Bayesian analysis of a physiologically based pharmacokinetic model for perchloroethylene in humans

Perchloroethylene (PCE) is a widely distributed pollutant in the environment, and is the primary chemical used in dry cleaning. PCE-induced liver cancer was observed in mice, and central nervous system (CNS) effects were reported in dry-cleaning workers. To support reconstruction of human PCE exposures, including the potential for CNS effects, an existing physiologically based pharmacokinetic (PBPK) model for PCE in the human (Covington et al., 2007) was modified by adding a brain compartment. A Bayesian approach, using Markov chain Monte Carlo (MCMC) analysis, was employed to re-estimate the parameters in the modified model by combining information from prior distributions for the model parameters and experimental data. Experimental data were obtained from five different human pharmacokinetic studies of PCE inhalation exposures ranging from 150 ppm to as low as 0.495 ppm. The data include alveolar or exhaled breath concentrations of PCE, blood concentrations of PCE and trichloroacetic acid (TCA), and urinary excretion of TCA. The PBPK model was used to predict target tissue dosimetry of PCE and its key metabolite, TCA, during and after the inhalation exposures. Posterior analysis was performed to see whether convergence criteria for each parameter were satisfied and whether the model with posterior distributions may be used to make accurate predictions of human kinetic data. With posteriors, the trend of percent of PCE metabolized in the liver at low concentrations was predicted under different exposure conditions. The 95th percentile for the fraction PCE metabolized at a concentration of 1 ppb was estimated to be 1.89%.

Quantitation of thyroid-stimulating hormone receptor mRNA with real-time PCR for early diagnosis of papillary thyroid microcarcinoma

Recently, the value of thyroid-stimulating hormone receptor(TSHR) mRNA as a molecular marker in diagnosis of thyroid cancer has been greatly explored. However, its role in detecting thyroid microcarcinoma has never been reported. In this study, we aim to investigate the value of TSHR mRNA in diagnosis of papillary thyroid microcarcinoma(PTMC). To do that, TSHR mRNA levels were measured by real time PCR in 30 healthy subjects and 72 patients (benign thyroid nodules, n=38; PTMC, n=34). TSHR mRNA levels were then compared with cancer volume in surgical specimen. We found that TSHR mRNA levels in PTMC were significantly higher than benign thyroid nodules(P<0.01). At a cutoff value of 0.71 ng/microg total RNA, the TSHR mRNA correctly classified 77.8% of patients preoperatively (sensitivity= 76.5%; specificity= 79.4%). Comparatively, it performed better in larger PTMC of 0.5-1.0 cm than <0.5 cm(sensitivity, 83.4% vs 72.4%; specificity, 88.5% vs 74.1%). Combining TSHR mRNA and ultra sound examination correctly detect 97.1% of PTMC and could spared surgery in 86.8% of patients with benign thyroid nodules. Thus, TSHR mRNA measured with real time PCR enhances the preoperative detection of PTMC in patients with thyroid nodules, which dramatically reduces unnecessary surgeries.

KEYWORDS

thyroid-stimulating hormone receptor, papillary thyroid microcarcinoma, diagnosis.

Conversion from cyclosporin A to sirolimus retards the progression of chronic allograft nephropathy in the long term in a rat kidney transplantation model

In a rat renal allograft model, the long-term effect of conversion from cyclosporin A (CsA) to sirolimus on recipient kidneys and growth factor expression were compared with continuous use or withdrawal of CsA. Kidneys from Fisher 344 rats were orthotopically transplanted into Lewis rats. Four Fisher 344 to Lewis allograft groups were treated post-transplant as follows: (i) CsA (transplant to week 8) then sirolimus (weeks 8 - 24); (ii) CsA (transplant to week 24); (iii) CsA (transplant to week 8) then vehicle (weeks 8 - 24); (iv) control vehicle (transplant to week 24). A fifth group underwent syngeneic isograft (Lewis to Lewis) with no drug treatment. Proteinuria was measured every 4 weeks and grafts harvested at 24 weeks for morphological and immunohistochemical analysis. Conversion from CsA to sirolimus resulted in a significant decrease in proteinuria at 24 weeks, a lower Banff sum score and lower expression of transforming growth factor mRNA compared with continuous use or withdrawal of CsA. In conclusion, conversion from CsA to sirolimus retarded progression of chronic allograft nephropathy in the rat model.

Species differences for stereoselective metabolism of ethofumesate and its enantiomers in vitro

1. The stereoselective metabolism of ethofumesate (ETO) and its enantiomers in rabbit and rat liver microsomes have been studied by chiral high-performance liquid chromatography (HPLC) method. Two metabolites were detected in both liver microsomes in the presence of beta-nicotinamide adenine dinucleotide phosphate (NADPH). 2. The T(1/2) of (+)-ETO and (-)-ETO in rabbit liver microsomes were 12.2 and 4.7 min of rac-ETO and 25.9 and 6.7 of ETO enantiomers. However, the T(1/2) of (+)-ETO and (-)-ETO in rat liver microsomes were 5.3 and 5.9 min of rac-ETO and 7.8 and 10.6 of ETO enantiomers. The stereoselective selectivity is similar to the in vivo study. 3. After incubation of ETO enantiomers, stereoselectivity was present in the formation of ETO-OH enantiomer in rabbit liver microsomes, but stereoselectivity was not evident in rat liver microsomes. 4. There was no chiral inversion from the (+)-ETO to (-)-ETO or inversion from (-)-ETO to (+)-ETO in both rabbit and rat liver microsomes.

Evaluation of the Clinical Curative Effect of an O(2)-O(3) mixture to Treat Lumbar Disc Herniation with Different Treatment Sessions

SUMMARY

To compare the effective rates among one week, two week and four week treatment sessions of ozone therapy for lumbar disc herniation to provide a foundation for clinical decision-making. One hundred and eighty-seven lumbar disc herniation patients were divided into three groups, 103 cases for one week, 61 cases for two week and 23 cases for four week treatment sessions. The clinical curative effective rates in the three groups were 82.52%, 85.24% and 95.65% respectively. The effective rate among the three groups showed no significant difference at statistical analysis. Considering the cost-effectiveness of ozone therapy, increasing the treatment course does not enhance the curative effect.

Experimental design for the determination of the injection barrier height at metal/organic interfaces using temperature dependent current-voltage measurements

Determination of the injection barrier height for holes or electrons at metal/organic interfaces is essential to understanding the device physics of organic electronics. Due to the disordered molecular packing of organic semiconductors, careful consideration is required in the design of both the device structure and the experimental measurement technique used to extract the barrier height. We report a methodology for extracting the injection barrier height at metal/organic interfaces from temperature dependent current-voltage measurements. This methodology includes the design of single carrier devices with specific consideration of the intrinsic properties of organic semiconductors, as well as the design of a variable temperature cryostat suited to the measurement of organic electronic device architectures. Experimental results for single carrier hole-only devices using two commonly studied hole transport materials, namely N,N(')-diphenyl-N,N(')-bis-(1-naphthyl)-1-1(')-biphenyl-4,4(')-diamine (alpha-NPD) and 4,4('),4(")-tris(N-3- methylphenyl-N-phenyl-amino)triphenylamine (m-MTDATA) are also presented as examples.

Effect of leptin on mouse trophoblast giant cells

Leptin plays a role in both energy homeostasis and reproduction, and it is required in early pregnancy. It stimulates metalloproteinase activity in cultured human trophoblasts and invasiveness of cultured mouse trophoblasts. Our goal has been to examine mechanisms that underpin the ability of leptin to promote trophoblast invasiveness in primary cultures of mouse trophoblasts. Leptin stimulated the phosphorylation of MEK (MAP2K1) but not signal transducer and activator of transcription 3 (STAT3) in the cultures, increased the concentration of the suppressor of cytokine signaling 3 (SOCS3) protein, and upregulated metalloproteinase activity. Microarray analysis revealed that leptin stimulated select genes with roles in cell motility, including Stmn, a gene linked to invasiveness in other cell types. There was also an increase in activity of several genes associated with MAPK and RhoGTPase signaling. In addition, leptin muted expression of genes correlated with terminal differentiation of trophoblast giant cells, including ones associated with the TGFbeta signaling pathway and endoreduplication of DNA, and upregulated selected prolactin-related family members. Feulgen staining of leptin-treated cells revealed a loss of cells with low ploidy. The data suggest that leptin accelerates disappearance of non-giant cells while inhibiting terminal differentiation of committed giant cells, possibly by maintaining cells in an intermediate stage of differentiation.

Tibolone rapidly attenuates the GABAB response in hypothalamic neurones

Tibolone is primarily used for the treatment of climacteric symptoms. Tibolone is rapidly converted into three major metabolites: 3 alpha- and 3beta-hydroxy (OH)-tibolone, which have oestrogenic effects, and the Delta 4-isomer (Delta 4-tibolone), which has progestogenic and androgenic effects. Because tibolone is effective in treating climacteric symptoms, the effects on the brain may be explained by the oestrogenic activity of tibolone. Using whole-cell patch clamp recording, we found previously that 17beta-oestradiol (E(2)) rapidly altered gamma-aminobutyric acid (GABA) neurotransmission in hypothalamic neurones through a membrane oestrogen receptor (mER). E(2) reduced the potency of the GABA(B) receptor agonist baclofen to activate G-protein-coupled, inwardly rectifying K(+) (GIRK) channels in hypothalamic neurones. Therefore, we hypothesised that tibolone may have some rapid effects through the mER and sought to elucidate the signalling pathway of tibolone's action using selective inhibitors and whole cell recording in ovariectomised female guinea pigs and mice. A sub-population of neurones was identified post hoc as pro-opiomelanocortin (POMC) neurones by immunocytochemical staining. Similar to E(2), we have found that tibolone and its active metabolite 3 beta OH-tibolone rapidly reduced the potency of the GABA(B) receptor agonist baclofen to activate GIRK channels in POMC neurones. The effects were blocked by the ER antagonist ICI 182 780. Other metabolites of tibolone (3 alpha OH-tibolone and Delta 4-tibolone) had no effect. Furthermore, tibolone (and 3 beta OH-tibolone) was fully efficacious in ER alpha knockout (KO) and ER beta KO mice to attenuate GABA(B) responses. The effects of tibolone were blocked by phospholipase C inhibitor U73122. However, in contrast to E(2), the effects of tibolone were not blocked by protein kinase C inhibitors or protein kinase A inhibitors. It appears that tibolone (and 3 beta OH-tibolone) activates phospholipase C leading to phosphatidylinositol bisphosphate metabolism and direct alteration of GIRK channel function. Therefore, tibolone may enhance synaptic efficacy through the G(q) signalling pathways of mER in brain circuits that are critical for maintaining homeostatic functions.

A new simple asymmetric hysteresis operator and its application to inverse control of piezoelectric actuators

Piezoelectric actuators (PEAs) are commonly used as micropositioning devices due to their high resolution, high stiffness, and fast frequency response. Because piezoceramic materials are ferroelectric, they fundamentally exhibit hysteresis behavior in their response to an applied electric field. The positioning precision can be significantly reduced due to nonlinear hysteresis effects when PEAs are used in relatively long range applications. This paper describes a new, precise, and simple asymmetric hysteresis operator dedicated to PEAs. The complex hysteretic transfer characteristic has been considered in a purely phenomenological way, without taking into account the underlying physics. This operator is based on two curves. The first curve corresponds to the main ascending branch and is modeled by the function f1. The second curve corresponds to the main reversal branch and is modeled by the function g2. The functions f(1) and g(2) are two very simple hyperbola functions with only three parameters. Particular ascending and reversal branches are deduced from appropriate translations of f(1) and g(2). The efficiency and precision of the proposed approach is demonstrated, in practice, by a real-time inverse feed-forward controller for piezoelectric actuators. Advantages and drawbacks of the proposed approach compared with classical hysteresis operators are discussed.

Population pharmacokinetics of mycophenolic acid in senile Chinese kidney transplant recipients

To explore the pharmacokinetic characteristics of mycophenolic acid (MPA) among elderly Chinese kidney transplant recipients, we enrolled 24 patients over 60 years old (65.6 +/- 3.6) as the (Gs) group and 24 patients of 39.6 +/- 14.3 years old as a control group (Ga). Venous blood samples were taken at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, and 12 hours after the morning dose of mycophenolate mofetil at 10 to 12 weeks posttransplant. Plasma MPA concentrations were measured by a validated high-performance liquid chromatography method. Within 6-month posttransplant follow-up, there had not been an acute rejection episode when five elderly and one other adult experienced severe adverse events (SAEs), such as pneumonia and leukocytopenia. MPA area under the curve (AUC) in Gs was significantly lower than that among Ga (P < .05), while there was no significant difference in predose, peak concentrations, or peak times (P > .05). The concentration-time curve of Gs showed a bipeak pattern in five patients (20.8%) during the early stage (2 to 4 hours postdose). AUC in the subgroup of Gs with SAEs (n = 5) was significantly higher than that of elderly subjects without SAEs (n = 19) (P = .042). When Gs were subdivided at a cutting AUC point of 25 mug/mL, the SAE incidence was significantly higher in the subgroup with a higher AUC than than those with the lower AUC (P = .047). Through multiple stepwise regression, we obtained a minimal model to estimate MPA AUC of elderly recipients: AUC = 3.0410 + 9.8588 x C(0) + 0.5963 x C(0.5) + 2.5612 x C(3) (R(2) = .893).

Dehydration-induced proteome changes in the rat hypothalamo-neurohypophyseal system

The hypothalamo-neurohypophyseal system (HNS) mediates neuroendocrine responses to dehydration through the action of the antidiuretic hormone vasopressin (VP). VP is synthesized as part of a prepropeptide in magnocellular neurons of the hypothalamic supraoptic nucleus (SON) and paraventricular nucleus. This precursor is processed during transport to axon terminals in the posterior pituitary gland, in which biologically active VP is stored until mobilized for secretion by electrical activity evoked by osmotic cues. During release, VP travels through the blood stream to specific receptor targets located in the kidney in which it increases the permeability of the collecting ducts to water, reducing the renal excretion of water, thus promoting water conservation. The HNS undergoes a dramatic function-related plasticity during dehydration. We hypothesize that alterations in steady-state protein levels might be partially responsible for this remodeling. We investigated dehydration-induced changes in the SON and pituitary neurointermediate lobe (NIL) proteomes using two-dimensional fluorescence difference gel electrophoresis. Seventy proteins were altered by dehydration, including 45 in the NIL and 25 in the SON. Using matrix-assisted laser desorption/ionization mass spectrometry, we identified six proteins in the NIL (four down, two up) and nine proteins in the SON (four up, five down) that are regulated as a consequence of chronic dehydration. Results for five of these proteins, namely Hsp1alpha (heat shock protein 1alpha), NAP22 (neuronal axonal membrane protein 22), GRP58 (58 kDa glucose regulated protein), calretinin, and ProSAAS (proprotein convertase subtilisin/kexin type 1 inhibitor), have been confirmed using independent methods such as semiquantitative Western blotting, two-dimensional Western blotting, enzyme-linked immunoassay, and immunohistochemistry. These proteins may have roles in regulating and effecting HNS remodeling.

HLA amino acid residue matching in 2575 kidney transplants

Donor-recipient HLA matching was retrospectively evaluated in 2575 renal transplants by comparing amino acid residue matches (Res M) with conventional six-antigen matches (Ag M). Only 6% of donor-recipient combinations had 0 to 1 mismatches using Ag M, whereas 42.8% of the recipients had no mismatch by Res M. Compared with the first year results of residue mismatched recipients, the 1102 patients with 0 residue mismatching displayed a low incidence of rejection (12.07% vs 5.37%) and less anti-HLA antibody production (class I 13.76 vs 38.12%; class II 7.66% vs 31.11%). The 1-to 10-year graft survival of the residue-matched group was similar to that of the Ag-matched group, and significantly better than the residue-mismatched recipients. In summary, Res M could be a good matching system for renal transplantation in the Han population.

The C-terminal peptide of connective tissue growth factor blocks the full molecule binding to tubular epithelial cell

OBJECTIVES

Interstitial fibrosis is a critical pathologic change in chronic allograft nephropathy. The cytokine connective tissue growth factor (CTGF, also CCN2) plays an important role in epithelial-mesenchymal transformation (EMT) of tubular epithelial cells to renal interstitial fibrosis. The hexadeca-peptide within the C-terminal of CTGF (named P2) contains the unique binding domain of CTGF to its potential receptor, integrin alphavbeta3. This study examined whether P2 bound preferentially to the receptor and served as an inhibitor of CTGF.

METHODS

All studies used an established rat kidney tubular epithelial cell line NRK-52E. Chemically synthesized P2 was purified, and some of it labeled with FITC. The affinity of CTGF or P2 to NRK-52E cells was examined by a solid-phase cell adhesion assay. Competitive binding between P2 and CTGF to NRK-52E cells was examined with flow cytometric analysis.

RESULTS

Both P2 and CTGF bound to the NRK-52E cells, mediating cell adhesion. When the cells were incubated in the mixture of P2 and CTGF, P2 bound to the cells preferentially. Furthermore, when cells were preincubated with excessive CTGF, it became difficult for subsequent P2 binding to occur.

CONCLUSIONS

P2 and CTGF seemed to bind to cell membranes at the same binding domain. P2 competitively blocked CTGF binding, acting as a CTGF inhibitor.

Interference of cyclosporine on glucose metabolism: potential role in chronic transplantation kidney fibrosis

OBJECTIVES

To explore the fibrosis induction effects of cyclosporine (CsA) on renal tubular epithelial cells, as well as the potential mechanisms of CsA-mediated alterations of glucose metabolism in chronic allograft nephropathy (CAN).

METHODS

The rat renal tubular epithelial cell line NRK-52E cells were cultured in medium with 50 mmol/L of D-glucose for 7, 14, or 28 days. The expression of TGF-beta1, CTGF, Smad3, and Smad7, which are involved in the fibrosis signal pathway, was detected by immunofluorescence and reverse-transcriptase polymerase chain reaction. Meanwhile, cells were cultured in various concentration of CsA in glucose-free medium for 24 hours followed by the addition of D-[3-(3)H]-glucose for 30 minutes; glucose uptake was detected by examining the radiation intensity.

RESULTS

The expression of TGF-beta1, Smad3, Smad7, and CTGF of NRK-52E cells were up-regulated significantly (P < .05) after culture with 50 mmol/L glucose for 7 days compared with those in 25 mmol/L glucose. At 14 and 28 days, TGF-beta1 was slightly decreased compared with 7 days, but CTGF, Smad3, and Smad7 increased robustly (P < .05). CsA significantly stimulated glucose uptake at various concentrations, with an absorption peak at 60 minutes that decreased at 75 minutes. Furthermore, CsA may have dose-dependent effects on glucose uptake.

CONCLUSION

High glucose concentrations may play an important role in the NRK-52E cell fibrosis during the CAN process due to an interference of CsA on glucose metabolism.

Characteristics of Neoplasm Occurrence and the Therapeutic Effect of Sirolimus in South Chinese Kidney Transplant Recipients

Kidney transplantation (KTx) recipients are at a higher risk of oncogenesis when compared to the general population. Sirolimus (SRL), a potent immunosuppressant, has shown promising antineoplastic effects in vitro and in vivo. This study retrospectively analyzed the neoplasm occurrence and the efficiency of SRL on unresectable malignancies in South Chinese KTx recipients. Thirty-three (1.64%) of 2017 patients who received KTx from January 1984 to December 2004 developed neoplasms at 4 to 117 months posttransplant, mostly in digestive organs (33.3%), the hematologic system (15.2%), or the skin (12.1%). The most common type was liver cancer (24.2%), followed by skin cancer, lymphoma, and thyroid cancer (9.1%). The median survival times were 41.5 and 6.0 months for those who did (n = 10) receive radical surgery or did not (n = 23), respectively. The 20-month survival rates were 70.0% versus 13.0% (P < .01). For unresectable patients, the median survival time of those treated with SRL (n = 8) was 14.5 months compared to 3.0 months for those who did not (n = 15). The survival rates at 12(th) and 20(th) months were 75.0% and 37.5% in the SRL group and 6.7% and 0% in the non-SRL group (P < .05). In conclusion, when compared with Western studies, a lower incidence and unique location pattern (liver cancer-dominant) are characteristics of de novo posttransplant neoplasms in South Chinese KTx recipients. Early diagnosis and feasible radical surgery are favorable for prognosis, and SRL is a treatment of choice for KTx recipients with neoplasms.