidney Diseases; Kidney Neoplasms; Kidney Transplantation; Male; Polyomavirus Infections; Renal Insufficiency; Tacrolimus; Tumor Virus Infections

Obliterative bronchiolitis (OB) is the major cause of morbidity and mortality after lung transplantation. The potential role of immunosuppressive drugs in the development of OB is uncertain, but there are limited data indicating that cyclosporine A (CsA) may have a direct fibrogenic effect on various human cell types. Epithelium-fibroblast interactions have been suggested to play a crucial role in the course of fibroproliferation, which is a major feature of OB.. We studied the effect of CsA and FK506 on primary human lung fibroblast proliferation in a human epithelial-fibroblast interactive model.. Clinically relevant concentrations of CsA (0.1-1 microg/mL) and FK506 (0.001-0.01 microg/mL) did not affect fibroblast proliferation in monocultures. Conditioned medium (CM) from untreated epithelial cells (Calu-3) stimulated fibroblast proliferation. CM from FK506-treated (0.001-0.1 microg/mL) epithelial cells had no significant additive effect on fibroblast proliferation compared with CM of untreated epithelial cells. In contrast, CM obtained from epithelial cells treated with 0.1 microg/mL CsA significantly enhanced fibroblast proliferation compared with CM of untreated epithelial cells. This proliferative effect of 0.1 microg/mL CsA was mediated by epithelial-derived factors greater than 100 kDa.. These data demonstrate that a clinically relevant concentration of CsA stimulates fibroblast proliferation through mediators produced by airway epithelial cells, raising the possibility that CsA may contribute to the development of OB after lung transplantation.

Topics: Adenocarcinoma; Cell Division; Cell Line, Tumor; Culture Media, Conditioned; Cyclosporine; Fibroblasts; Humans; Immunosuppressive Agents; Lung Neoplasms; Respiratory Mucosa; Tacrolimus

Oxidative stress can lead to cellular injury and apoptosis within the pulmonary allograft. We investigated the effects of oxidative damage on the growth and survival of cultured human pulmonary epithelial cells treated with hydrogen peroxide (H(2)O(2)) in the presence and absence of cyclosporin A (CsA) and tacrolimus. Treatment of A549 cells with 1 mmol/l H(2)O(2) for 48 h led to a 39% decrease in cell growth. Treatment with 500 ng/ml CsA for 48 h reduced cell survival by 68%, and treatment with 30 ng/ml tacrolimus reduced cell survival by 32%. The addition of CsA or tacrolimus to cells grown in H(2)O(2) did not further diminish cell survival. These studies demonstrated that H(2)O(2), CsA, and tacrolimus treatments decrease survival of pulmonary epithelial cells. However, CsA and tacrolimus do not further potentiate H(2)O(2)-induced toxicity.

Topics: Adenocarcinoma; Cell Line, Tumor; Cell Survival; Cyclosporine; Humans; Hydrogen Peroxide; Lung Neoplasms; Oxidative Stress; Respiratory Mucosa; Tacrolimus

Malignancy is a dreaded complication of organ transplantation. Immunosuppressive drug therapy-induced impairment of the organ graft recipient's immune surveillance is considered to be the mechanism for the heightened incidence and metastatic progression. We identified a cell-autonomous and host-immunity independent mechanism for cyclosporine-associated tumor progression. In this study, we investigated the effect of rapamycin on tumor progression, in the presence and absence of cyclosporine.. A spontaneously arising renal adenocarcinoma (renal cancer) of BALB/c origin was used as the model tumor. The effect of rapamycin on renal cancer cell phenotype, molecules (E-cadherin, p27 kip1, cyclin D1) implicated in tumor progression, and the effect of rapamycin on in vivo tumor progression were explored in BALB/c mice and in T-cell, B-cell, and natural killer (NK) cell-deficient severe combined immune deficiency (SCID)-beige mice. In the SCID-beige mice, T24 human bladder transitional cell carcinoma also was used as the tumor inoculum.. Rapamycin conditioning of renal cancer cells upregulated E-cadherin expression and induced phenotypic transition from invasive spindle, or dome-shaped cells, with exploratory pseudopodia to noninvasive cuboidal cells that formed cell-to-cell adhesions. Rapamycin increased p27 kip1, reduced cyclinD1, and arrested the growth of renal cancer cells in G1/S phase. In vivo, rapamycin prevented tumor growth and metastatic progression in syngeneic BALB/c or SCID-beige mice, and in BALB/c or SCID-beige mice treated with cyclosporine. Rapamycin treatment alone, or with cyclosporine, prolonged the survival of mice inoculated with renal cancer cells or T24 human bladder cancer cells.. Our findings, in addition to unlinking mechanisms of immunosuppression from that of tumor progression, suggest that rapamycin may be of value for the management of posttransplant malignancy.

Topics: Adenocarcinoma; Animals; Antibiotics, Antineoplastic; B-Lymphocytes; Cadherins; Carcinoma, Renal Cell; Cell Cycle Proteins; Cyclin D1; Cyclin-Dependent Kinase Inhibitor p27; Disease Progression; DNA Primers; Genes, Tumor Suppressor; Immunosuppression Therapy; Immunosuppressive Agents; Kidney Neoplasms; Killer Cells, Natural; Mice; Mice, Inbred BALB C; Mice, SCID; Sirolimus; T-Lymphocytes; Tacrolimus; Tumor Cells, Cultured; Tumor Suppressor Proteins

Topics: Adenocarcinoma; Animals; Colonic Neoplasms; fas Receptor; Gene Expression Regulation, Neoplastic; Genes, p53; Immunosuppressive Agents; Male; Mice; Mice, Inbred C57BL; Tacrolimus; Tumor Suppressor Protein p53

We examined alterations in cell morphology and expression of adhesion molecules in response to a general protein kinase inhibitor K252a treatment of non-adherent colon adenocarcinoma Colo201 cells. K252a induced rapid cell adhesion and spreading with concomitant formation of actin stress fibers. A protein kinase A inhibitor KT5720 also induced cell adhesion, but the rate of spread was slower than that seen with K252a. These adhesions were mediated by integrin molecules since cell adhesion required Mg2+, Mn2+ or Ca2+, and was inhibited by monoclonal antibodies for integrins alpha2 and beta1. Indirect immunofluorescence microscopic observations revealed that integrin alpha2 and beta1 molecules in K252a-treated cells were concentrated at sites of focal adhesion, but expressions of integrin molecules were not modulated. Tyrosine phosphorylation of focal adhesion kinase (FAK) and paxillin increased during K252a- or KT5720-induced cell adhesion. Immunosuppressants FK506 and cyclosporin A suppressed the K252a-induced cell adhesion and abolished tyrosine phosphorylation of cellular proteins including FAK and paxillin. Furthermore, W7 and calmidazolium, inhibitors of calmodulin, also inhibited the cell adhesion. Based on findings that FK506 and cyclosporin A are inhibitors of the calcium calmodulin-dependent protein phosphatase, calcineurin, this phosphatase may regulate integrin-dependent cell adhesion and spread of Colo201 cells. This Colo201 cell model provides a pertinent system for studying molecules involved in signal transduction pathways and can shed light on mechanisms of metastasis and invasion of colon carcinoma cells.

Topics: Adenocarcinoma; Carbazoles; Cell Adhesion; Cell Adhesion Molecules; Colonic Neoplasms; Cyclosporine; Cytoskeletal Proteins; Enzyme Inhibitors; Extracellular Matrix; Focal Adhesion Kinase 1; Focal Adhesion Protein-Tyrosine Kinases; Humans; Immunosuppressive Agents; Indole Alkaloids; Indoles; Integrins; Neoplasm Metastasis; Paxillin; Phosphoproteins; Phosphorylation; Protein Kinase C; Protein-Tyrosine Kinases; Pyrroles; Sulfonamides; Tacrolimus; Tumor Cells, Cultured; Tyrosine

Rats transplanted with the androgen-sensitive, syngeneic Dunning R3327 PAP prostatic tumor were castrated and treated with estrogen or vehicle for 4, 12 and 24 hr and for 6 weeks. Tumor growth was retarded by castration and further inhibited by estrogen. Immediately after castration, an increased number of activated macrophages and T-cells were found in parallel with increasing apoptotic tumor cells. Administration of an immunosuppressive drug, FK 506, abolished the growth-inhibitory effects of castration and estrogen. The tumor growth rate correlated negatively with the number of R73- and OX8-positive T-cells and NK cells and with the percentage of ED3-positive macrophages. There was a positive correlation between the percentage of TdT-mediated-dUTP nick end labeling (TUNEL)-positive apoptotic cells and that of ED3-positive cells. Our results suggest that apoptosis of prostatic carcinoma cells induced by endocrine treatment in vivo is partly due to a rapid infiltration by immunocompetent cells.

Topics: Adenocarcinoma; Animals; Apoptosis; Cell Division; Estradiol; Immunosuppressive Agents; Killer Cells, Natural; Macrophage Activation; Macrophages; Male; Orchiectomy; Prostatic Neoplasms; Rats; T-Lymphocytes, Cytotoxic; Tacrolimus; Tumor Cells, Cultured

Xenobiotics frequently induce proteins involved in their detoxification. Because many drugs that are metabolized by human cytochromes P450 (CYP) 3A4 and 3A5 are also transported by the drug efflux pump P-glycoprotein, we determined whether expression of these proteins was altered by a variety of drugs in a cell line derived from a human colon adenocarcinoma, LS180/WT, and its adriamycin-resistant subline, LS180/AD50. P-glycoprotein and CYP3A4 were constitutively expressed in both LS180/AD50 and LS180/WT cells, and both proteins were up-regulated after treatment with many drugs, including rifampicin, phenobarbital, clotrimazole, reserpine, and isosafrole. However, there were some exceptions because P-glycoprotein was up-regulated by midazolam and nifedipine, whereas CYP3A4 was not. CYP3A5, which is also constitutively expressed in these cells, remained unchanged with most drug treatments but was up-regulated by reserpine and clotrimazole. The apparent coordinated coexpression of the CYP3A gene family and P-glycoprotein in the LS180 cells suggests that for common orally administered drugs, P-glycoprotein may play an important role in net drug absorption and drug/drug interactions of shared CYP3A4/P-glycoprotein substrates.

Topics: Adenocarcinoma; ATP Binding Cassette Transporter, Subfamily B, Member 1; Base Sequence; Blotting, Northern; Cell Line; Clotrimazole; Colonic Neoplasms; Cytochrome P-450 CYP2E1; Cytochrome P-450 Enzyme System; Dexamethasone; DNA Primers; Doxorubicin; Gene Expression Regulation, Neoplastic; Humans; Midazolam; Mixed Function Oxygenases; Molecular Sequence Data; Multigene Family; Phenobarbital; Phenytoin; Polymerase Chain Reaction; Rifampin; Tumor Cells, Cultured; Verapamil

A novel antitumor bicyclic depsipeptide, FR901228, was isolated from a broth culture of Chromobacterium violaceum No. 968 as colorless prisms and the molecular formula was determined as C24H36N4O6S2. This antibiotic reverted the transformed morphology of a Ha-ras transformant to normal, and exhibited prominent antitumor activities against murine and human tumor cell lines both in vitro and in vivo.

Topics: 3T3 Cells; Adenocarcinoma; Animals; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Carcinoma; Cell Line, Transformed; Chromobacterium; Depsipeptides; Drug Screening Assays, Antitumor; Female; Fermentation; Humans; Magnetic Resonance Spectroscopy; Mice; Mice, Inbred C57BL; Mice, Inbred DBA; Mice, Nude; Microbial Sensitivity Tests; Neoplasm Transplantation; Peptides, Cyclic; Tacrolimus; Tumor Cells, Cultured