Systemic antibiotics combined with SRP offer additional clinical improvements compared to SRP alone. Although there were no statistically significant differences, there was a trend that for initially moderate and deep pockets, metronidazole or metronidazole combined with amoxicillin, resulted in clinical improvements that were more pronounced over doxycycline or azithromycin. Additionally, there was a trend that the magnitude of the clinical benefit became smaller over time (1 year).

For the treatment of patients with aggressive periodontitis, systemic antibiotics combined with non-surgical periodontal therapy resulted in a significant additional effect compared to non-surgical therapy alone. There is a visible trend that showed metronidazole + amoxicillin is the most potent antibiotic combination.

Abstract:The ATP-binding cassette (ABC) transporters of class G display a different domain organisation than P-glycoprotein/ABCB1 and bacterial homologues with a nucleotidebinding domain preceding the transmembrane domain. The linker region connecting these domains is unique and its function and structure cannot be predicted. Sequence analysis revealed that the human ABCG2 linker contains a LSGGE sequence, homologous to the canonical C motif/ABC signature present in all ABC nucleotidebinding domains. Predictions of disorder and of secondary structures indicated that this C2-sequence was highly mobile and located between an α-helix and a loop similarly to the C-motif. Point mutations of the two first residues of the C2 sequence fully abolished the transport-coupled ATPase activity, and led to the complete loss of cell resistance to Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationmitoxantrone. The interaction with potent, selective and non-competitive, ABCG2 inhibitors was also significantly altered upon mutation. These results suggest an important mechanistic role for the C2-sequence of the ABCG2 linker region in ATP binding and/or hydrolysis coupled to drug efflux. Running title: Linker region of human ABCG2Keywords: ABC transporter, breast cancer resistance protein/ABCG2, ATP hydrolysis, C motif/ABC signature, drug efflux coupling, specific sequence. Abbreviations: ABC, ATP-binding cassette; MDR, multidrug resistanceRevised Manuscript Click here to download Manuscript CMLS_C2_R1.docx 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2 Click here to view linked References AbstractThe ATP-binding cassette (ABC) transporters of class G display a different domain organisation than P-glycoprotein/ABCB1 and bacterial homologues with a nucleotidebinding domain preceding the transmembrane domain. The linker region connecting these domains is unique and its function and structure cannot be predicted.Sequence analysis revealed that the human ABCG2 linker contains a LSGGE sequence, homologous to the canonical C-motif/ABC signature present in all ABC nucleotide-binding domains. Predictions of disorder and of secondary structures indicated that this C2-sequence was highly mobile and located between an -helix and a loop similarly to the C-motif. Point mutations of the two first residues of the C2-sequence fully abolished the transport-coupled ATPase activity, and led to the complete loss of cell resistance to mitoxantrone. The interaction with potent, selective and non-competitive, ABCG2 inhibitors was also significantly altered upon mutation.These results suggest an important mechanistic role for the C2-sequence of the ABCG2 linker region in ATP binding and/or hydrolysis coupled to drug efflux.

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Introduction After the recent advent of Immune Checkpoint Inhibitors (ICIs), one of current challenge of clinical cancer trials is certainly to develop the optimal combinations of ICIs with DNA-Damaging Agents (chemotherapy and/or radiotherapy, named DDAs hereafter). Elucidating resistance mechanisms to these different treatments is pivotal to propose new predictive biomarkers and to develop therapeutic strategies to improve ICI efficiency. We hypothesized that resistance to DDA and ICIs is mediated in part by intrinsic tumor mechanisms, some of which may be shared. Methods To address this knowledge gap, we compared RNA expression signatures, antigen presentation, and PD-L1 expression from cohorts of cancer patients treated with radiotherapy, chemotherapy, and immunotherapy to identify shared molecular pathways that may mediate cross-resistance. Using a panel of lung cancer cell lines, we then confirmed that the tumor-cell-intrinsic expression of SQSTM1 is positively correlated with antigen presentation, and inversely with DNA damage repair and DDA/ICIs resistance gene signatures. This SQSTM1/HERV pathway was then supported in vitro using engineered silenced cell-lines (SQSTM1, MAVS, and STING ShRNA) treated with FDA-approved DDA (cisplatin, oxaliplatin, doxorubicin, and ionizing radiations) or synthetic double-stranded RNA (5’ppp dsRNAs and poly IC). Results Through three complementary approaches (in silico, ex vivo on patient cohorts, and in vitro), we identify the p62/SQSTM1 scaffold protein as a key molecular mediator able of predicting and controlling sensitivity for DDA and ICIs. Mechanistically, in response to DNA damage, we found that SQSTM1 is essential for the inhibition of DNA repair and the reactivation of human endogenous retroviruses (hERV). Analogous to a “viral alarm”, the hERV are sensed and activate IFN responses that drive the expression of MHC-I and PD-L1, leading to tumor immune evasion. Targeting the hERV pathways in SQSTM1-depleted tumor cells by poly(I:C)/Lyovec, or docetaxel treatment can rescue the hERV, IFN, and MHC pathway, providing a promising therapeutic avenue turning a “cold” into a “hot” tumor in non-responders cancer patients. Conclusion Depending on its levels, we thus propose SQSTM1 as a predictive biomarker for guiding treatment decisions from i) ICI alone, ii) ICI combined with cisplatin, or; iii) ICI combined with poly(I:C)/Lyovec or docetaxel, with the aim to increase immunotherapy efficacy. Citation Format: Iris Grosjean, Grégoire D’Andréa, Nathalie Yazbeck, Amine Belaid, Barnabé Roméo, Marie Angela Domdom, Nicolas Guillot, Eric Gilson, Emmanuel Chamorey, Gérard Milano, Véronique Hofman, Marius Ilié, Isabelle Benard-Thiery, Simon Heeke, Patrick Brest, François Ghiringhelli, Paul Hofman, Baharia Mograbi. The tumor scaffold protein SQSTM1 at the crossroads of DNA damage and immunotherapy responses in solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1284.