We aimed to identify factors associated with transmission of human immunodeficiency virus (HIV) from injecting drug users (IDUs) to their wives in Manipur, northeast India, where the prevalence of HIV among IDUs is 80% via a case-control study. One hundred and sixty-one HIV-infected IDUs and their wives were recruited from September 1996 to August 1997 inclusive. HIV status was determined by enzyme-linked immunosorbent assay (ELISA) plus Western blot, Interviews were administered anonymously. Regression analysis identified factors associated with transmission of HIV from IDU husbands to their non-injecting wives. Seventy-two wives (45%) were HIV-positive. Only 15% of the couples reported regular usage of condoms during intercourse. On multivariate analysis, a sexually transmitted disease (STD) in either member, reported by the husband, estimated duration of HIV in the husband for >8 years, and a history of blood transfusions were associated with infection in the wife. In conclusion, STDs are associated with transmission of HIV from husband to wife. Improved control of STDs, condom promotion, and improved blood screening are urgently needed in Manipur.

SUMMARY Oncogenic mutations of FLT3 and KIT receptors are associated with poor survival in patients with acute myeloid leukemia (AML) and myeloproliferative neoplasms (MPN) and currently available drugs are largely ineffective. Although Stat5 has been implicated in regulating several myeloid and lymphoid malignancies, how precisely Stat5 regulates leukemogenesis, including its nuclear translocation to induce gene transcription is poorly understood. In leukemic cells, we show constitutive activation of focal adhesion kinase (FAK), whose inhibition represses leukemogenesis. Downstream of FAK, activation of Rac1 is regulated by RacGEF Tiam1, whose inhibition prolongs the survival of leukemic mice. Inhibition of the Rac1 effector PAK1 prolongs the survival of leukemic mice in part by inhibiting the nuclear translocation of Stat5. These results reveal a leukemic pathway involving FAK/Tiam1/Rac1/PAK1 and demonstrate an essential role for these signaling molecules in regulating the nuclear translocation of Stat5 in leukemogenesis.

Although more than 90% systemic mastocytosis (SM) patients express gain of function mutations in the KIT receptor, recent next generation sequencing has revealed the presence of several additional genetic and epigenetic mutations in a subset of these patients, which confer poor prognosis and inferior overall survival. A clear understanding of how genetic and epigenetic mutations cooperate in regulating the tremendous heterogeneity observed in these patients will be essential for designing effective treatment strategies for this complex disease. In this review, we describe the clinical heterogeneity observed in patients with mastocytosis, the nature of relatively novel mutations identified in these patients, therapeutic strategies to target molecules downstream from activating KIT receptor and finally we speculate on potential novel strategies to interfere with the function of not only the oncogenic KIT receptor but also epigenetic mutations seen in these patients.

Intracellular mechanism(s) that contribute to promiscuous signaling via oncogenic KIT in systemic mastocytosis and acute myelogenous leukemia are poorly understood. We show that SHP2 phosphatase is essential for oncogenic KITinduced growth and survival in vitro and myeloproliferative disease (MPD) in vivo.Genetic disruption of SHP2 or treatment of oncogene-bearing cells with a novel SHP2 inhibitor alone or in combination with the PI3K inhibitor corrects MPD by disrupting a protein complex involving p85␣, SHP2, and Gab2. Importantly, a single tyrosine at position 719 in oncogenic KIT is sufficient to develop MPD by recruiting p85␣, SHP2, and Gab2 complex to oncogenic KIT. Our results demonstrate that SHP2 phosphatase is a druggable target that cooperates with lipid kinases in inducing MPD. (Blood. 2012; 120(13):2669-2678) IntroductionGain-of-function mutations in KIT receptor in humans are associated with gastrointestinal stromal tumors (GIST), systemic mastocytosis (SM), and acute myelogenous leukemia (AML). [1][2][3][4] An activating KIT receptor mutation of aspartic acid to valine at codon 814 in mice (KITD814V) or codon 816 in humans (KITD816V) results in altered substrate recognition and constitutive tyrosine autophosphorylation leading to promiscuous signaling. 5,6 Consequently, cell lines and primary BM cells that express the oncogenic KITD814V demonstrate ligand-independent proliferation in vitro and myeloproliferative disease (MPD) in vivo. [5][6][7][8][9] However, the intracellular signals that contribute to KITD814V-induced MPD are not known. Although activating mutations of KIT involving the juxtamembrane domain found in GIST are highly sensitive to inhibition by imatinib mesylate (ie, Gleevec), KIT mutations within tyrosine kinase domain found in SM and AML, including KITD816V, are relatively resistant to imatinib treatment. [10][11][12] Thus, it is vital to identify novel drug targets for diseases involving KITD816V mutation.Emerging data suggest an essential role for SHP2 in MPD. SHP2 is a protein tyrosine phosphatase that is encoded by PTPN11 gene and has been implicated in diverse signaling pathways induced by a number of stimuli, including growth factors, cytokines, extracellular matrix, and even cellular stress. [13][14][15] Given that activating mutations in SHP2 have been found in leukemias and solid tumors, 16,17 efforts are ongoing to define the potential efficacy of SHP2 phosphatase inhibition in diseases bearing SHP2 hyperactivation, either because of activating SHP2 mutations or those in which SHP2 collaborates with other oncogenes. Using genetic approaches, including primary BM cells derived from SHP2 Ϫ/Ϫ and Gab2 Ϫ/Ϫ mice and a novel SHP2 inhibitor, II-B08, identified from a focused library of indole-based salicylic acid derivatives, 18 we demonstrate that SHP2 is essential for KITD814V-induced MPD. We further demonstrate that SHP2 constitutively binds to p85␣ and Gab2 in KITD814V-bearing cells, which can be disrupted by II-B08 resulting in impaired ligand-independent growth in vitro a...