vasoactive-intestinal-peptide and Urinary-Bladder-Neoplasms

INTRODUCTION Accurate staging of urothelial bladder cancer (UBC) with imaging, which guides effective bladder cancer treatment, remains challenging. This investigation is to validate a hypothesis that targeting Vasoactive intestinal and pituitary adenylate cyclase activating peptide (VPAC) receptors using ⁶⁴Cu-TP3805 can PET image UBC efficiently.. Nineteen patients (44-84 years of age) scheduled for radical cystectomy, underwent VPAC positron emission tomography (PET) imaging prior to surgery. Sixteen had completed neoadjuvant chemotherapy prior to imaging. All 19 received ⁶⁴Cu-TP3805 (148 % ± 10% MBq) intravenously, and were imaged 60 to 90 minutes later. Standard uptake value (SUV)max for malignant lesions and SUVmean for normal tissues were determined and mean +/-SEM recorded. Following radical cystoprostatectomy, pelvic lymphadenectomy and urinary diversion imaging, results were compared with final surgical pathology.. ⁶⁴Cu-TP3805 had no adverse events, negligible urinary excretion and rapid blood clearance. UBC PET images for residual disease were true positive in 11 patients and true negative in four. Of remaining 4, one had false positive and 3 had false negative scans, equating to 79% sensitivity (95%, CI 49%-95%), 80% specificity (95%, CI 28%-100%), 92% positive predictive value (95%, CI 62%-100%) and 57% negative predictive value (95%, CI 18%-90%).. These first in man results, in a group, heavily pretreated with neoadjuvant chemotherapy, indicate that VPAC PET imaging can identify UBC effeiciently and suggest, that VPAC PET can diagnose UBC in a treatment naïve cohort for accurate staging, guide biopsy and treatment in patients with suspected metastasis and determine response to therapy. Further investigation of this molecular imaging approach is warranted.

Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Transitional Cell; Coordination Complexes; Cystectomy; Humans; Middle Aged; Peptides; Pituitary Adenylate Cyclase-Activating Polypeptide; Tomography, X-Ray Computed; Urinary Bladder Neoplasms; Vasoactive Intestinal Peptide

The proto-oncogene proviral integration site for moloney murine leukemia virus (PIM) kinases (PIM-1, PIM-2, and PIM-3) are serine/threonine kinases that are involved in a number of signaling pathways important to cancer cells. PIM kinases act in downstream effector functions as inhibitors of apoptosis and as positive regulators of G1-S phase progression through the cell cycle. PIM kinases are upregulated in multiple cancer indications, including lymphoma, leukemia, multiple myeloma, and prostate, gastric, and head and neck cancers. Overexpression of one or more PIM family members in patient tumors frequently correlates with poor prognosis. The aim of this investigation was to evaluate PIM expression in low- and high-grade urothelial carcinoma and to assess the role PIM function in disease progression and their potential to serve as molecular targets for therapy. One hundred thirty-seven cases of urothelial carcinoma were included in this study of surgical biopsy and resection specimens. High levels of expression of all three PIM family members were observed in both noninvasive and invasive urothelial carcinomas. The second-generation PIM inhibitor, TP-3654, displays submicromolar activity in pharmacodynamic biomarker modulation, cell proliferation studies, and colony formation assays using the UM-UC-3 bladder cancer cell line. TP-3654 displays favorable human ether-à-go-go-related gene and cytochrome P450 inhibition profiles compared with the first-generation PIM inhibitor, SGI-1776, and exhibits oral bioavailability. In vivo xenograft studies using a bladder cancer cell line show that PIM kinase inhibition can reduce tumor growth, suggesting that PIM kinase inhibitors may be active in human urothelial carcinomas.

Topics: Animals; Antineoplastic Agents; Blotting, Western; Carcinoma, Transitional Cell; Female; Humans; Imidazoles; Male; Mice; Mice, Nude; Multiplex Polymerase Chain Reaction; Oligopeptides; Protein Kinase Inhibitors; Proto-Oncogene Mas; Proto-Oncogene Proteins c-pim-1; Pyridazines; Rats; Rats, Sprague-Dawley; Reverse Transcriptase Polymerase Chain Reaction; RNA, Small Interfering; Transduction, Genetic; Urinary Bladder Neoplasms; Vasoactive Intestinal Peptide; Xenograft Model Antitumor Assays

Specimens of the detrusor muscle of the bladder from four patients with lower motor neurone lesion and three patients with carcinoma of the bladder used as "controls", were studied immunohistochemically for vasoactive intestinal polypeptide, neuropeptide Y, calcitonin-gene related peptide, substance P and somatostatin. The greatest density of nerves in the bladder from "control" patients contained neuropeptide Y, followed in a decreasing order by vasoactive intestinal polypeptide, calcitonin gene-related peptide, substance P and somatostatin. Neuropeptide Y- and vasoactive intestinal polypeptide-immunoreactive nerves were found throughout the smooth muscle and the base of the mucosa, while calcitonin gene-related peptide-, substance P- and somatostatin-immunoreactive nerves were found predominantly in nerve bundles with a few single fibres at the base of the mucosa. Vasoactive intestinal polypeptide-, neuropeptide Y- and calcitonin gene-related peptide-immunoreactive nerves were also located around blood vessels. In patients with lower motor neurone lesion, there was a decrease in the density of vasoactive intestinal polypeptide-, calcitonin gene-related peptide- and substance P-immunoreactive nerves, but there was little change in neuropeptide Y- or somatostatin-immunoreactive nerves. Urinary retention, bladder areflexia and deficient sensation may be directly linked to neuropeptide neuropathy in patients with lower motor neurone lesion.

Topics: Adult; Calcitonin Gene-Related Peptide; Fluorescent Antibody Technique; Humans; Male; Meningomyelocele; Neuropeptide Y; Somatostatin; Substance P; Urinary Bladder; Urinary Bladder Neoplasms; Urinary Bladder, Neurogenic; Vasoactive Intestinal Peptide

In order to evaluate a possible role of several peptides in the human urogenital tract, peptide concentrations in urogenital tissues collected from surgery were measured using specific radioimmunoassay. The specimens were extracted in boiling 0.5M acetic acid, and these extracts were utilized to measure neuropeptide concentrations, i.e., neuropeptide Y(NPY), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP) and peptide 7B2. The highest concentrations of NPY were found in seminal vesicle (145 +/- 42pmol/g) and vas deference (104 +/- 26pmol/g). There was no significant difference in NPY concentration between malignant and non-malignant tissues (prostate and urinary bladder). High concentrations of VIP were also observed in several urogenital tissues (seminal vesicle, vas deference and urethra). VIP concentrations in prostatic cancer and carcinoma of urinary bladder seemed to be reduced, though no significant difference could be found in each corresponding tissue. Pituitary peptide 7B2 was found to be present in the human urogenital tract in relatively low concentrations. A significant difference was observed in CGRP concentration between carcinoma of urinary bladder and adjacent normal vesicular tissues (p less than 0.05). These four peptide immunoreactivities were further characterized by gel permeation or high performance liquid chromatography. Each main immunoreactivity in urogenital extracts seemed to correspond to each synthetic standard or pituitary extracts (in case of 7B2). These results demonstrated that pituitary peptide 7B2 was shown to be present in the human urogenital tract and that the distribution patterns of these peptides might correlate to their pathophysiological role in the urogenital tract. Furthermore, the absence of CGRP immunoreactivity in carcinoma of urinary bladder may be useful for additional diagnostic information.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcitonin Gene-Related Peptide; Child; Child, Preschool; Chromatography, Gel; Chromatography, High Pressure Liquid; Female; Humans; Male; Middle Aged; Nerve Tissue Proteins; Neuroendocrine Secretory Protein 7B2; Neuropeptide Y; Neuropeptides; Pituitary Hormones; Prostatic Hyperplasia; Prostatic Neoplasms; Radioimmunoassay; Urinary Bladder Neoplasms; Urogenital Neoplasms; Urogenital System; Vasoactive Intestinal Peptide

Specimens obtained by transurethral sphincterectomy from patients with spinal cord injury and carcinoma of the bladder were studied immunohistochemically. In the smooth muscle region of the sphincter, vasoactive intestinal polypeptide-, substance P- and somatostatin-immunoreactive fluorescent, varicose nerve fibers were seen. In the striated muscle region, VIP-immunoreactive nerves were found around striated muscle fibers and bundles, while somatostatin- and substance P-immunoreactive nerves were confined to nerve bundles. In both the smooth and striated muscle regions of the intrinsic external urethral sphincter, VIP-immunoreactive nerves were seen around blood vessels. No differences were observed in the immunohistochemical localization of these peptide-containing nerves in the two groups of patients. No immunofluorescence for [Met]enkephalin, bombesin, neurotensin or serotonin was found in any nerves in the urethra.

Topics: Adolescent; Adult; Aged; Fluorescent Antibody Technique; Humans; Muscle, Smooth; Muscles; Nerve Fibers; Somatostatin; Spinal Cord Injuries; Substance P; Urethra; Urinary Bladder Neoplasms; Urinary Bladder, Neurogenic; Vasoactive Intestinal Peptide