Day 1 :
Keynote Forum
Georgi V Petkov
University of South Carolina
USA
Keynote: BK channels as non-genomic targets for oestrogens and potential novel molecular targets for the treatment of overactive bladder
Time : 09:35-10:15
Biography:
Georgi V Petkov is a Tenured Professor of Pharmacology at the University of South Carolina. His studies have helped to identify new pharmacological targets for drugs targeting urinary bladder dysfunction. He has published over 50 peer-reviewed papers in journals such as Journal of Physiology (London), American Journal of Physiology, Journal of Urology. He serves as Editor and Reviewer for many peer-reviewed journals including Journal of Urology. He has given many invited seminars worldwide and received various academic honors and awards at national and international level.
Abstract:
Overactive Bladder (OAB) is a significant medical problem affecting ~17% of the population at an annual cost of over $65 billion in the United States alone. Current OAB therapies are limited in efficacy and relief. Novel therapeutic approaches are urgently needed especially those that directly target detrusor smooth muscle (DSM). This is important because many forms of OAB are associated with increased DSM contractions during bladder filling and urinary storage which is normally facilitated by DSM relaxation. Recent studies from Dr Petkov’s laboratory at the University of South Carolina indicate that in human DSM, the large conductance voltage- and Ca2+-activated K+ (BK) channels are critical regulators of DSM myogenic and neurogenic contractions. BK channel function in DSM is to control Ca2+ influx through voltage-gated Ca2+ (CaV) channels which in turn determine the degree of DSM contractility. New data from the Petkov’s laboratory reveal that oestrogens can directly activate BK channels in human DSM cells thus reducing DSM excitability and contractility. Initial experiments by the Petkov laboratory show that oestrogens reduce spontaneous phasic contractions of human DSM isolated strips in a concentration-dependent manner which involves a direct interaction of oestrogens with BK channels independent of oestrogen receptors as demonstrated in excised membrane patches. Modulation of BK channel activity or their regulatory mechanisms by oestrogens may provide the basis for developing new therapeutic interventions for OAB. To facilitate such novel approaches we need to have a better understanding of BK channels regulation by oestrogens.
Keynote Forum
Rosanna Paciucci
Vall d’Hebron Institute of Research
Spain
Keynote: Prostate tumor overexpressed-1 (PTOV1) is an oncogenic protein promoting prostate cancer progression: Its implications in the chemotherapy resistance
Time : 10:15-10:55
Biography:
Rosanna Paciucci has completed her PhD from New York University Medical School, NY, USA and postdoctoral studies from University of Cantabria, Spain and\\\\r\\\\nlater on at the Institut Municipal d’Investigacio Medica (IMIM), Barcelona, Spain. She is group leader of the Biomedical Research group in Urology at Vall d’Hebron\\\\r\\\\nInstitut of Research, Barcelona, Spain. She has published more than 25 papers in high impact factor journals and has two patents. The major focus of her research is directed to understanding the biology of castration-resistant prostate cancer.
Abstract:
Prostate Cancer (PC) is the most common male malignancy and the second leading cause of cancer deaths. Approximately 85% of newly diagnosed prostate cancer cases are localized to the prostate whereas the remainders are invasive or metastatic disease. Patients with metastatic prostate cancer responds initially to androgen deprivation therapy (ADT), however progression to castration-resistant prostate cancer (CRPC) occurs in the majority of patients. In CRPC patients’ docetaxel improves survival and it is considered a standard first-line therapy. Unfortunately most patients at his stage of progression develop strong resistant tumors. Several mechanisms of resistance to docetaxel have been described although in general the resistant phenotype is still poorly understood. Therefore, further studies in CRPC are needed to improve current therapies. Accumulating evidences suggest that Prostate tumor overexpressed-1 (PTOV1) protein acts as oncogenic driver in PC. PTOV1 is strongly expressed in prostate carcinoma and expressed at low levels in the benign prostate epithelium. High levels of expression of PTOV1 in prostate tumors and other neoplasias (colorectal, renal, bladder, ovarian cancer) are significantly associated with their proliferative status and with high grade malignant tumors. Our aim is to elucidate the mechanisms by which PTOV1 modulates PC progression and its possible implication in the acquisition of resistance to treatments. We have shown that in CRPC cells PTOV1 interacts with the receptor of activated protein kinase C (RACK1) and ribosomes and modulate protein synthesis. In these cells, PTOV1 promotes selective translation of mRNAs including the oncogene c-Jun and the cancer stem cell protein SNAIL1 inducing an epithelial-mesenchymal transition. In addition, in vivo experiments carried out in SCID-beige mice inoculated subcutaneously with CRPC PC3 cells knocked down for PTOV1 supported the role of PTOV1 in tumorigenesis and metastatic spreading. In CRPC Du145 and PC3 cells the ectopic overexpression of PTOV1 confers resistance to Docetaxel. Interestingly, Docetaxel Resistant (DR) cell lines showed higher levels of endogenous PTOV1 compared to control cells and the depletion of PTOV1 in these cells induces a G2/M cell cycle arrest and apoptosis. Together, these results unveil new functions of PTOV1 in the regulation of protein translation and in the progression of prostate cancer to an invasive and metastatic disease.
- Neurourology and Urodynamics
- Pediatric Urology
- Robotic Urology
- Urinary Incontinence
Chair
Dana L Jacoby
BSM Consulting, USA
Session Introduction
Dana L Jacoby
BSM Consulting, USA
Title: Optimizing urology group partnerships: Collaboration, compensation, and centers of excellence
Time : 11:15-11:45
Biography:
Dana Jacoby has more than fifteen years of experience in healthcare with roles in sales, operations, consulting, and management.
Dana has been involved in change management, operations, and strategic planning in 30 of the 35 major medical markets in the United States. In addition she has conducted training and business development in European and Asian medical markets. She has been responsible for business planning with management, staff, and physicians at 17 top tier hospitals as ranked by U.S. News and World Report.
Ms. Jacoby holds a Bachelor of Science degree from Louisiana State University in Baton Rouge and a Master of Management from Tulane University in New Orleans. In addition, she holds a Master of Health Systems from the University of Medicine and Dentistry in Newark, NJ and is a Wharton Fellow at Wharton University in Philadelphia, PA.
Abstract:
Market forces in healthcare have created substantial regulatory, legislative, and reimbursement changes that have impacted urology group practices and health systems. Although group operations vary considerably, the majority of groups have struggled with the development of a strong culture, eff ective decision making, and consensus building around shared resources, income, and standardized care. Creating a sustainable business model requires urology group leaders to allocate appropriate time and resources to address these issues in a proactive manner. Th is presentation will outline collaboration strategies for creating eff ective culture, governance and leadership while providing practical suggestions on how to optimize urology group practice performance. Research suggests that successful urology groups and medical institutions have outstanding physician leaders who recognize the importance of creating a common culture built around a strong mission, vision, and set of values. Physicians must understand the value of developing a compensation plan and cultural structure that eff ectively aligns the incentives of the group in achieving long-term objectives. Principles of governance to be covered as a part of the discussion: • Trust, transparency, and communication. Proven methods to reduce the ineffi ciencies of stymied communication. • Physician-Hospital Interdependence. How to best achieve respective economic and clinical goals through collaboration and integration. • Aligning fi nancial incentives. Delivering cost-eff ective, high-quality care consistent with best practices to produce shared incentives • Quality-Identify and measure relevant indicators • Shared Leadership, Physician-driven and professionally managed clinical enterprise solutions
Mireia Olivan Riera
Vall d’Hebron Institute of Research, Spain
Title: Protein biomarkers in urinary exosome for the diagnosis of prostate cancer
Time : 11:45-12:15
Biography:
After her PhD based on therapeutic strategies for cancer cachexia (University of Barcelona), her first postdoctoral fellowship led her to work at the University of Sao Paulo (Brazil), where she studied the role of adipose tissue in inflammation during cachectic syndrome. When she returned to Barcelona, she obtained a postdoctoral position in the Group of Biomedical Research in Urology in the Research Institute of Vall Hebron Hospital. The last years, her main research has been in the field of biomarkers for the detection of aggressive prostate cancer. Recently, she spent a fruitful period at Mount Sinai Hospital (New York), where she studied the potential of miRNAs as therapeutic targets. The last year, she has also been focused in the study of urinary exosomes as a new source of biomarkers.
Abstract:
Background: Rapid and reliable diagnosis of prostate cancer (PCa) is highly desirable. Sensitivity and failure rate of current methods for diagnosis limit the success to early detect this type of cancer and consequently advanced disease is often encountered. Furthermore, the identification of PCa biomarkers that can classify patients into high- and low-risk groups of disease progression and therefore help in the treatment decision-making is a major area of ongoing research.
Objectives: Since the prostate is in direct contact with the urethra, desquamated cells and secreted products including exosomes like vesicles (ELV) are abundant in human urine and serve as potential source for PCa biomarkers. In this study we aimed to identify protein biomarkers in urinary exosomes for early non-invasive detection and stratification of PCa.
Methods: Protein biomarker candidates for PCa were initially identified from a discovery phasedone in urinary exosomes isolated by ultracentrifugation from urine obtained after digital rectal examination. Specifically, label-free LC-MS/MS protein quantitation was performed on 24 samples: 8 benign samples, 8 low-risk PCa samples (Gleason=7(3+4)) and 8 high-risk PCa samples (Gleason>7). Proteins significantly changing in abundance were selected for further selected reaction monitoring (SRM) validation in 53 urinary exosomes samples from PCa patients and 54 from benign counterparts.
Results & Discussion: We identified 1673 proteins including PSA, PSMA and ACPP and selected a panel of 64 candidates for validation by SRM. Ultimately we identified a profile of 2 novel urinary exosome-associated protein biomarkers after the comparison between benign and PCa patients and a promising profile of 5 proteins able to significantly distinguish between high (Gleason ≥7 (4+3)) and low (Gleason ≤7 (3+4)) risk patients. The presence of the candidates was confirmed in urinary exosomes of PCa and benign prostate pathologies patients by western blot and analyzed in TMA PCa samples. In summary, our proteomic studies identified a list of markers which are very good candidates for evaluation of their clinical utility in future studies in order to reduce PCa related over-diagnosis and over-treatment.
Sibel Silici
Erciyes University, Turkey
Title: In vivo nephroprotective efficacy of propolis against contrast-induced nephropathy
Time : 12:15-12:45
Biography:
Sibel Silici is a professor from Erciyes University, Turkey
Abstract:
Objective: Contrast-induced nephrophaty (CIN) is a common cause of hospital-acquired renal failures following the administration of computer tomography contrast agent Diatrizoate, but can be prevented using pretreatment with pharmaceutical compounds, such as N-acetylcystein (NAC) and Calpain. Th is paper explores the value of natural antioxidant compound Propolis with demonstrated benefi ts in health care as a potential nephroprotector. Materials &Methods: In vivo experiments were performed with a total of 35 male rats divided equally into 5 groups: Control, Diatrizoate administered (6 mg/kg/bw i.v.) and pretreatment with either propolis (100 mg/kg/bw), NAC (300 mg/kg/bw) or Calpain (10 mg/kg/bw) 1 hr before the Diatrizoate administration (6 mg/kg/bw i.v.). Th ree days later, blood, urine and renal tissue samples were collected and quantitatively processed for critical biomarkers sensitive to the indicated manipulations. Specifi cally, Malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) activities in renal tissue in addition to plasma urea and serum creatinine levels were measured and statistically analyzed to determine the response and effi cacy of each of the selected pretreatment approach. Results: Overall, pretreatment with Propolis was consistently proven to be more eff ective in restoring the values of the measured parameters to within their normal ranges compared to NAC and Calpain. Conclusion: With its robust power to eliminate free radicals and other adverse eff ects induced by Diatrizoate, Propolis plays an important protective role in preventing kidney from getting CIN.
Mireia Las Heras Alonso
Hospital Universitario de Getafe, Madrid Universidad Europea
Title: Penile low-intensity shock wave therapy: A promising novel modality for erectile dysfunction
Time : 12:45-13:15
Biography:
Mireia Las Heras is an urologist, and did her andrology training in the Fundación Puigvert (Barcelona) in 2005. She obtained his Doctorate degree from the Universidad Autónoma de Barcelona in 2010, and developed the Fellow of European Board of Sexology in Amsterdan in 2012. She currently works at the Hospital Universitario de Getafe (Madrid), where she developed her work as andrologist and conducting research.
Abstract:
Penile extracorporeal low-intensity shock wave therapy (LIST) to thepenis has recently emerged as a novel and promising modality in the treatment of erectile dysfunction (ED). LIST has angiogenic properties and stimulates neovascularization. If applied to the corpora cavernosa, LIST can improve penile blood fl ow and endothelial function. In a series of clinical trials, including randomized double-blind sham-controlled studies, LIST has been shown to have a substantial eff ect on penile hemodynamics and erectile function in patients with vasculogenic ED. LIST is eff ective in patients who are responsive to phosphodiesterase 5 inhibitors (PDE5i) and can also convert PDE5i non-responders to responders. Th e response to LIST wanes gradually over time, and aft er 2 years, about half of the patients manintain their function. Extensive research is needed to understand the eff ect of LIST on erectile tissue, to modify the treatment protocol to maximize its outcomes, and to identify the patients who will benefi t the most from this treatment.
Suzi Demirbag
Gulhane Military Medical Academy, Turkey
Title: Indications and effectiveness of the open surgery in vesicoureteral reflux
Time : 14:00-14:30
Biography:
Suzi Demirbag has completed his MD at the age of 23 years from Gulhane Military Medical School and Postdoctoral studies from same center. He has published more than 36 papers in reputed journals.
Abstract:
Vesicoureteral reflux (VUR) is retrograde flow of urine from the bladder into the ureters and is still one of the most common causes of end-stage renal disease in infancy and childhood. In this abstract we will discuss indications and effectiveness of the open surgery in VUR. The prevalence of VUR in healthy children is around 1-3% and varies depending on sex, age and race. There are two treatment options for patients with VUR: Medical and surgical. The main goal in the management of vesicoureteral reflux in children is to protect renal function. There is a still disagreement regarding the optimal management of the VUR.
Chetan Mehndiratta
Ranbaxy Laboratories Limited, India
Title: Silodosin improves low urinary tract symptoms associated with benign prostatic hyperplasia
Time : 14:30-15:00
Biography:
Chetan Mehndiratta is a researcher from Ranbaxy Laboratories Limited, India
Abstract:
Introduction & Objective: Benign prostatic hyperplasia (BPH) is a globally prevalent histological condition with approximately 80% to 90% men aff ected in their 70s and 80s. Th e present study was a pan-India survey conducted among 655 urologists for highlighting the role of silodosin, a highly selective α1A-AR antagonist in the management of lower urinary tract symptoms (LUTS) associated with BPH. Methods: Th e survey consisted of an objective, time based questionnaire to be completed by the urologists to obtain their opinion on the best drug choice for LUTS management. Th e response to silodosin on the relevance scale (scores of 1-5) was categorized as average-1, above average-2, good-3, very good-4 and excellent-5. Th e results were expressed as mean scores and percentage values. Results: According to approximately 85% of urologists, silodosin has a good to excellent relevance in patients suff ering from moderate to severe nocturia. Silodosin was also eff ective in the group of LUTS patients who were concomitantly treated with antihypertensive medications and PDE5 inhibitors as well as patients who were not satisfi ed with previous therapy of alpha blockers. Conclusions: Silodosin might prove a potent agent in the improvement of the clinical symptoms related to LUTS with BPH, especially in elderly patients