Shigeki Miyamoto, Ph.D.
Professor, McArdle Laboratory for Cancer Research – UW Carbone Cancer Center
Department of Oncology, School of Medicine and Public Health
University of Wisconsin-Madison
“Inside-out” NF-κB signaling in cancer and other pathologies
The NF-κB/Rel family of transcription factors contributes to critical cellular processes, including immune, inflammatory and cell survival responses. As such, NF-κB is implicated in immunity-related diseases, as well as multiple types of human malignancies. Indeed, genetic alterations in the NF-κB signaling pathway are frequently observed in multiple human malignancies. NF-κB is normally kept inactive in the cytoplasm by inhibitor proteins. Extracellular ligands can induce the release of NF-κB from the inhibitors to allow its migration into the nucleus to regulate a variety of target genes. NF-κB activation is also induced in response to multiple stress conditions, including those induced by DNA-damaging anticancer agents. Although precise mechanisms are still unclear, research from our group has revealed a unique nuclear-to-cytoplasmic signaling pathway. In collaboration with bioengineers, clinicians and pharmaceutical industry, our lab has developed new methods to analyze primary cancer patient samples and identified several compounds with different mechanisms that mitigate this cell survival pathway. Further contributions from other labs have also revealed additional mechanisms and molecular players in this “inside-out” signaling pathway and expanded its role in other physiological and pathological processes, including B cell development, premature aging and therapy resistance of certain cancers. Our own new findings, along with these recent developments in the field, will be highlighted.
H S M Kort, J-W J Lammers, S N W Vorrink, T Troosters
Introduction
Chronic Obstructive Pulmonary Disease (COPD) is a disabling airway disease with variable extrapulmonary effects that may contribute to disease severity in individual patients (Rabe et al. 2007). The world health organization predicts that COPD will become the third leading cause of death worldwide by 2030. Patients with COPD demonstrate reduced levels of spontaneous daily physical activity (DPA) compared with healthy controls (Pitta et al. 2005). This results in a higher risk of hospital admission and shorter survival (Pitta et al. 2006). Pulmonary rehabilitation can help to improve the DPA level, however, obtained benefits decline after 1–2 years (Foglio et al. 2007).
Purpose
In order to maintain DPA in COPD patients after rehabilitation, we developed a mobile phone application. This application measures DPA as steps per day, measured by the accelerometer of the smartphone, and shows the information to the patient via the display of the mobile phone. A physiotherapist can monitor the patient via a secure website where DPA measurements are visible for all patients. Here, DPA goals can be adjusted and text messages sent.
Method
Three pilot studies were performed with healthy students and COPD patients to test the application for usability, user friendliness and reliability with questionnaires and focus groups. Subjects also wore a validated accelerometer. For the Randomized Controlled Trial (RCT) 140 COPD patients will be recruited in Dutch physiotherapy practises. They will be randomised in an intervention group that receives the smartphone for 6 months and a control group. Measurements include lungfunction, dyspnea, and exercise capacity and are held at 0, 3, 6 and 12 months.
Results and Discussion
The application was found to be useful, easy to learn and use. Subjects had no problems with health care professionals seeing information on their physical activity performance. They do find it important to be able to determine who can see the information. Correlations between the accelerometer and the measurements on DPA of the smartphone for steps per hour were 0.69 and 0.70 for pilot studies 1 (students) and 2 (COPD patients) respectively. The version of the application in pilot study 3 contained an error, which made correlations with the accelerometer unusable. The RCT study is now being executed.