Browsing by Subject "Prognosis"
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Item Open Access A novel gene list identifies tumors with a stromal-mesenchymal phenotype and worse prognosis in gastric cancer(MDPI, 2023-06-02) Demirkol Canlı, Seçil; Üner, M.; Küçükkaraduman, Barış; Karaoğlu, D. A.; Işık, A.; Turhan, N.; Akyol, A.; Gömceli, I.; Güre, A. O. ABackground: Molecular biomarkers that predict disease progression can help identify tumor subtypes and shape treatment plans. In this study, we aimed to identify robust biomarkers of prognosis in gastric cancer based on transcriptomic data obtained from primary gastric tumors. Methods: Microarray, RNA sequencing, and single-cell RNA sequencing-based gene expression data from gastric tumors were obtained from public databases. Freshly frozen gastric tumors (n = 42) and matched FFPE (formalin-fixed, paraffin-embedded) (n = 40) tissues from a Turkish gastric cancer cohort were used for quantitative real-time PCR and immunohistochemistry-based assessments of gene expression, respectively. Results: A novel list of 20 prognostic genes was identified and used for the classification of gastric tumors into two major tumor subgroups with differential stromal gene expression (“Stromal-UP” (SU) and “Stromal-DOWN” (SD)). The SU group had a more mesenchymal profile with an enrichment of extracellular matrix-related gene sets and a poor prognosis compared to the SD group. Expression of the genes within the signature correlated with the expression of mesenchymal markers ex vivo. A higher stromal content in FFPE tissues was associated with shorter overall survival. Conclusions: A stroma-rich, mesenchymal subgroup among gastric tumors identifies an unfavorable clinical outcome in all cohorts tested.Item Open Access A-To-I RNA editing events, potential biomarkers for prognosis and chemosensitivity in gastric cancer(2022-09) Çela, IsliGastric cancer (GC) is one of the leading causes of cancer mortality, and it frequently presents in advanced stages with a poor prognosis and response to treatment. Although extensive research has identified many potential biomarkers in GC, the heterogeneity of the disease is an impediment to validation, so only a small number find limited application in clinics. RNA editing is an epigenetic modification that results in nucleotide changes in the RNA sequence. Adenosine to Inosine (A-to-I) substitutions are the most common editing events in humans, and they are mediated by Adenosine deaminases acting on RNA (ADAR) enzymes. Inosine (I) mimics Guanosine (G) and creates pairs with Cytidine (C), resulting in changes in RNA structure and stability, amino acid substitutions, alternative splicing, or gene expression regulation via miRNA target site modifications.RNA editing dysregulations have been found in breast, lung, kidney, brain, and gastric cancers, but the utility of specific editing events as biomarkers is largely unexplored. In this study we investigate the potential of A-to-I editing events as chemosensitivity and prognostic biomarkers in GC. Across multiple datasets, our analysis shows that RNA editing events at 305 unique positions correlate with drug sensitivity measures of 17 approved chemotherapeutics in GC cell lines.The most significant editing event-drug sensitivity correlations indicate that higher editing levels are associated with higher chemosensitivity. Interestingly, the expression levels of genes with identified editing events have a weaker or no correlation with drug sensitivity, implying that editing events are biomarkers independent of transcript levels. We show that, while ADAR enzymes mediate editing events, ADAR expression levels are not interchangeable with editing frequencies as chemosensitivity biomarkers in GC. We discovered a non-synonymous editing event in the C11orf80 coding sequence, resulting in an amino acid substitution (S.p133G). Also, we identified an editing event in the 3'UTR of SOGA1 that correlates with increased SOGA1 expression. The presence of this editing site in a putative target site of miR-9-5p suggests that gene expression might be regulated by miRNA target site modifications. In the TCGA and Singapore cohorts, the prognostic role of editing events in GC was investigated. Overall, higher levels of editing are associated with better survival in GC patients. In both cohorts, we found an editing event in the CLPX gene at the position 65442098 to be an independent good prognostic factor. We chose editing events that would best categorize our patients into "High" and "Low" edited groups using the Log Rank Multiple Cut-off (LRMC) plot distribution. In each dataset, we propose two editing events, one good and one bad prognostic factor that independently correlate with survival in GC patients. In the Singapore Cohort, high editing levels in ZNF587 are associated with a good prognosis, while those in DCAF16 are associated with a poor prognosis.High editing levels in CTSB correlate with better overall survival (OS) in the TCGA cohort, while those in NUP43 correlate with worse OS. Because transcript levels do not correlate with survival, the prognostic effects of these editing events are unaffected by gene expression levels.We believe that editing levels at specific positions can be used as prognostic biomarkers in a significant way, providing a more cost-effective and applicable alternative to prognostic editing signature models. Our findings suggest that editing events could be used as independent biomarkers for chemosensitivity and prognosis in gastric cancer, however more investigation is required to elucidate the mechanisms underlying the observed relationships.Item Open Access Characterization of differential expression patterns of the extracellular purinergic enzymes in colorectal cancer(Trakya University, 2022-10-15) Göktuna, SerkanThe aim of this study is to characterize tumor cell specific expression of purinergic ecto-enzymes CD39 and CD73, and to associate prognostic significance of these expression patterns in colorectal cancer (CRC) patients. Protein and gene expression of the target genes in various CRC cell lines were assessed via Western Blot (WB) analysis and Real Time PCR (RT-PCR). Additionally, tumor vs stromal cell expression of the target genes was analyzed from publicly available patient expression datasets. Finally, the correlation between CD39 and CD73 expression with patient prognosis was analyzed via The Cancer Genome Atlas (TCGA) datasets. In CRC cell lines, CD39 was found to be not expressed at all while CD73 was expressed extensively in most cell lines via WB and RT-PCR analyses. Patient microarray expression data confirmed the results from CRC cell lines that CD39 expression was very low in epithelial/tumor cells relative to other stromal cell types yet CD73 was expressed abundantly in every cell type within patient tumor samples. Interestingly, CD39 expression in patient tumors was correlated with favorable prognosis while CD73 expression was associated with worse prognosis. Although CD39 and CD73 are related enzymes involved in extracellular purinergic signaling, their expression patterns in tumor cells and prognostic effects in patients show opposing outcomes. Therefore, better insights in understanding the functional involvement of purinergic ecto-enzymes in colorectal tumor development is needed via further mechanistic studies.Item Open Access CHRNA5 belongs to the secondary estrogen signaling network exhibiting prognostic significance in breast cancer(Springer, 2021-04) Shehwana, Huma; Keskus, Ayse Gokce; Ozdemir, E. Sila; Acikgöz, Azer Aylin; Biyik-Sit, Rumeysa; Cagnan, I.; Gunes, Damla; Jahja, Ermira; Cingir-Koker, Sahika; Olmezer, Gizem; Sucularli, Ceren; Konu, OzlenCholinergic signals can be important modulators of cellular signaling in cancer. We recently have shown that knockdown of nicotinic acetylcholine receptor subunit alpha 5, CHRNA5, diminishes the proliferative potential of breast cancer cells. However, modulation of CHRNA5 expression in the context of estrogen signaling and its prognostic implications in breast cancer remained unexplored.Item Open Access A combined ULBP2 and SEMA5A expression signature as a prognostic and predictive biomarker for colon cancer(Ivyspring International Publisher, 2017) Demirkol, S.; Gomceli, I.; Isbilen, M.; Dayanc, B. E.; Tez, M.; Bostanci, E. B.; Turhan, N.; Akoglu, M.; Ozyerli, E.; Durdu, S.; Konu, O.; Nissan, A.; Gonen, M.; Gure, A. O.Background: Prognostic biomarkers for cancer have the power to change the course of disease if they add value beyond known prognostic factors, if they can help shape treatment protocols, and if they are reliable. The aim of this study was to identify such biomarkers for colon cancer and to understand the molecular mechanisms leading to prognostic stratifications based on these biomarkers. Methods and Findings: We used an in house R based script (SSAT) for the in silico discovery of stage-independent prognostic biomarkers using two cohorts, GSE17536 and GSE17537, that include 177 and 55 colon cancer patients, respectively. This identified 2 genes, ULBP2 and SEMA5A, which when used jointly, could distinguish patients with distinct prognosis. We validated our findings using a third cohort of 48 patients ex vivo. We find that in all cohorts, a combined ULBP2/SEMA5A classification (SU-GIB) can stratify distinct prognostic sub-groups with hazard ratios that range from 2.4 to 4.5 (p=0.01) when overall- or cancer-specific survival is used as an end-measure, independent of confounding prognostic parameters. In addition, our preliminary analyses suggest SU-GIB is comparable to Oncotype DX colon(®) in predicting recurrence in two different cohorts (HR: 1.5-2; p=0.02). SU-GIB has potential as a companion diagnostic for several drugs including the PI3K/mTOR inhibitor BEZ235, which are suitable for the treatment of patients within the bad prognosis group. We show that tumors from patients with worse prognosis have low EGFR autophosphorylation rates, but high caspase 7 activity, and show upregulation of pro-inflammatory cytokines that relate to a relatively mesenchymal phenotype. Conclusions: We describe two novel genes that can be used to prognosticate colon cancer and suggest approaches by which such tumors can be treated. We also describe molecular characteristics of tumors stratified by the SU-GIB signature.Item Open Access Discovery of cancer-specific and independent prognostic gene subsets of the slit-robo family using TCGA-PANCAN datasets(Mary Ann Liebert, 2021-12-08) Özhan, Ayşe; Tombaz, Melike; Konu, ÖzlenThe Slit-Robo family of axon guidance molecules works in concert, playing important roles in organ devel opment and cancer. Expressions of individual Slit-Robo genes have been used in calculating univariable hazard ratios (HRuni) for predicting cancer prognosis in the literature. However, Slit-Robo members do not act in dependently; hence, hazard ratios from multivariable Cox regression (HRmulti) on the whole gene set can further lead to identification of cancer-specific, novel, and independent prognostic gene pairs or modules. Herein, we obtained mRNA expressions of the Slit-Robo family consisting of four Robos (ROBO1/2/3/4) and three Slits (SLIT1/2/3), along with four types of survival outcome across cancers found in the Cancer Genome Atlas (TCGA). We used cluster heat maps to visualize closely associated pairs/modules of prognostic genes across 33 different cancers. We found a smaller number of significant genes in HRmulti than in HRuni, suggesting that the former analysis was less redundant. High ROBO4 expression emerged as relatively protective within the family, in both types of HR analyses. Multivariable Cox regression, on the other hand, revealed significantly more HR signatures containing Slit-Robo pairs acting in opposing directions than those containing Slit-Slit or Robo-Robo pairs for disease-specific survival. Furthermore, we discovered, through the online app SmulTCan’s lasso regression, Slit-Robo gene subsets that significantly differentiated between high- versus low-risk prog nosis patient groups, particularly for renal cancers and low-grade glioma. The statistical pipeline reported herein can help test independent and significant pairs/modules within a codependent gene family for cancer prog nostication, and thus should also prove useful in personalized/precision medicine research.Item Open Access Endothelial progenitor cells display clonal restriction in multiple myeloma(BioMed Central Ltd., 2006) Braunstein, M.; Özçelik, T.; Baǧişlar, S.; Vakil, V.; Smith, E. L. P.; Dai, K.; Akyerli, C. B.; Batuman O. A.Background: In multiple myeloma (MM), increased neoangiogenesis contributes to tumor growth and disease progression. Increased levels of endothelial progenitor cells (EPCs) contribute to neoangiogenesis in MM, and, importantly, covary with disease activity and response to treatment. In order to understand the mechanisms responsible for increased EPC levels and neoangiogenic function in MM, we investigated whether these cells were clonal by determining X-chromosome inactivation (XCI) patterns in female patients by a human androgen receptor assay (HUMARA). In addition, EPCs and bone marrow cells were studied for the presence of clonotypic immunoglobulin heavy-chain (IGH) gene rearrangement, which indicates clonality in B cells; thus, its presence in EPCs would indicate a close genetic link between tumor cells in MM and endothelial cells that provide tumor neovascularization. Methods: A total of twenty-three consecutive patients who had not received chemotherapy were studied. Screening in 18 patients found that 11 displayed allelic AR in peripheral blood mononuclear cells, and these patients were further studied for XCI patterns in EPCs and hair root cells by HUMARA. In 2 patients whose EPCs were clonal by HUMARA, and in an additional 5 new patients, EPCs were studied for IGH gene rearrangement using PCR with family-specific primers for IGH variable genes (VH). Results: In 11 patients, analysis of EPCs by HUMARA revealed significant skewing (≥ 77% expression of a single allele) in 64% (n = 7). In 4 of these patients, XCI skewing was extreme (≥ 90% expression of a single allele). In contrast, XCI in hair root cells was random. Furthermore, PCR amplification with VH primers resulted in amplification of the same product in EPCs and bone marrow cells in 71 % (n = 5) of 7 patients, while no IGH rearrangement was found in EPCs from healthy controls. In addition, in patients with XCI skewing in EPCs, advanced age was associated with poorer clinical status, unlike patients whose EPCs had random XCI. Conclusion: Our results suggest that EPCs in at least a substantial subpopulation of MM patients are related to the neoplastic clone and that this is an important mechanism for upregulation of tumor neovascularization in MM. © 2006 Braunstein et al; licensee BioMed Central Ltd.Item Open Access Expression of CK-19 and CEA mRNA in peripheral blood of gastric cancer patients(2010) Kutun, S.; Celik, A.; Cem Kockar, M.; Erkorkmaz, U.; Eroǧlu, A.; Cetin, A.; Erkosar, B.; Yakicier, C.Aim: To investigate the clinical and pathological relevance of detection of circulating tumor cells (CTC) in the peripheral blood of gastric carcinoma patients before operation. Patients and Methods: Fifty patients with gastric adenocarcinoma were analysed prospectively. Patients were divided into two groups according to the extent of the tumor. Group I (unresectable) consisted of 22, and group II (resectable) consisted of 28 patients. Peripheral blood samples were collected pre-operatively from all 50 patients as well as from ten healthy controls and analyzed for carcinoembryonic antigen (CEA) and cytokeratin-19 (CK-19) messenger ribonucleic acids (mRNAs). Tumor localisation, stage, presence of signet cell formation, nodal metastases, serousal and lymphovascular invasion were recorded for all patients. Results: Expression of CK-19 was detected in 24 (48%), and CEA in 10 (20%) cases. Nine patients (40%) in group I and 15 (53.6%) in group II were positive for CK-19 expression. CEA expression was more frequent among group I patients (6 vs. 4 cases). There was no significant difference between the groups in the expression of CK-19 and CEA mRNA, tumor localisation, presence of signet formation, and presence and extent of nodal metastases. Patients with major vascular invasion (MVI) expressed significantly higher levels of CTC mRNA compared to those without MVI (p = 0.023 for CEA, and p = 0.009 for CK-19). The median 1 and 2-year survival was 9.5 and 10.5 months for group I, and 20 and 28.5 months for group II, respectively (p = 0.001). The mean survival was 6.7 months for patients with MVI, and 30.2 months for those without MVI (p = 0.0001). Conclusions: High levels of CTCs were observed in patients with MVI invasion, rather than other causes of unresectability. It can be suggested that expression of both CEA and CK-19 in the peripheral blood of gastric cancer patients are strong predictors of MVI and significantly worse survival rates. Copyright © Experimental Oncology, 2010.Item Open Access Expression of IFITM1 in chronic myeloid leukemia patients(Elsevier, 2005) Akyerli, C. B.; Beksac, M.; Holko, M.; Frevel, M.; Dalva, K.; Özbek, U.; Soydan, E.; Özcan, M.; Özet, G.; İlhan, O.; Gürman, G.; Akan, H.; Williams, B. R. G.; Özçelik, T.We investigated the peripheral blood gene expression profile of interferon induced transmembrane protein 1 (IFITM1) in sixty chronic myeloid leukemia (CML) patients classified according to new prognostic score (NPS). IFITM1 is a component of a multimeric complex involved in the trunsduction of antiproliferative and cell adhesion signals. Expression level of IFITM1 was found significantly different between the high- and low-risk groups (P = 9.7976 × 10-11) by real-time reverse transcription polymerase chain reaction (RT-PCR). Higher IFITM1 expression correlated with improved survival (P = 0.01). These results indicate that IFITM1 expression profiling could be used for molecular classification of CML, which may also predict survival.Item Open Access Extraction and prioritization of a gene-cancer-by-survival network involved in homeostasis of intracellular calcium concentrations using TCGA PANCAN data(Mary Ann Liebert, Inc. Publishers, 2022-05-26) Tombaz, Melike; Yanyatan, Çağdaş; Keşküş, Ayşe Gökçe; Konu, ÖzlenRegulation of intracellular calcium concentrations, [Ca++]i is important in maintaining the viability of normal as well as cancer cells and can be mediated by tumor microenvironment. Calcium release-activated calcium channel protein (ORAI) calcium channels on the plasma membrane (PM) become physically connected by stromal interaction molecules (STIMs) to the endoplasmic reticulum (ER), on which paralogous receptors of inositol phosphate and of ryanodine are also present along with ATP2A/SERCA (sarco/endoplasmic reticulum calcium ATPases) subunits (also known as PM-ER geneset). Proper expression of this functionally and physically interconnected geneset is essential for the maintenance of [Ca++]i, yet has not been interrogated as a whole for its role in cancer prognosis using multivariable Cox regression. In the present study, we examined whether the expression profile of the PM-ER geneset exhibited prognostic significance across different cancers found in The Cancer Genome Atlas (TCGA) by generating gene-cancer-by-survival networks, in which the nodes represented either genes or cancers and the edges, the logarithmically transformed hazard ratios for overall survival (OS). We then applied network clustering to identify the gene-cancer subnetworks with high connectivity, among which uveal melanoma (UVM) emerged exhibiting the highest degree of genes (k = 10). BAP1, a well-known [Ca++]i regulator and a tumor suppressor, was not found to be significant in predicting OS by PM-ER geneset for UVM, yet it was for several others, including mesothelioma (MESO). Moreover, the best subset of the PM-ER geneset obtained by lasso predicted OS in the TCGA UVM cohort with an area under the receiver operating characteristics (AUC) of 91.4%, comparable to or better than previous prognostic signatures in the literature. Our findings indicate that homeostasis of [Ca++]i is an essential determinant of prognosis in multiple cancers and particularly in UVM. The proposed gene-cancer-by-survival network approach can be extended with other gene sets as well as different survival types.Item Open Access Identification and utilization of autologous anti-tumor antibodies for the diagnosis and prognosis of cancer(2015-12) Atakan, ŞükrüLung cancer is the leading cause of cancer related death worldwide. Current diagnostic methods have limited power and unable to extend patient life significantly. SCLC; the most aggressive subtype of lung cancer is an immunogenic cancer type and able to elicit an immune response of which autologous antibodies are a measurable component. These antibodies are elicited even when the tumor is microscobic and impossible to be diagnosed clinically by the current methods of diagnosis thus antibodies can be utilized for early diagnosis. We aimed to develop a method to identify novel autologous antibodies, identify these antibodies for SCLC, Colorectal, Gastric and Ovarian cancers and validate these antibodies for SCLC diagnosis and prognosis and investigate their utility for autoimmune disease. We have developed and optimized PA screening for novel autologous antibody discovery. We have screened PA with serum pools of cancer patients (SCLC, Colorectal, Gastric and Ovarian), BD and healthy controls since PAs have many advantages compared to other discovery methods like SEREX. We have also performed sensitivity and specificity evaluations by screening custom PAs by individual sera. Image analysis softwares developed by collaboration utilized for evaluation of the screenings. The filtered valuable clones were ordered from the PA manufacturer and HisTagged protein expression and purification was performed with these clones. Pure proteins were screened with 3 independent SCLC and 2 Healthy control cohorts by an iterative ELISA approach for validation of these antibodies as valuable biomarkers. ELISA results were also confirmed by Western blotting. Monte Carlo, SVM and PC were utilized for cut-off determination, panel formation and ROC plotting. AUC was compared for evaluation of diagnostic power. Kaplan-Meier, UCR and MCR analysis was performed for prognostic analysis of the valuable antibodies. Seperately protein expression and autologous antibody presence correlation was evaluated by comparison of IHC and ELISA. The same autologous antibody identification strategy was utilized as a collaborative support for an independent study for identification of NBD specific biomarkers.We have identified 23 distinct autologous antibody biomarkers for SCLC after evaluation of PA and custom PA screenings. For 8 of these antibodies we have completed ELISA screening for all 3 SCLC and 2 healthy control cohorts. 6 of these autologous antibodies were shown to be valuable as a panel for SCLC diagnosis both by MC and SVM. Utilization of 4 of these antibodies; SOX2, p53, POLB and C11orf20, as a panel resulted in superior AUC thus high sensitivity and specificity values (55% sensitivity, 90% specificity). PC method resulted in higher AUC even only by combination of SOX2 and p53 (82% sensitivity, 90% specificity). Although individual correlations were identified, we were unable to show a significant correlation of seropositivity with survival for any of the antibodies which is common to all cohorts. We have identified a significant correlation between SOX2 antigen expression intensity and autologous antibody presence. Mtch1 was identified as a NBD specific autologous antibody by the utilization of our autologous antibody discovery and validation methodology. We were able to identify a panel of 4 antibodies; SOX2, p53, POLB and C11orf20, which resulted in 55% sensitivity at 90% specificity for SCLC. 2 of these antibodies were identified by this study as novel biomarkers; POLB and C11orf20. The panel is capable of exceeding the diagnostic power of the only commercially available diagnostic kit; EarlyCDT-Lung. PC method is very promising since a sensitivity value of 82% was reached at 90% specificity which is a diagnostic power comparable that of low-dose CT. As a future perspective we are planning to apply PC method to all the PA data and develop a kit based on this method to be utilized for SCLC diagnosis.Item Open Access Identification of theranostic gene markers in cancers and prognostic validation in colorect al cancer(2015-01) İşbilen, MuratColorectal cancer (CRC) is the fourth most prevalent cancer type worldwide. Although the 5-year survival rate of CRC is higher than many cancer types, prediction of prognosis and identification of accurate biomarkers still maintain their importance for chemotherapy benefits, thus survival of the patients. Current techniques to identify biomarkers for clinical use are based on building models with multi-gene signatures. However, the accuracy rates of such signatures are not high enough due to heterogeneity of the tumors and low sensitivity of gene expression measurement techniques, although cell lines can be predicted very well with such signatures. There has also been sufficient evidence that multi-gene signatures may not be better predictors than random signatures with the same size. Therefore, in this study, we aimed to develop two R-based statistical analysis tools, SSAT and USAT, to identify single-gene expression markers for prognosis with chemotherapy benefit prediction power. We identified two genes, ULBP2 and SEMA5A, with SSAT and 6 genes, PTRF, TGFB1I1, DUSP10, KLF9, CLCN7 and CLDN3, with USAT for colon cancer and CRC, respectively. We were able to validate independent prognostic power of ULBP2 and SEMA5A in an independent cohort. However, we could only validate CLCN7 among 6 genes that we identified by USAT. Those results showed that SSAT may be a better tool to identify prognostic gene markers and USAT needs to be improved to identify better candidate genes. We could also reveal the chemotherapy benefit prediction power of ULBP2 and SEMA5A in CCLE and CGP drug databases, although these in silico results should be validated by in vitro experiments. We believe that the approach that we used in this study may pioneer the studies to develop commercial theranostic tools for clinical use in various types of cancer.Item Open Access In silico validation of prognostic mRNA signature in gastric cancer and identification and validation of novel gastric tissue specific reference genes for quantitative PCR(2021-07) Ishraq, MarzanaGastric adenocarcinoma is a molecularly and histologically heterogeneous neoplasm with a predictively disastrous outcome if undiagnosed at early stages. Amidst global declines of gastric cancer rates, it remains the 5th most common malignancy with the 4th worst outcome of all cancers. Predictive and prognostic clinical biomarkers are scarce in gastric cancer due to its immense heterogeneity. Identifying novel biomarkers for gastric cancer is an emerging field. Previously in our lab, a 20 gene mRNA signature was developed which successfully stratified gastric cancer patients into poor and good prognosis. In this thesis, we attempted to shorten this list to a five gene signature which will successfully stratify patients into similar clusters as the 20 genes. The 5 genes being, HEYL, CALD1, ACTA2, TAGLN and TPM2. Moreover, we validated the efficacy of our 5-gene signature to stratify patients based on their prognoses in silico. The second half of the thesis focuses on identifying a set of gastric tissue specific reference genes by analyzing high-throughput gene expression data. Most commonly used reference genes are known to have varying expression in cancer tissue which often leads to an issue with reproducibility in cancer research. We aimed to design an algorithm which identifies a list of stable transcripts within a particular tissue type. We identified 3 genes EWSR1, SF1 and HNRNPK which showed stable expression throughout gastric tissue, both in normal and cancer in silico. Ex vivo validation experiments using gastric tumor and adjacent normal RNA show promise for the efficacy of our genes compared to GAPDH and B2M.Item Open Access Opposing roles of the aldo-keto reductases AKR1B1 and AKR1B10 in colorectal cancer(Springer Netherlands, 2017-09) Taskoparan, B.; Seza, E. G.; Demirkol, S.; Tuncer, S.; Stefek, M.; Gure, A. O.; Banerjee, S.Purpose: Aldo-keto reductases (including AKR1B1 and AKR1B10) constitute a family of oxidoreductases that have been implicated in the pathophysiology of diabetes and cancer, including colorectal cancer (CRC). Available data indicate that, despite their similarities in structure and enzymatic functions, their roles in CRC may be divergent. Here, we aimed to determine the expression and functional implications of AKR1B1 and AKR1B10 in CRC. Methods: AKR1B1 and AKR1B10 gene expression levels were analyzed using publicly available microarray data and ex vivo CRC-derived cDNA samples. Gene Set Enrichment Analysis (GSEA), The Cancer Genome Atlas (TCGA) RNA-seq data and The Cancer Proteome Atlas (TCPA) proteome data were analyzed to determine the effect of high and low AKR1B1 and AKR1B10 expression levels in CRC patients. Proliferation, cell cycle progression, cellular motility, adhesion and inflammation were determined in CRC-derived cell lines in which these genes were either exogenously overexpressed or silenced. Results: We found that the expression of AKR1B1 was unaltered, whereas that of AKR1B10 was decreased in primary CRCs. GSEA revealed that, while high AKR1B1 expression was associated with increased cell cycle progression, cellular motility and inflammation, high AKR1B10 expression was associated with a weak inflammatory phenotype. Functional studies carried out in CRC-derived cell lines confirmed these data. Microarray data analysis indicated that high expression levels of AKR1B1 and AKR1B10 were significantly associated with shorter and longer disease-free survival rates, respectively. A combined gene expression signature of AKR1B10 (low) and AKR1B1 (high) showed a better prognostic stratification of CRC patients independent of confounding factors. Conclusions: Despite their similarities, the expression levels and functions of AKR1B1 and AKR1B10 are highly divergent in CRC, and they may have prognostic implications.Item Open Access Precariousness, the secured present and the sustainability of the future: learning from Koselleck and extrapolating from Elias(Sage Publications Ltd., 2008) Carvounas, D.; Ireland, C.Theorists concerned with the current status of the future have rightly acknowledged their debt to Koselleck’s historicization of modern future-oriented temporality. Koselleck, however, does not address how such a temporality can be sustained. Elias can be of help here. Anticipating recent inquiry into the effects of precariousness on temporality, Elias established a historical link between a present secured from unpredictability and the capacity for temporal extension beyond immediate concerns. Although Elias does not directly address modern temporality, his work, when combined with Koselleck’s, can shed light on some of the preconditions for the sustainability of modern future-orientedness. Such a combination of Koselleck’s work with Elias’s can help lay the groundwork for a more historically informed diagnostic assessment of our current temporal horizons.Item Open Access Prediction of prognosis and chemosensitivity in gastrointestinal cancers(2017-12) Demirkol, SeçilColon and gastric cancers are the third and fifth cancer types with the poorest survival. Surgery is considered the primary treatment option, which can be curative. However the decision as to whether chemotherapy administration after surgery is needed, is critical for especially stage 2 colon cancer; since a group of patients who receive chemotherapy do not have significantly improved clinical outcome. For this purpose, clinical risk factors are currently evaluated to determine patients with a high risk of progression. However this is not standardized by guidelines yet. Therefore, in this thesis my first aim was to ex vivo validate two novel independent mRNA based biomarkers, ULBP2 and SEMA5A, which have been previously identified in our lab, and to generate a prognostic signature which could stratify colon cancer patients with differential prognostic profiles using the best stratification method. I showed that a 3-group prognostic signature, SU-GIB, based on expression of these two genes is associated with cancer-specific, disease-free, and overall survival independent of clinical confounding factors in colon cancer. I performed in silico analysis in order to understand the biological details of the prognostic distinction, and revealed that patients with poorer prognosis show higher expression of pro-inflammatory cytokines and a more mesenchymal profile. Patients with better clinical outcome exhibit a more epithelial profile with higher levels of phosphorylated EGFR and Shc proteins. Analysis of high-throughput drug cytotoxicity databases also showed that colon cancer cell lines with „Bad‟ SU-GIB signature are more sensitive to a dual PI3K-MTOR inhibitor, BEZ235. In this thesis, my second goal was to define prognostic and molecular sub-groups for gastric cancer and characterize the specific biology of each sub-group. Utilizing an unsupervised approach on publicly available microarray data, I identified 3 biological groups, which harbor differential characteristics related to ECM involvement, EMT, proliferation and cell cycle. Moreover I identified distinct prognostic groups which are related to this molecular classification which can further stratify patients with known pathologic subtypes (diffuse and intestinal). I found that EMT was an important parameter for molecular and prognostic classifications for both types of cancers. I therefore, studied high-throughput drug cytotoxicity databases in order to identify selective compounds with selective growth inhibition on epithelial or mesenchymal cancer cells. I identified EGFR inhibitors as being significantly more effective on epithelial cancer cells regardless of the tissue type. My future plans include the large scale validation of SU-GIB, ex vivo validation of the gastric prognostic signature, and in vitro studies that would demonstrate effectivity of EGFR inhibitors on epithelial cancer cells and combination of EGFR inhibitors with MET inducers.Item Open Access Prognostic biomarker identification and classification of colorectal cancer patients: a dual gene-based and sample-based approach(2023-08) Naeemaee, RonakColorectal cancer (CRC) is one of the most heterogeneous cancer types, with high mortality rates making it the one of the deadliest cancer among men and women. The heterogeneity of CRC comes from the numerous clinicopathological characteristics of these tumors, including; KRAS/BRAF mutation, Microsatellite Instability (MSI), and stage. Another essential factor recently emphasized is the tumor location (proximal or distal). Consequently, many studies have focused on finding prognostic biomarkers for CRC patients to increase the efficiency of their treatment plans. However, despite the attempts, these biomarkers fail in clinical transition as they lack robustness and consistent results in their validation studies. Moreover, understanding the mechanism behind CRC progression can significantly help the personalization of treatments. Recently, the cancer neuroscience field has been focusing on elucidating neuropeptides' role in cancer and CRC as they have been proven to be involved in cancer progression. Accordingly, the thesis was divided into two approaches. The first approach was to further examine the role of neuropeptides by finding a subset of neuropeptides for the classification of the CRC samples and following functional analysis to understand the mechanism of their involvement. Moreover, the second approach attempted the determination of robust prognostic biomarkers in a specific sample group (Proximal, Stages 2 and 3) while controlling for the inconsistencies. In the first approach, a subset of 9 neuropeptide genes was found through Principle Component Analysis (PCA) with the ability to stratify the CRC samples into high and low expression groups. Functional analyses of these groups identified an association between the up-regulation of these neuropeptides and Hedgehog's (HHG) signaling pathway, and these activities are hypothesized to be primarily specific to the stroma of the tumor. Up-regulation of these neuropeptides was also linked with other pathways involved in cancer progression, such as; EMT, angiogenesis, and TGFβ activities. The second approach utilized a new methodology pipeline that aimed to ensure the selection of genes with no discrepancies among their probesets and across different technologies. Following the pipeline, 3 genes were identified, associated with favorable and non-favorable prognoses for Proximal, Stage 2, and 3 samples. However, although a very stringent methodology was used and various clinicopathological parameters such as the stage and location were considered, the prognostic associations observed were not as consistent, indicating the importance of the sample's molecular characteristics. This study also pointed out potential implications of neuropeptides in CRC progression and development. More elaborative studies are required for the clarification of the interactions of neuropeptides with the HHG signaling pathway. Furthermore, the identified prognostic biomarkers need to be validated through comprehensive validation studies in their associating subgroups of samples, as they are robust biomarkers with the potential to be used in clinics.Item Open Access Prognostic value of midkine, syndecan-1, hyaluronan synthase-2, sestrin-1, laminin subunit alpha-4 and fibulin-3 for malignant pleural mesothelioma(Termedia & Banach, 2023-03-01) Akgün, H.; Metintaş, S.; Ak, G.; Canlı, Seçil Demirkol; İşbilen, Murat; Güre, Ali Osmay; Metintaş, M.Introduction: The prognosis of malignant pleural mesothelioma (MPM) is poor, with a limited survival time. In this study, we aimed to examine expression levels of genes selected from relevant literature and to utilize in silico methods to determine genes whose expression could reflect the prognosis of patients with MPM by ex-vivo validation experiments. Material and methods: The study group consisted of 54 MPM patients treated with chemotherapy. Expression of 6 genes – midkine (MDK), syndecan-1 (SDC1), hyaluronan synthase-2 (HAS2), sestrin-1 (SESN1), laminin subunit alpha-4 (LAMA4), and fibulin-3 (FBLN3) – was examined by qPCR in tumor tissues. Sestrin-1 and LAMA4 were identified using an in house R-based script: Unsupervised Sur- vival Analysis Tool. Midkine, SDC1, HAS2, and FBLN3 were selected from cur- rent literature. We used two housekeeping genes, i.e. glucose-6-phosphate dehydrogenase and TATA-box binding protein, as controls. Results: Of the patients, 43 (79.6%) had epithelioid mesothelioma. The median survival for all patients was 10 (±1.2 SE) months (95% CI: 7.7–12.3). In multivariate analyses, MDK (p = 0.007), HAS2 (p = 0.008) and SESN1 (p = 0.014) expression levels were related to survival time in the whole group. In epithelioid type MPM patients, MDK (p = 0.014), FBLN3 (p = 0.029), HAS2 (p = 0.014) and SESN1 (p = 0.045) expression was related to survival time in multivariate analyses. Conclusions: High HAS2 and SESN1 expressions and low MDK are potential biomarkers of good prognosis in MPM. High HAS2 and SESN1 expression and low MDK and FBLN3 can also be utilized as biomarkers of good prognosis for epithelioid MPM. Those results should be further investigated in sera, plasma, and pleural effusions.Item Open Access Renin angiotensin system genes are biomarkers for personalized treatment of acute myeloid leukemia with Doxorubicin as well as etoposide(Public Library of Science, 2020) Türk, S.; Türk, C.; Akbar, Muhammad Waqas; Küçükkaraduman, Barış; İşbilen, Murat; Demirkol-Canlı, S.; Malkan, Ü. Y.; Okay, M.; Uçar, G.; Sayınalp, N.; Haznedaroğlu, İ. C.; Güre, Ali OsmayDespite the availability of various treatment protocols, response to therapy in patients with Acute Myeloid Leukemia (AML) remains largely unpredictable. Transcriptomic profiling studies have thus far revealed the presence of molecular subtypes of AML that are not accounted for by standard clinical parameters or by routinely used biomarkers. Such molecular subtypes of AML are predicted to vary in response to chemotherapy or targeted therapy. The Renin-Angiotensin System (RAS) is an important group of proteins that play a critical role in regulating blood pressure, vascular resistance and fluid/electrolyte balance. RAS pathway genes are also known to be present locally in tissues such as the bone marrow, where they play an important role in leukemic hematopoiesis. In this study, we asked if the RAS genes could be utilized to predict drug responses in patients with AML. We show that the combined in silico analysis of up to five RAS genes can reliably predict sensitivity to Doxorubicin as well as Etoposide in AML. The same genes could also predict sensitivity to Doxorubicin when tested in vitro. Additionally, gene set enrichment analysis revealed enrichment of TNF-alpha and type-I IFN response genes among sensitive, and TGF-beta and fibronectin related genes in resistant cancer cells. However, this does not seem to reflect an epithelial to mesenchymal transition per se. We also identified that RAS genes can stratify patients with AML into subtypes with distinct prognosis. Together, our results demonstrate that genes present in RAS are biomarkers for drug sensitivity and the prognostication of AML.Item Open Access A shiny application for pancan survival analysis with paralog/miRNA pairs and in vitro validation of miRNA synergism in liver cancer(2022-09) Tombaz, MelikeEmerging cancer survival tools can predict risk of disease and identify prognostic biomarkers. Multivariable Cox proportional hazards models with mRNA and microRNAs (miRNAs) expression can differentiate survival outcomes. Previous studies showed that genes that belong to the same pathways/families may act independently, and in a cancer-specific manner. In this thesis, cancer-dependent hazard ratios of paralog genes and sense-antisense strands of miRNAs were tested for TCGA PANCAN. The results were presented in a R/Shiny web application that provides gene-by-survival networks. The gene-by-survival network approach also was applied to the plasma membrane-endoplasmic reticulum (PM-ER) calcium channel geneset. Among paralogs, cancer-specific prognostic signatures and functional compartmentalization were observed. Some cancers like UVM, MESO emerged as hub cancers for PM-ER signalling. Further the proposed gene-by-survival network approach has been extended for miRNA-mRNA triplets that may act in synergy in hepatocellular carcinoma (HCC). Next, the effects of synergistic miRNA pairs provided by miRCoop algorithm were tested on cell viability and target gene expression for selected triplets. The results have revealed that the combinatorial miRNA treatments show promising results as RNAi therapeutics yet future studies with different doses and triplets are needed.