This work was supported by Associazione Italiana per la Ricerca sul Cancro, Italian Ministry of University and Research, Prin projects and Progetti di Ricerca di Ateneo, grant N&#176; CPDA137871, Fondazione Cariplo, grant N&#176; 2011-0485 to MdB, and by Finanziamento Giovani Studiosi, University of Padua, to Gaia Codolo.

All the procedures for animal handling have been approved by the Italian Ministry of Health (D.M. 204/2011-B).
1. Animals
<ol>
	<li>Grow&#8203; C57BL6/J female mice to 8 weeks of age in individually ventilated cages with microisolation filters. 
	Note: Females are preferred because the anatomic conformation of their external uro-genital apparatus renders the catheterization easier than in males.</li>
</ol>
2. Cell Culture
<ol>
	<li>Maintain the mouse urothelial...

<ol>
	<li>Siegel, R., Ma, J., Zou, Z., Cancerstatistics Jemal, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> CA Cancer J Clin. 64, 9-29 (2014).</li><li>Saint, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prognostic+value+of+a+T+helper+1+urinary+cytokine+response+after+intravesical+bacillus+Calmette-Guerin+treatment+for+superficial+bladder+cancer.">Prognostic value of a T helper 1 urinary cytokine response after intravesical bacillus Calmette-Guerin treatment for superficial bladder cancer.</a> J Urol. 167, 364-367 (2002).</li><li>Shahin, O., Thalmann, G. N., Rentsch, C., Mazzucchelli, L., Studer, U. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+retrospective+analysis+of+153+patients+treated+with+or+without+intravesical+bacillus+Calmette-Guerin+for+primary+stage+T1+grade+3+bladder+cancer:+recurrence,+progression+and+survival.">A retrospective analysis of 153 patients treated with or without intravesical bacillus Calmette-Guerin for primary stage T1 grade 3 bladder cancer: recurrence, progression and survival.</a> J Urol. 169, 96-100 (2003).</li><li>Lamm, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complications+of+bacillus+Calmette-Guerin+immunotherapy.">Complications of bacillus Calmette-Guerin immunotherapy.</a> Urol Clin North Am. 19, 565-572 (1992).</li><li>De Jager, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+complete+remission+in+bladder+carcinoma+in+situ+with+intravesical+TICE+bacillus+Calmette+Guerin.+Overview+analysis+of+six+phase+II+clinical+trials.">Long-term complete remission in bladder carcinoma in situ with intravesical TICE bacillus Calmette Guerin. Overview analysis of six phase II clinical trials.</a> Urology. 38, 507-513 (1991).</li><li>Dovedi, S. J., Davies, B. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Emerging+targeted+therapies+for+bladder+cancer:+a+disease+waiting+for+a+drug.">Emerging targeted therapies for bladder cancer: a disease waiting for a drug.</a> Cancer Metastasis Rev. 28, 355-367 (2009).</li><li>Evans, D. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+a+Helicobacter+pylori+neutrophil-activating+protein.">Characterization of a Helicobacter pylori neutrophil-activating protein.</a> Infect Immun. 63, 2213-2220 (1995).</li><li>Grant, R. A., Filman, D. J., Finkel, S. E., Kolter, R., Hogle, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+crystal+structure+of+Dps,+a+ferritin+homolog+that+binds+and+protects+DNA.">The crystal structure of Dps, a ferritin homolog that binds and protects DNA.</a> Nat Struct Biol. 5, 294-303 (1998).</li><li>Amedei, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+neutrophil-activating+protein+of+Helicobacter+pylori+promotes+Th1+immune+responses.">The neutrophil-activating protein of Helicobacter pylori promotes Th1 immune responses.</a> J Clin Invest. 116, 1092-1101 (2006).</li><li>Bernard, M., D'Elios, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+immune+modulating+activity+of+the+Helicobacter+pylori+HP-NAP:+Friend+or+foe.">The immune modulating activity of the Helicobacter pylori HP-NAP: Friend or foe.</a> Toxicon. 56, 1186-1192 (2010).</li><li>Codolo, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+neutrophil-activating+protein+of+Helicobacter+pylori+down-modulates+Th2+inflammation+in+ovalbumin-induced+allergic+asthma.">The neutrophil-activating protein of Helicobacter pylori down-modulates Th2 inflammation in ovalbumin-induced allergic asthma.</a> Cell Microbiol. 10, 2355-2363 (2008).</li><li>Gunther, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimizing+syngeneic+orthotopic+murine+bladder+cancer+(MB49).">Optimizing syngeneic orthotopic murine bladder cancer (MB49).</a> Cancer Res. 59, 2834-2837 (1999).</li><li>Codolo, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HP-NAP+inhibits+the+growth+of+bladder+cancer+in+mice+by+activating+a+cytotoxic+Th1+response.">HP-NAP inhibits the growth of bladder cancer in mice by activating a cytotoxic Th1 response.</a> Cancer Immunol Immunother. 61, 31-40 (2012).</li><li>Chan, E., Patel, A., Heston, W., Larchian, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+orthotopic+models+for+bladder+cancer+research.">Mouse orthotopic models for bladder cancer research.</a> BJU Int. 104, 1286-1291 (2009).</li><li>Kubota, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Metastatic+models+of+human+cancer+xenografted+in+the+nude+mouse:+the+importance+of+orthotopic+transplantation.">Metastatic models of human cancer xenografted in the nude mouse: the importance of orthotopic transplantation.</a> J Cell Biochem. 56, 4-8 (1994).</li><li>Loi, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+the+orthotopic+model+to+validate+antivascular+therapies+for+cancer.">The use of the orthotopic model to validate antivascular therapies for cancer.</a> Int J Dev Biol. 55, 547-555 (2011).</li><li>Miyazaki, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preconditioning+methods+influence+tumor+property+in+an+orthotopic+bladder+urothelial+carcinoma+rat+model.">Preconditioning methods influence tumor property in an orthotopic bladder urothelial carcinoma rat model.</a> Mol Clin Oncol. 2, 65-70 (2014).</li><li>Horiguchi, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+of+orthotopic+mouse+superficial+bladder+tumor+model+for+studies+on+intravesical+treatments.">Establishment of orthotopic mouse superficial bladder tumor model for studies on intravesical treatments.</a> Hum Cell. 21, 57-63 (2008).</li></ol>

The authors declare that they have no competing financial interests.

The majority of advances in cancer therapy require tests in animal models before starting clinical trials. The possibility of studying tumour biology in vivo, taking advantage of animal models, represents a crucial tool for researchers investigating cancer pathogenesis, enabling the assessment of different therapeutic approaches. Orthotopic models remain the gold standard14-15, both because of the huge amount of cell lines available to set up a tumour model and because they mimic the environment of th...

Bladder cancer is one of the most common cancers of the urogenital tract, with nearly 75,000 new cases every year in the USA1. High rates of recurrence require lifelong follow-up, which makes bladder cancer one of the costliest cancers to treat. The gold standard treatment for the high-grade NMIBC is trans-urethral resection, followed by intravesical immunotherapy with BCG. Although the precise mechanism of the anti-tumour activity of BCG remains to be fully elucidated, it is accepted that the activation of a cell-mediated immune response enriched in T helper (Th)1 and cytotoxic T (Tc)1 cells is crucial for the success of the therapy2.
Despite the fact that BCG remains the treatment of choice for NMIBC, a high proportion of patients do not respond to the therapy; moreover, it can cause a number of side effects: about 70% of treated tumours recur after some time and ~15% progress to the muscle-invasive form of the disease. Other side effects associated with BCG treatment include dysuria, cystitis and kidney infection3-6.
The development of novel therapeutic strategies must take into consideration the use of preclinical models, following initial in vitro assessment; this is particularly relevant in tumours whose microenvironment can significantly influence their development and responsiveness to treatment.
Over the last decade, we have addressed multiple aspects of the immune modulating activity of HP-NAP, a protein produced by the bacterium Helicobacter pylori, initially identified as capable of promoting endothelial adhesion of polymorphonuclear cells (PMNs)7. Structurally, HP-NAP belongs to the DNA-protecting protein under starved conditions (Dps) family8 and consists of 12 identical subunits arranged in a dodecameric shell.
We have demonstrated that HP-NAP is a Toll-like receptor (TLR)2 agonist, with a strong immuno-modulating activity responsible for driving the differentiation of T lymphocytes towards the Th1 phenotype, both in vitro and in vivo9-10. In virtue of this activity, HP-NAP is able to redirect the Th2 immune response into the more beneficial Th1 response in a murine model of allergic asthma11.
To evaluate the Th1-dependent anti-tumour potential of HP-NAP, we took advantage of a mouse model of bladder cancer developed several years ago by O&#8217;Donnel and colleagues12 for evaluating the impact of the BCG administration.
With this protocol, we demonstrate that HP-NAP has a strong anti-tumour potential against bladder cancer and that the efficacy of HP-NAP administration parallels the significant accumulation, within tumour and regional lymph nodes, of both Th1 and Tc1 lymphocytes producing Interferon (IFN)-&#947;13. Tumours isolated from HP-NAP-treated mice showed more necrosis and less vascularization than the untreated counterpart.
The present report provides a stepbystep protocol, detailing the preparation of the animals, their urethral catheterization, the chemical burning required for the attachment of cells to the bladder mucosa, and the injection of the tumour cells. We also describe the topical administration of HP-NAP that can be considered as a prototype of any therapeutic agents developed for the treatment of bladder cancer. The evidence obtained by comparing tumours isolated from control and HP-NAP-treated animals emphasizes not only the fact that HP-NAP could be a good candidate for bladder cancer immunotherapy, but also the general effectiveness of the experimental set up.

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td>Materials</td>
		</tr>
		<tr>
			<td>C57BL/6J female mice</td>
			<td>Harlan Italy (Udine, Italy)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>MB49 Cells</td>
			<td></td>
			<td></td>
			<td>Obtained from Prof. O&#39;Donnel, University of Iowa Carver College of Medicine, Iowa, USA</td>
		</tr>
		<tr>
			<td>RPMI</td>
			<td>Sigma-Aldrich (St. Louis, Missouri, USA)</td>
			<td>R8758</td>
			<td></td>
		</tr>
		<tr>
			<td>FBS</td>
			<td>Sigma-Aldrich</td>
			<td>F7524</td>
			<td></td>
		</tr>
		<tr>
			<td>PBS</td>
			<td>Sigma-Aldrich</td>
			<td>D1408</td>
			<td>10X, to be diluted in apyrogenic water</td>
		</tr>
		<tr>
			<td>Flask</td>
			<td>Becton Dickinson (Franklin Lakes, New Jersey, USA)</td>
			<td>353135</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe 1ml</td>
			<td>Becton Dickinson</td>
			<td>301358</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypsin</td>
			<td>Life Technologies (Waltham, Massachusetts, USA)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Gentamycin</td>
			<td>Life Technologies</td>
			<td>15710-049</td>
			<td></td>
		</tr>
		<tr>
			<td>Xilor</td>
			<td>Bio 98 s.r.l. (Milano, Italy)</td>
			<td></td>
			<td>2% Xylazin</td>
		</tr>
		<tr>
			<td>Zoletil</td>
			<td>Virbac (Carros, France)</td>
			<td>359713301992</td>
			<td>5% Zolazepam + 5% Tiletamine</td>
		</tr>
		<tr>
			<td>24G Catheter</td>
			<td>Terumo (Rome, Italy)</td>
			<td>SR+DM2419PX</td>
			<td></td>
		</tr>
		<tr>
			<td>HCl</td>
			<td>Carlo Erba Reagents (Milano, Italy)</td>
			<td>403871</td>
			<td>Liquid</td>
		</tr>
		<tr>
			<td>NaOH</td>
			<td>JT Baker (Center Valley, Pennsylvania, USA)</td>
			<td>10095011</td>
			<td>Powder</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td>Equipment</td>
		</tr>
		<tr>
			<td>Surgical Scalpel</td>
			<td>Albion Surgical Limited (Sheffield, England)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Microtome</td>
			<td>Leica Microsystem ( Wetzlar, Germany)</td>
			<td>RM2235</td>
			<td></td>
		</tr>
		<tr>
			<td>Microscope Slides</td>
			<td>VWR International (Radnor, Pennsylvania, USA)</td>
			<td>631-0108</td>
			<td></td>
		</tr>
		<tr>
			<td>Image Analyzer</td>
			<td>Zeiss (Jena, Germany)</td>
			<td>Cyres System</td>
			<td></td>
		</tr>
	</tbody>
</table>
Materials C57BL/6J female mice Harlan Italy (Udine, Italy) MB49 Cells Obtained from Prof. O&#39;Donnel, University of Iowa Carver College of Medicine, Iowa, USA RPMI Sigma-Aldrich (St. Louis, Missouri, USA) R8758 FBS Sigma-Aldrich F7524 PBS Sigma-Aldrich D1408 10X, to be diluted in apyrogenic water Flask Becton Dickinson (Franklin Lakes, New Jersey, USA) 353135 Syringe 1ml Becton Dickinson 301358 Trypsin Life Technologies (Waltham, Massachusetts, USA) Gentamycin Life Technologies 15710-049 Xilor Bio 98 s.r.l. (Milano, Italy) 2% Xylazin Zoletil Virbac (Carros, France) 359713301992 5% Zolazepam + 5% Tiletamine 24G Catheter Terumo (Rome, Italy) SR+DM2419PX HCl Carlo Erba Reagents (Milano, Italy) 403871 Liquid NaOH JT Baker (Center Valley, Pennsylvania, USA) 10095011 Powder Equipment Surgical Scalpel Albion Surgical Limited (Sheffield, England) Microtome Leica Microsystem ( Wetzlar, Germany) RM2235 Microscope Slides VWR International (Radnor, Pennsylvania, USA) 631-0108 Image Analyzer Zeiss (Jena, Germany) Cyres System

evaluation of the efficacy of the h. pylori protein hp-nap as a therapeutic tool for treatment of bladder cancer in an orthotopic murine model

Bladder cancer is one of the most common malignancies of the urogenital tract. Intravesical injection of Bacillus Calmette-Gu&#233;rin (BCG) is the gold standard treatment for the high-grade non-muscle invasive bladder cancer (NMIBC). However, since the treatment-related side effects are relevant, newer biological response modifiers with a better benefit/side effects ratio are needed.
The tumour microenvironment can influence both tumour development and therapy efficacy. In order to obtain a good model, it is desirable to implant tumour cells in the organ from which the cancer originates.
In this protocol, we describe a method for establishing a tumour in the bladder cavity of female mice and subsequent delivery of therapeutic agents; the latter are exemplified by our use of Helicobacter pylori neutrophil activating protein (HP-NAP). A preliminary chemical burn of the mucosa, followed by the injection of mouse urothelial carcinoma cell line MB49 via urethral catheterization, enables the cells to attach to the bladder mucosa. After a period, required to allow an initial proliferation of the cells, mice are treated with HP-NAP, administrated again via catheterization. The anti-tumour activity of HP-NAP is evaluated comparing the tumour volume, the extent of necrosis and the degree of vascularization between vehicle- and HP-NAP-treated animals.

Figure 1 shows the catheterization technique; the mouse is catheterized and instilled with 0.5 &#215; 106 MB49 cells. Treatment with HP-NAP is started 3 days after the injection of tumour cells, to enable them to attach to the bladder wall and proliferate. All the animals belonging to the control group develop the tumour; some of them may die before the end of the 13 day period due to the occlusion of the urethra.
After the first injection with HP-NAP, the animals a...

Watch this Scientific Journal Video about Evaluation of the Efficacy of the H. pylori Protein HP-NAP as a Therapeutic Tool for Treatment of Bladder Cancer in an Orthotopic Murine Model at JoVE.com

Evaluation of the Efficacy of the H. pylori Protein HP-NAP as a Therapeutic Tool for Treatment of Bladder Cancer in an Orthotopic Murine Model

Here the method to establish a syngeneic mouse model of orthotopic bladder tumour to evaluate the anti-tumour efficacy of the bacterial protein HP-NAP is described.

Evaluation of the Efficacy of the H. pylori Protein HP-NAP as a Therapeutic Tool for Treatment of Bladder Cancer in an Orthotopic Murine Model

Bladder cancer is one of the most common malignancies of the urogenital tract. Intravesical injection of Bacillus Calmette-Gu&#233;rin (BCG) is the gold ...

evaluation-efficacy-h-pylori-protein-hp-nap-as-therapeutic-tool-for

Research

JoVE Journal

Medicine

7.2K visualizações.  University of Padua. Here the method to establish a syngeneic mouse model of orthotopic bladder tumour to evaluate the anti-tumour efficacy of the bacterial protein HP-NAP is described.