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Biomedical subjects

J William Harbour

Publications and source records attributed to J William Harbour.

At least 19 recordsLinked to original sources
PubMed2006

Functional gene expression analysis uncovers phenotypic switch in aggressive uveal melanomas.

Microarray gene expression profiling is a powerful tool for generating molecular cancer classifications. However, elucidating biological insights from these large data sets has been challenging. Previously, we identified a gene expression-based classification of primary uveal melanomas that accurately predicts metastatic death. Class 1 tumors have a low risk and class 2 tumors a high risk for metastatic death. Here, we used genes that discriminate these tumor classes to identify biological correlates of the aggressive class 2 signature. A search for Gene Ontology categories enriched in our class-discriminating gene list revealed a global down-regulation of neural crest and melanocyte-specific genes and an up-regulation of epithelial genes in class 2 tumors. Correspondingly, class 2 tumors exhibited epithelial features, such as polygonal cell morphology, up-regulation of the epithelial adhesion molecule E-cadherin, colocalization of E-cadherin and beta-catenin to the plasma membrane, and formation of cell-cell adhesions and acinar structures. One of our top class-discriminating genes was the helix-loop-helix inhibitor ID2, which was strongly down-regulated in class 2 tumors. The class 2 phenotype could be recapitulated by eliminating Id2 in cultured class 1 human uveal melanoma cells and in a mouse ocular melanoma model. Id2 seemed to suppress the epithelial-like class 2 phenotype by inhibiting an activator of the E-cadherin promoter. Consequently, Id2 loss triggered up-regulation of E-cadherin, which in turn promoted anchorage-independent cell growth, a likely antecedent to metastasis. These findings reveal new roles for Id2 and E-cadherin in uveal melanoma progression, and they identify potential targets for therapeutic intervention.

Animals↗
PubMed2006

Lipid exudation following plaque radiotherapy for posterior uveal melanoma.

PURPOSE: To investigate factors associated with lipid exudation after plaque radiotherapy for uveal melanoma. DESIGN: Retrospective interventional case series. METHODS: Records of 139 consecutive uveal melanoma patients treated with I-125 plaque radiotherapy were reviewed. Lipid exudation was the major outcome measured. RESULTS: Lipid exudation was detected in 19 patients (13.7%). Mean time from plaque therapy to lipid exudation was 10 months (range, 3-23 months). Lipid exudation was associated with younger patient age (P = .0002), increased low-density lipoprotein (P = .004), decreased high-density lipoprotein (P = .026), increased tumor thickness (P = .024), and exudative retinal detachment (P = .016). Patients with lipid exudation had worse visual outcome (P < .0001) and increased neovascular glaucoma (P = .01). CONCLUSIONS: Lipid exudation after plaque radiotherapy for uveal melanoma is associated with poor ocular outcome. Factors associated with this lipid exudation are distinct from those associated with radiation retinopathy, and they may suggest interventions to combat this complication.

Brachytherapy↗
PubMed2006

Rb at the interface between cell cycle and apoptotic decisions.

The retinoblastoma (RB) gene was the first tumor suppressor to be identified, and it continues to be the subject of intense scientific interest. Not only is the RB gene mutated in the rare eye tumor and some other cancers, the Rb protein is functionally inactivated in virtually all human cancers, suggesting that it plays a general role in cellular homeostasis. Rb initially was envisaged as a simple 'on-off' regulator of the cell cycle, and this function was thought to account for its role as a tumor suppressor. Subsequently, however, closer scrutiny revealed unexpected and complex properties of Rb that together contribute to the unique role of Rb in cell biology. For example, Rb appears to be dispensable for normal cell cycling, but it has a special role in triggering permanent cell cycle exit associated with differentiation and senescence. Further, although the role of Rb as tumor suppressor is firmly established, it also has the ability to block apoptosis, which is generally thought to be a property of oncogenes. Our lab has been interested in understanding the dual and seemingly incongruous roles of Rb in cell cycle control and apoptosis. For many of these studies, we have chosen the melanocyte lineage as a model cell system because of the established role for Rb in melanocyte differentiation and survival, and the frequent deregulation of the Rb pathway in melanoma.

Animals↗
PubMed2006

Prognostic testing in uveal melanoma by transcriptomic profiling of fine needle biopsy specimens.

Many uveal melanoma patients die of metastasis despite ocular treatment. Transcriptomic profiling of enucleated tumors can identify patients at high metastatic risk. Because most uveal melanomas do not require enucleation, a biopsy would be required for this analysis. Here, we establish the feasibility of transcriptomic analysis of uveal melanomas from fine needle aspirates. Transcriptomic profiles were analyzed from postenucleation "mock" needle biopsies and matching tumors from eight enucleated eyes and from fine needle aspirates in 17 uveal melanomas before radiotherapy. Predictive accuracy was assessed using a weighted voting classifier optimized for probe set selection using a minimal redundancy/maximum relevance algorithm. Transcriptomic profiles from mock biopsies were highly similar to those from their matching tumor samples (P < 0.0001). Transcriptomic profiles from fine needle aspirates clustered into two classes with discriminating probe sets that overlapped significantly with those for our published classification (P < 0.00001). No loss of predictive accuracy was identified among eight needle aspirates obtained from a distant location. Thus, it is feasible to obtain RNA of adequate quality and quantity to perform transcriptomic analysis on uveal melanoma samples obtained by fine needle biopsy. This method can be applied to specimens obtained from distant geographic locations and can stratify uveal melanoma patients based on metastatic risk.

Adult↗
PubMed2005

DDEF1 is located in an amplified region of chromosome 8q and is overexpressed in uveal melanoma.

PURPOSE: The molecular pathogenesis of uveal melanoma is poorly understood but is usually accompanied by amplification of chromosome 8q, suggesting the activation of one or more oncogenes. We recently identified a gene expression profile that distinguishes low-grade from high-grade melanomas. In this profile, a cluster of genes at chromosome 8q was overexpressed in high-grade tumors, providing an opportunity to search for potential oncogenes in this region. EXPERIMENTAL DESIGN: Gene expression microarray analysis was done on 25 primary uveal melanomas. Microarray comparative genomic hybridization (CGH), quantitative PCR, and immunohistochemistry were done on a subset of these tumors. Cell motility was measured using a wound-healing assay. RESULTS: In melanomas analyzed for microarray gene expression and CGH, gain of chromosome 8q correlated most strongly with expression of DDEF1, a gene located at 8q24. In contrast, the nearby MYC oncogene exhibited no significant change in expression. Confirming the microarray findings, DDEF1 mRNA levels and protein expression were significantly higher in high-grade melanomas. Furthermore, ectopic expression of DDEF1 in low-grade melanoma cells resulted in a significant increase in cell motility, a feature of high-grade metastasizing cells. CONCLUSIONS: These findings suggest that DDEF1 overexpression may be a pathogenetically relevant consequence of chromosome 8q amplification, which commonly occurs in high-grade uveal melanomas. We conclude that DDEF1 may act as an oncogene in this cancer, and it may be a useful diagnostic marker and therapeutic target.

Adaptor Proteins, Signal Transducing↗
PubMed2005

NBS1 expression as a prognostic marker in uveal melanoma.

PURPOSE: Up to half of uveal melanoma patients die of metastatic disease. Treatment of the primary eye tumor does not improve survival in high-risk patients due to occult micrometastatic disease, which is present at the time of eye tumor diagnosis but is not detected and treated until months to years later. Here, we use microarray gene expression data to identify a new prognostic marker. EXPERIMENTAL DESIGN: Microarray gene expression profiles were analyzed in 25 primary uveal melanomas. Tumors were ranked by support vector machine (SVM) and by cytologic severity. Nbs1 protein expression was assessed by quantitative immunohistochemistry in 49 primary uveal melanomas. Survival was assessed using Kaplan-Meier life-table analysis. RESULTS: Expression of the Nijmegen breakage syndrome (NBS1) gene correlated strongly with SVM and cytologic tumor rankings (P < 0.0001). Further, immunohistochemistry expression of the Nbs1 protein correlated strongly with both SVM and cytologic rankings (P < 0.0001). The 6-year actuarial survival was 100% in patients with low immunohistochemistry expression of Nbs1 and 22% in those with high Nbs1 expression (P = 0.01). CONCLUSIONS: NBS1 is a strong predictor of uveal melanoma survival and potentially could be used as a clinical marker for guiding clinical management.

Biomarkers, Tumor↗
PubMed2005

Loss of Rb-E2F repression results in caspase-8-mediated apoptosis through inactivation of focal adhesion kinase.

Molecular hardwiring of the cell cycle to the apoptotic machinery is a critical tumor suppressor mechanism for eliminating hyperproliferative cells. Deregulation of the Rb-E2F repressor complex by genetic deletion or functional inhibition of Rb triggers apoptosis through both the intrinsic (caspase-9 mediated) and extrinsic (caspase-8 mediated) death pathways. Induction of the intrinsic pathway has been studied extensively and involves release of free E2F and direct transcriptional activation of E2F-responsive apoptotic genes such as ARF, APAF1, and CASP9. In contrast, the mechanisms leading to activation of the extrinsic pathway are less well understood. There is growing evidence that Rb-E2F perturbation induces the extrinsic pathway, at least in part, through derepression (as opposed to transactivation) of apoptotic genes. Here, we explore this possibility using cells in which Rb-E2F complexes are displaced from promoters without stimulating E2F transactivation. This derepression of Rb-E2F-regulated genes leads to apoptosis through inactivation of focal adhesion kinase and activation of caspase-8. These findings reveal a new mechanistic link between Rb-E2F and the extrinsic (caspase 8-mediated) apoptotic pathway.

ADP-Ribosylation Factors↗
PubMed2005

Association between microarray gene expression signature and extravascular matrix patterns in primary uveal melanomas.

PURPOSE: To determine whether there is an association between gene expression profile and looping extravascular matrix patterns in primary uveal melanomas. DESIGN: Laboratory investigation. METHODS: Formalin-fixed, paraffin-embedded sections from 22 primary uveal melanomas that previously were analyzed by microarray gene expression profiling were stained for periodic acid-Schiff and scored in a masked fashion for the presence of looping extravascular matrix patterns. RESULTS: A strong association was observed between looping patterns and the unfavorable class 2 molecular prognostic signature (P < .001). CONCLUSIONS: Looping extravascular matrix patterns occur almost exclusively in class 2 uveal melanomas. This finding may provide new insights into the pathogenesis and management of uveal melanoma.

Gene Expression↗
PubMed2005

Functional analysis of the p53 pathway in response to ionizing radiation in uveal melanoma.

PURPOSE: Uveal melanomas are notoriously radioresistant and thus necessitate treatment with extremely high radiation doses that often cause ocular complications. The p53 tumor suppressor pathway is a major mediator of the cellular response to radiation-induced DNA damage, suggesting that this pathway may be defective in uveal melanoma. The current study was conducted to analyze the functional integrity of the p53 pathway in primary uveal melanoma cells. METHODS: The p53 gene was sequenced in three primary uveal melanoma cells lines. Cultured primary uveal melanoma cells (MM28, MM50, Mel202, Mel270, and Mel290), MCF7 breast carcinoma cells, normal uveal melanocytes (UM47), and normal human diploid fibroblasts (NHDFs) were irradiated at 250 kVp and 12 mA at a dose rate of 1.08 Gy/min for a total dose of up to 20 Gy. Cell viability was analyzed with trypan blue exclusion. Western blot analysis was used to analyze the expression of p53, p53-phospho-Ser15, p21, Bax, PUMA, and Bcl-x(L). RESULTS: No p53 gene mutations were found in MM28, MM50, or Mel270 cells. Upstream signaling to p53 was intact, with normal induction of p53 and phosphorylation of p53-Ser15, in all five cell lines. Radiation-induced downstream activation of p21 was defective in MM28 and MM50 cells, and activation of Bax was defective in MM50 and Mel290 cells. MM28, MM50, and Mel202 cells failed to deamidate Bcl-x(L) in response to radiation-induced DNA damage. Overall, four of the five uveal melanoma cell lines exhibited at least one downstream defect in the p53 pathway. CONCLUSIONS: Expression of p53 and upstream signaling to p53 in response to radiation-induced DNA damage appear to be intact in most uveal melanomas. In contrast, functional defects in the p53 pathway downstream of p53 activation appear to be common. Further elucidation of p53 pathway abnormalities in uveal melanoma may allow therapeutic interventions to increase the radiosensitivity of the tumors.

Apoptosis Regulatory Proteins↗
PubMed2004

MITF links differentiation with cell cycle arrest in melanocytes by transcriptional activation of INK4A.

Cell cycle exit is required for proper differentiation in most cells and is critical for normal development, tissue homeostasis, and tumor suppression. However, the mechanisms that link cell cycle exit with differentiation remain poorly understood. Here, we show that the master melanocyte differentiation factor, microphthalmia transcription factor (MITF), regulates cell cycle exit by activating the cell cycle inhibitor INK4A, a tumor suppressor that frequently is mutated in melanomas. MITF binds the INK4A promoter, activates p16(Ink4a) mRNA and protein expression, and induces retinoblastoma protein hypophosphorylation, thereby triggering cell cycle arrest. This activation of INK4A was required for efficient melanocyte differentiation. Interestingly, MITF was also required for maintaining INK4A expression in mature melanocytes, creating a selective pressure to escape growth inhibition by inactivating INK4A. These findings demonstrate that INK4A can be regulated by a differentiation factor, establish a mechanistic link between melanocyte differentiation and cell cycle exit, and potentially explain the tissue-specific tendency for INK4A mutations to occur in melanoma.

Animals↗
PubMed2004

Gene expression profiling in uveal melanoma reveals two molecular classes and predicts metastatic death.

Melanomas are notoriously difficult to classify because of a lack of discrete clinical and pathological stages. Here, we show that primary uveal melanomas surprisingly cluster into two distinct molecular classes based on gene expression profile. Genes that discriminate class 1 (low-grade) from class 2 (high-grade) include highly significant clusters of down-regulated genes on chromosome 3 and up-regulated genes on chromosome 8q, which is consistent with previous cytogenetic studies. A three-gene signature allows biopsy-size tumor samples to be assigned accurately to tumor classes using either array or PCR platforms. Most importantly, this molecular classification strongly predicts metastatic death and outperforms other clinical and pathological prognostic indicators. These studies offer new insights into melanoma pathogenesis, and they provide a practical foundation for effective clinical predictive testing.

Chromosome Aberrations↗
PubMed2004

Photodynamic therapy for choroidal metastasis from carcinoid tumor.

PURPOSE: To determine the efficacy of photodynamic therapy for the treatment of a choroidal metastasis unresponsive to chemotherapy and radiation therapy. DESIGN: Interventional case report. METHODS: Photodynamic therapy with verteporfin was performed. Visual acuity, local tumor control, and complications were assessed. RESULTS: A 72-year-old woman was diagnosed with bilateral, biopsy-proven choroidal metastasis from a pulmonary carcinoid tumor that was resistant to chemotherapy and radiotherapy. The tumor in the left eye caused a retinal detachment and vision loss to light perception. The smaller lesion in the right eye progressively enlarged toward the fovea despite therapy and was treated with photodynamic therapy with verteporfin. Within 2 months, the exudative detachment resolved, the visual acuity returned to baseline, and the tumor volume decreased by 50%. CONCLUSION: Photodynamic therapy may be an effective treatment option for selected patients with choroidal metastasis.

Aged↗
PubMed2004

Optical coherence tomography in the evaluation of retinal changes associated with suspicious choroidal melanocytic tumors.

PURPOSE: Subretinal fluid (SRF) is a strong risk factor for growth of choroidal melanocytic tumors. However, subtle SRF can be difficult to assess clinically and to distinguish from chronic retinal changes overlying a dormant lesion. This study investigates optical coherence tomography (OCT) in evaluating SRF in suspicious choroidal melanocytic tumors. DESIGN: Interventional case series. METHODS: Review of 33 patients with untreated choroidal melanocytic tumors who underwent OCT for suspicion of subtle SRF. Fluorescein angiography was performed in 26 of the patients. The main outcome was tumor growth. RESULTS: No retinal separation was found in 12 tumors, of which 1 (8%) grew on follow-up and 3 (25%) were treated. Chronic retinal changes (localized retinal separation with retinal atrophy or intraretinal cysts) were found in nine tumors: one (11%) grew on follow-up and none were treated. Active SRF (localized retinal separation with normal retinal appearance) was found in 12 tumors: 6 (50%) grew on follow-up, and 7 (58%) were treated. The active OCT pattern was associated with fluorescein angiography hotspots (P =.041), documented tumor growth (P =.033), and tumor treatment (P =.014), and inversely associated with drusen (P =.024), atrophic retinal pigment epithelium changes surrounding the tumor (P =.048), and intraretinal cysts by OCT (P =.002). CONCLUSIONS: Optical coherence tomography is useful in distinguishing active subretinal fluid from chronic retinal changes overlying a choroidal melanocytic tumor. Optical coherence tomography findings may have predictive value in identifying tumors that are likely to grow and require treatment.

Adult↗