CHAPTER 4: RESULTS, DISCUSSIONS AND FUTURE WORK
4.10 Future work
Our work in this project has provided definitive data on the direct effect of Col 3 coated fibrous
scaffolds in promoting breast cancer cell apoptosis. Our next step would be to conduct in vitro
specificity tests to confirm that our methods are not promoting similar responses in non-
pathologic cells, although published and preliminary data from the Volk laboratory and others
suggest that this is extremely unlikely. It is possible that non-pathological cells differentially
express Col 3 receptors (ex. integrins), thereby effecting the fate of such cells, i.e. probably
limiting the pro-apoptotic effect of Col 3 on such cells. In addition, we will compare the effect
of Col 3- and Col 1-coated unaligned fibrous scaffolds on breast cancer cell apoptosis, to
determine if Col 3 coating remains superior in its ability to induce apoptosis in the context of an
unaligned scaffold. An important next step will be to shift focus to in vivo studies, where we
would be experimenting with fibrous scaffolds with an added sacrificial component. Research
by the Mauck lab has shown that composites containing the slow-degrading PCL and water-
73
mesh, by selectively removing the sacrificial component55. This enables for enhanced cell
infiltration and improved matrix integration. This also leads to an increase in the tensile
properties of the engineered constructs (providing for a close imitation of the native ECM)55. In
relation, we will also be conducting porosity analysis on our composite scaffolds to determine
the effect of porosity on cancer cell infiltration and apoptosis. Ultimately, we will assess if these
scaffolds promote apoptosis of microscopic residual disease in resection sites in vivo and if this
promotion of apoptosis would be able to prevent local recurrence and ultimately metastasis.
Based on previous research, we also predict these biomaterials will improve quality of healing
post-surgery. Future studies will directly test this hypothesis. Additional potential avenues of
research also include whether Col 3-based biomaterials (in other forms) would be prevent the
progression of benign cancer into more aggressive types.
The possibility that Col 3 biomaterials can eliminate microscopic disease and therefore limit
local recurrence and ultimately metastasis provides for an exciting avenue for the treatment of
breast cancer, particularly if able to replace more toxic therapies such as chemo- or radiation
74 References
1"Cancer Facts and Statistics | American Cancer Society", Cancer.org, 2016. [Online]. Available:
http://www.cancer.org/research/cancerfactsstatistics. [Accessed: 20-Mar-2016].
2B. Brisson, E. Mauldin, W. Lei, L. Vogel, A. Power, A. Lo, D. Dopkin, C. Khanna, R. Wells, E. Puré
and S. Volk, "Type III Collagen Directs Stromal Organization and Limits Metastasis in a Murine Model of Breast Cancer", The American Journal of Pathology, vol. 185, no. 5, pp. 1471-1486, 2015.
3N. Houssami, P. Macaskill, M.L. Marinovich and M. Morrow, "The Association of Surgical
Margins and Local Recurrence in Women with Early-Stage Invasive Breast Cancer Treated with Breast-Conserving Therapy: A Meta-Analysis", Annals of Surgical Oncology, vol. 21, no. 3, pp. 717-730, 2014.
4S. Feldman, "Surgical Margins in Breast Conservation", International Journal of Surgical
Oncology, vol. 2013, pp. 1-2, 2013.
5S. Singletary, "Surgical margins in patients with early-stage breast cancer treated with breast
conservation therapy", The American Journal of Surgery, vol. 184, no. 5, pp. 383-393, 2002.
6R. Demicheli, M. Retsky, W. Hrushesky, M. Baum and I. Gukas, "The effects of surgery on
tumor growth: a century of investigations", Annals of Oncology, vol. 19, no. 11, pp. 1821-1828, 2008.
7J. Hobson, P. Gummadidala, B. Silverstrim, D. Grier, J. Bunn, T. James and M. Rincon, "Acute
inflammation induced by the biopsy of mouse mammary tumors promotes the development of metastasis", Breast Cancer Res Treat, vol. 139, no. 2, pp. 391-401, 2013.
8E. Mathenge, C. Dean, D. Clements, A. Vaghar-Kashani, S. Photopoulos, K. Coyle, M.
Giacomantonio, B. Malueth, A. Nunokawa, J. Jordan, J. Lewis, S. Gujar, P. Marcato, P. Lee and C. Giacomantonio, "Core Needle Biopsy of Breast Cancer Tumors Increases Distant Metastases in a Mouse Model", Neoplasia, vol. 16, no. 11, pp. 950-960, 2014.
9 G. Freedman and B. Fowbie, "Local Recurrence After Mastectomy or Breast-Conserving
Surgery and Radiation", Oncology Journal, vol. 1411, pp. 1561-1581, 2000.
10 M. Donker, S. Litiere, G. Werutsky, J. Julien, I. Fentiman, R. Agresti, P. Rouanet, C. de Lara, H.
Bartelink, N. Duez, E. Rutgers and N. Bijker, "Breast-Conserving Treatment With or Without Radiotherapy in Ductal Carcinoma In Situ: 15-Year Recurrence Rates and Outcome After a Recurrence, From the EORTC 10853 Randomized Phase III Trial", Journal of Clinical Oncology, vol. 31, no. 32, pp. 4054-4059, 2013.
75
11L. Newman, "Advances in Breast Conservation Therapy", Journal of Clinical Oncology, vol. 23,
no. 8, pp. 1685-1697, 2005.
12I. Meattini, M. Guenzi, A. Fozza, C. Vidali, P. Rovea, F. Meacci and L. Livi, "Overview on cardiac,
pulmonary and cutaneous toxicity in patients treated with adjuvant radiotherapy for breast cancer", Breast Cancer, 2016.
13"Breast Cancer: Statistics | Cancer.Net", Cancer.Net, 2012. [Online]. Available:
http://www.cancer.net/cancer-types/breast-cancer/statistics. [Accessed: 20- March- 2016].
14“The Value of Medicines in Metastatic Breast Cancer (mBC)”, Pfizer.com, 2014. [Online].
Available:https://www.pfizer.com/files/health/VOMPaper_MetastaticBreastCancer.pdf.[Access ed: 20-Mar-2016].
15J. Sims-Mourtada, K. Arnold, L. Opdenaker and D. Flynn, "Wound Healing and Cancer Stem
Cells: Inflammation as a Driver of Treatment Resistance in Breast Cancer", Cancer Growth Metastasis, vol. 2015, no. 8, pp. 1-13, 2015.
16B. Rybinski, J. Franco-Barraza and E. Cukierman, "The wound healing, chronic fibrosis, and
cancer progression triad", Physiological Genomics, vol. 46, no. 7, pp. 223-244, 2014.
17S. Volk, Y. Wang, E. Mauldin, K. Liechty and S. Adams, "Diminished Type III Collagen Promotes
Myofibroblast Differentiation and Increases Scar Deposition in Cutaneous Wound Healing", Cells Tissues Organs, vol. 194, no. 1, pp. 25-37, 2011.
18V. Sarrazy, F. Billet, L. Micallef, B. Coulomb and A. Desmoulière, "Mechanisms of pathological
scarring: Role of myofibroblasts and current developments", Wound Repair and Regeneration, vol. 19, pp. s10-s15, 2011.
19G. Karagiannis, T. Poutahidis, S. Erdman, R. Kirsch, R. Riddell and E. Diamandis, "Cancer-
Associated Fibroblasts Drive the Progression of Metastasis through both Paracrine and Mechanical Pressure on Cancer Tissue", Molecular Cancer Research, vol. 10, no. 11, pp. 1403- 1418, 2012.
20M. Yamashita, T. Ogawa, X. Zhang, N. Hanamura, Y. Kashikura, M. Takamura, M. Yoneda and
T. Shiraishi, "Role of stromal myofibroblasts in invasive breast cancer: stromal expression of alpha-smooth muscle actin correlates with worse clinical outcome", Breast Cancer, vol. 19, no. 2, pp. 170-176, 2010.
21C. Mehner, A. Hockla, E. Miller, S. Ran, D. Radisky and E. Radisky, "Tumor cell-produced matrix
metalloproteinase 9 (MMP-9) drives malignant progression and metastasis of basal-like triple negative breast cancer", Oncotarget, vol. 5, no. 9, pp. 2736-2749, 2014.
76
22Y. Huang, A. Simms, A. Mazur, S. Wang, N. León, B. Jones, N. Aziz and T. Kelly, "Fibroblast
activation protein-α promotes tumor growth and invasion of breast cancer cells through non- enzymatic functions", Clin Exp Metastasis, vol. 28, no. 6, pp. 567-579, 2011.
23X. Catteau, P. Simon and J. Noël, "Myofibroblastic stromal reaction and lymph node status in
invasive breast carcinoma: possible role of the TGF-β1/TGF-βR1 pathway", BMC Cancer, vol. 14, no. 1, 2014.
24T. Lyons, J. O'Brien, V. Borges, M. Conklin, P. Keely, K. Eliceiri, A. Marusyk, A. Tan and P.
Schedin, "Postpartum mammary gland involution drives progression of ductal carcinoma in situ through collagen and COX-2", Nature Medicine, vol. 17, no. 9, pp. 1109-1115, 2011.
25G. Maskarinec, I. Pagano, M. Little, S. Conroy, S. Park and L. Kolonel, "Mammographic density
as a predictor of breast cancer survival: the Multiethnic Cohort", Breast Cancer Research, vol. 15, no. 1, p. R7, 2013.
26P. Provenzano, K. Eliceiri, J. Campbell, D. Inman, J. White and P. Keely, "Collagen
reorganization at the tumor-stromal interface facilitates local invasion", BMC Medicine, vol. 4, no. 1, p. 38, 2006.
27M. Conklin, J. Eickoff, K. Riching, C. Pehlke, K. Eliceiri, P. Provenzano, F. Andreas and P. Keely,
"Aligned collagen is a prognostic signature for survival in human breast carcinoma", Cancer Research, vol. 71, no. 8, pp. 4749-4749, 2011.
28X. Zeng, R. Morgenstern and A. Nyström, "Nanoparticle-directed sub-cellular localization of
doxorubicin and the sensitization breast cancer cells by circumventing GST-Mediated drug resistance", Biomaterials, vol. 35, no. 4, pp. 1227-1239, 2014.
29J. Lannutti, D. Reneker, T. Ma, D. Tomasko and D. Farson, "Electrospinning for tissue
engineering scaffolds", Materials Science and Engineering: C, vol. 27, no. 3, pp. 504-509, 2007.
30J. Barthes, H. Özçelik, M. Hindié, A. Ndreu-Halili, A. Hasan and N. Vrana, "Cell
Microenvironment Engineering and Monitoring for Tissue Engineering and Regenerative Medicine: The Recent Advances", BioMed Research International, vol. 2014, pp. 1-18, 2014.
31H. Li, X. Fan and J. Houghton, "Tumor microenvironment: The role of the tumor stroma in
cancer", Journal of Cellular Biochemistry, vol. 101, no. 4, pp. 805-815, 2007.
32S. Saha, X. Duan, L. Wu, P. Lo, H. Chen and Q. Wang, "Electrospun Fibrous Scaffolds Promote
Breast Cancer Cell Alignment and Epithelial–Mesenchymal Transition", Langmuir, vol. 28, no. 4, pp. 2028-2034, 2012.
77
33H. Kim, A. Jiao, N. Hwang, M. Kim, D. Kang, D. Kim and K. Suh, "Nanotopography-guided tissue
engineering and regenerative medicine", Advanced Drug Delivery Reviews, vol. 65, no. 4, pp. 536-558, 2013.
34M. Nikkhah, F. Edalat, S. Manoucheri and A. Khademhosseini, "Engineering microscale
topographies to control the cell–substrate interface", Biomaterials, vol. 33, no. 21, pp. 5230- 5246, 2012.
35A. Bruce, D. Bray, K. Hopkin, A. Jhonson, J. Lewis, M. Raff, K. Roberts and P. Walter, Essential
Cell Biology, Fourth Edition, 4th ed. New York: Garland Science, pp. 683-726,2014.
36S. Chattopadhyay and R. Raines, "Review collagen-based biomaterials for wound healing",
Biopolymers, vol. 101, no. 8, pp. 821-833, 2014.
37M. Shoulders and R. Raines, "Collagen Structure and Stability", Annu. Rev. Biochem., vol. 78,
no. 1, pp. 929-958, 2009.
38J. Uitto and A. Perejda, Connective tissue disease. New York: Marcel Dekker, p. 9,1987.
39S. Volk, S. Shah, A. Cohen, Y. Wang, B. Brisson, L. Vogel, K. Hankenson and S. Adams, "Type III
Collagen Regulates Osteoblastogenesis and the Quantity of Trabecular Bone", Calcified Tissue International, vol. 94, no. 6, pp. 621-631, 2014.
40E. Miedel, B. Brisson, T. Hamilton, H. Gleason, G. Swain, L. Lopas, D. Dopkin, J. Perosky, K.
Kozloff, K. Hankenson and S. Volk, "Type III collagen modulates fracture callus bone formation and early remodeling", Journal of Orthopaedic Research, vol. 33, no. 5, pp. 675-684, 2015.
41D. Gilkes, G. Semenza and D. Wirtz, "Hypoxia and the extracellular matrix: drivers of tumour
metastasis", Nature Reviews Cancer, vol. 14, no. 6, pp. 430-439, 2014.
42P. Provenzano, D. Inman, K. Eliceiri, J. Knittel, L. Yan, C. Rueden, J. White and P. Keely,
"Collagen density promotes mammary tumor initiation and progression", BMC Medicine, vol. 6, no. 1, p. 11, 2008.
43A. Schroeder, D. Heller, M. Winslow, J. Dahlman, G. Pratt, R. Langer, T. Jacks and D. Anderson,
"Treating metastatic cancer with nanotechnology", Nature Reviews Cancer, vol. 12, no. 1, pp. 39-50, 2011.
44"Metastatic Cancer", National Cancer Institute, 2016. [Online]. Available:
http://www.cancer.gov/about-cancer/what-is-cancer/metastatic-fact-sheet. [Accessed: 20- Mar- 2016].
78
45M. Al-Qattan, M. Abd-Elwahed, K. Hawary, M. Arafah and M. Shier, "Myofibroblast Expression
in Skin Wounds Is Enhanced by Collagen III Suppression", BioMed Research International, vol. 2015, pp. 1-6, 2015
46R. Dent, M. Trudeau, K. Pritchard, W. Hanna, H. Kahn, C. Sawka, L. Lickley, E. Rawlinson, P. Sun
and S. Narod, "Triple-Negative Breast Cancer: Clinical Features and Patterns of Recurrence", Clinical Cancer Research, vol. 13, no. 15, pp. 4429-4434, 2007.
47F. Podo, L. Buydens, H. Degani, R. Hilhorst, E. Klipp, I. Gribbestad, S. Van Huffel, H. W.M. van
Laarhoven, J. Luts, D. Monleon, G. Postma, N. Schneiderhan-Marra, F. Santoro, H. Wouters, H. Russnes, T. Sørlie, E. Tagliabue and A. Børresen-Dale, "Triple-negative breast cancer: Present challenges and new perspectives", Molecular Oncology, vol. 4, no. 3, pp. 209-229, 2010.
48D. Holliday and V. Speirs, "Choosing the right cell line for breast cancer research", Breast
Cancer Research, vol. 13, no. 4, p. 215, 2011.
49B. Pulaski and S. Ostrand-Rosenberg, "Mouse 4T1 Breast Tumor Model", Current Protocols in
Immunology, 2001.
50D. Giard, S. Aaronson, G. Todaro, P. Arnstein, J. Kersey, H. Dosik and W. Parks, "In vitro
cultivation of human tumors: establishment of cell lines derived from a series of solid tumors", J Natl Cancer Inst, vol. 515, pp. 1417-23, 1973.
51Z. Huang, Y. Zhang, M. Kotaki and S. Ramakrishna, "A review on polymer nanofibers by
electrospinning and their applications in nanocomposites", Composites Science and Technology, vol. 63, no. 15, pp. 2223-2253, 2003.
52W. Fu, Z. Liu, B. Feng, R. Hu, X. He, H. Wang, M. Yin, H. Huang, H. Zhang and W. Wang,
"Electrospun gelatin/PCL and collagen/PLCL scaffolds for vascular tissue engineering", International Journal of Nanomedicine, p. 2335, 2014.
53L. Ionescu and R. Mauck, "Porosity and Cell Preseeding Influence Electrospun Scaffold
Maturation and Meniscus Integration In Vitro", Tissue Engineering Part A, vol. 19, no. 3-4, pp. 538-547, 2013.
54M. Woodruff and D. Hutmacher, "The return of a forgotten polymer—Polycaprolactone in the
21st century", Progress in Polymer Science, vol. 35, no. 10, pp. 1217-1256, 2010.
55B. Baker, R. Shah, A. Silverstein, J. Esterhai, J. Burdick and R. Mauck, "Sacrificial nanofibrous
composites provide instruction without impediment and enable functional tissue formation", Proceedings of the National Academy of Sciences, vol. 109, no. 35, pp. 14176-14181, 2012.
79
56R. Delaine-Smith, N. Green, S. Matcher, S. MacNeil and G. Reilly, "Monitoring Fibrous Scaffold
Guidance of Three-Dimensional Collagen Organisation Using Minimally-Invasive Second Harmonic Generation", PLoS ONE, vol. 9, no. 2, p. e89761, 2014.
57P. Friedl and K. Wolf, "Tumour-cell invasion and migration: diversity and escape mechanisms",
Nature Reviews Cancer, vol. 3, no. 5, pp. 362-374, 2003
58M. Nelson, A. Short, S. Cole, A. Gross, J. Winter, T. Eubank and J. Lannutti, "Preferential,
enhanced breast cancer cell migration on biomimetic electrospun nanofiber ‘cell highways’", BMC Cancer, vol. 14, no. 1, p. 825, 2014.
59D. Jaalouk and J. Lammerding, "Mechanotransduction gone awry", Nature Reviews Molecular
Cell Biology, vol. 10, no. 1, pp. 63-73, 2009.
60S. Fulda, "Tumor resistance to apoptosis", International Journal of Cancer, vol. 124, no. 3, pp.
511-515, 2009.
61A. Porter and R. Jänicke, "Emerging roles of caspase-3 in apoptosis", Cell Death Differ, vol. 6,
no. 2, pp. 99-104, 1999.
62S. Ghavami, M. Hashemi, S. Ande, B. Yeganeh, W. Xiao, M. Eshraghi, C. Bus, K. Kadkhoda, E.
Wiechec, A. Halayko and M. Los, "Apoptosis and cancer: mutations within caspase genes", Journal of Medical Genetics, vol. 46, no. 8, pp. 497-510, 2009.
63S. Cullen and S. Martin, "Caspase activation pathways: some recent progress", Cell Death
Differ, vol. 16, no. 7, pp. 935-938, 2009
64O. Gani and R. Engh, "Protein kinase inhibition of clinically important staurosporine
analogues", Nat. Prod. Rep., vol. 27, no. 4, p. 489, 2010.
65D. Kerr and P. Workman, New molecular targets for cancer chemotherapy. Boca Raton: CRC
Press, pp. 121-134,1994.
66G. Lonne, K. Masoumi, J. Lennartsson and C. Larsson, "Protein Kinase C Supports Survival of
MDA-MB-231 Breast Cancer Cells by Suppressing the ERK1/2 Pathway", Journal of Biological Chemistry, vol. 284, no. 48, pp. 33456-33465, 2009.
67Y. Wang, H. Yang, H. Liu, J. Huang and X. Song, "Effect of staurosporine on the mobility and
invasiveness of lung adenocarcinoma A549 cells: an in-vitro study", BMC Cancer, vol. 9, no. 1, p. 174, 2009.
80
69"Scanning Electron Microscopy (SEM)", Techniques, 2016. [Online]. Available:
http://serc.carleton.edu/research_education/geochemsheets/techniques/SEM.html. [Accessed: 1-Apr- 2016].
70S. Nalinanon, S. Benjakul, W. Visessanguan and H. Kishimura, "Use of pepsin for collagen
extraction from the skin of bigeye snapper (Priacanthus tayenus)", Food Chemistry, vol. 104, no. 2, pp. 593-601, 2007.
71P. Singh, S. Benjakul, S. Maqsood and H. Kishimura, "Isolation and characterisation of collagen
extracted from the skin of striped catfish (Pangasianodon hypophthalmus)", Food Chemistry, vol. 124, no. 1, pp. 97-105, 2011.
72T. Fujii and K. Kühn, "Isolation and Characterization of Pepsin-Treated Type III Collagen from
Calf Skin", Hoppe-Seyler´s Zeitschrift für physiologische Chemie, vol. 356, no. 2, pp. 1793-1802, 1975.
73B. Wang, Z. Yang, B. Brisson, H. Feng, Z. Zhang, E. Welch, S. Peltz, E. Barton, R. Brown and H.
Sweeney, "Membrane blebbing as an assessment of functional rescue of dysferlin-deficient human myotubes via nonsense suppression", Journal of Applied Physiology, vol. 109, no. 3, pp. 901-905, 2010.
74L. Gao, Y. Zhao, Y. Liang, X. Lin, Y. Tan, D. Wu, X. Li, B. Ye, F. Kong, J. Sheng and H. Huang, "The
impaired myocardial ischemic tolerance in adult offspring of diabetic pregnancy is restored by maternal melatonin treatment", J. Pineal Res., 2016.
75V. Tillgren, J. Ho, P. Önnerfjord and S. Kalamajski, "The Novel Small Leucine-rich Protein
Chondroadherin-like (CHADL) Is Expressed in Cartilage and Modulates Chondrocyte Differentiation", Journal of Biological Chemistry, vol. 290, no. 2, pp. 918-925, 2014.
76M. Kimoto, N. Shima, M. Yamaguchi, S. Amano and S. Yamagami, "Role of Hepatocyte Growth
Factor in Promoting the Growth of Human Corneal Endothelial Cells Stimulated by l -Ascorbic Acid 2-Phosphate", Investigative Opthalmology & Visual Science, vol. 53, no. 12, p. 7583, 2012.
77F. Allen and O. Johnson, "Automated conformational analysis from crystallographic data. 4.
Statistical descriptors for a distribution of torsion angles", Acta Crystallogr Sect B, vol. 47, no. 1, pp. 62-67, 1991.
78M. MacArthur and J. Thornton, "Conformational analysis of protein structures derived from
81
79K. McAndrews, D. McGrail, N. Ravikumar and M. Dawson, "Mesenchymal Stem Cells Induce
Directional Migration of Invasive Breast Cancer Cells through TGF-β", Sci. Rep., vol. 5, p. 16941, 2015.
82 Appendix
MATLAB program for quantifying circular variance
function [VarF]=Circular(Fetal2)%To input variance values
Fetal2=(Fetal2.*pi./180).*2;%To convert sin and cos angle values for i=1:length(Fetal2)%specifying length of array
Cosi(i)=cos(Fetal2(i));%converting input angle into cos angle
Sini(i)=sin(Fetal2(i));converting input angle into sin angle end
SumCos=(sum(Cosi)).^2;%squaring the summation of cos angle SumSin=(sum(Sini)).^2;%squaring the summation of sin angle RsqF2=SumCos+SumSin; %adding cos and sin angled
RF=sqrt(RsqF2);
Rfv=RF/length(Fetal2); VarF=1-Rfv;