Korean red ginseng: a new approach for the treatment of graft-versus-host disease after liver transplantation

BACKGROUND

Graft-versus-host disease (GVHD) is a rare complication after liver transplantation with an extremely poor prognosis; its occurrence offers great challenges.

METHODS

We have reported herein one case of acute GVHD after liver transplantation who was treated with a traditional Chinese medicine named Korean Red Ginseng (KRG).

RESULTS

The acute GVHD was successfully cured by KRG.

CONCLUSIONS

The successful salvage of acute GVHD after liver transplantation by KRG may provide a new viable therapeutic option.

Proposal for photonic quantization with differential encoding using a phase modulator and delay-line interferometers

A photonic quantization approach to implementing analog-to-digital conversion (ADC) in the optical domain with differential encoding employing a phase modulator and delay-line interferometers (DLIs) is proposed and demonstrated. In the proposed ADC system, the phase-modulated signal is sent to an array of DLIs that have identical time delay difference, but different phase shifts, which are employed to achieve quantization with differential encoding. A proof-of-concept experiment is performed. The quantization of a 10 GHz sinusoidal signal with a bit length of 4 is experimentally demonstrated.

Küpffer cells promote acute rejection via induction of Th17 differentiation in rat liver allografts

BACKGROUND

Th17, a newly identified CD4+ T-cell subset, has been implicated in transplant rejection. Differentiation of Th17 cells is associated with transforming growth factor-β (TGF-β) and interleukin-6 (IL-6), which are the main products of Küpffer cells.

OBJECTIVE

To determine whether Küpffer cells promote acute liver allograft rejection by inducing Th17 cell differentiation.

METHODS

A rat model of allogeneic liver transplantation using Dark Agouti (DA) to Brown Norway (BN) rats was established with or without gadolinium chloride (GdCl(3)) pretreatment. Isogeneic liver transplantation (BN to BN) was performed as a control. Concentrations of cytokines secreted by Küpffer cells or Th17-related cytokines detected in the liver and peripheral blood were analyzed using immunohistochemistry assays, flow cytometry, and enzyme-linked immunosorbent assays. Survival differences were compared between treatment groups. In vitro, Küpffer cells from liver grafts were isolated and co-cultured with naïve CD4 T cells.

RESULTS

Both Küpffer cells and Th17 cells infiltrated liver allografts, accompanied by an increase in concentrations of IL-6 and TGF-β. Pretreatment with GdCl(3) attenuated intragraft infiltration of Küpffer cells and Th17 cells, and decreased IL-6 and TGF-β concentrations. Liver function improved after pretreatment, and mean (SD) survival time was prolonged, compared with the control group (16.33 [0.96] days vs 11.50 [0.99] days, respectively; P < .01). In vitro, Küpffer cells from livers with allografts secreted significantly higher concentrations of IL-6 and TGF-β and induced Th17 differentiation more effectively compared with livers with isografts (30.8% vs 8.1%, respectively).

CONCLUSION

Küpffer cells have the potential to induce Th17 cells by secreting IL-6 and TGF-β, and as a result, promote acute liver allograft rejection.

Herbivore-induced volatiles of cabbage (Brassica oleracea) prime defence responses in neighbouring intact plants

When attacked by herbivores, plants release herbivore-induced plant volatiles (HIPV) that may function in direct defence by repelling herbivores or reducing their growth. Emission of HIPV may also contribute to indirect defence by attracting natural enemies of the herbivore. Here, cabbage (Brassica oleracea L.) plants (receiver plants) previously exposed to HIPV and subsequently induced through feeding by five Pieris brassicae L. caterpillars attracted more Cotesia glomerata L. parasitoids than control plants. HIPVs to which receiver plants had been exposed were emitted by B. oleracea infested with 50 P. brassicae caterpillars. Control plants had been exposed to volatiles from undamaged plants. In contrast, there were no differences in the attraction of wasps to receiver plants induced through feeding of one or ten larvae of P. brassicae compared to control plants. In addition, RT-PCR demonstrated higher levels of LIPOXYGENASE (BoLOX) transcripts in HIPV-exposed receiver plants. Exposure to HIPV from emitter plants significantly inhibited the growth rate of both P. brassicae and Mamestra brassicae caterpillars compared to growth rates of caterpillars feeding on control receiver plants. Our results demonstrate plant-plant signalling leading to priming of both indirect and direct defence in HIPV-exposed B. oleracea plants.

Transcription factors BmPOUM2 and BmβFTZ-F1 are involved in regulation of the expression of the wing cuticle protein gene BmWCP4 in the silkworm, Bombyx mori

In Bombyx mori, the wing cuticle protein gene BmWCP4 is expressed specifically in the epidermis at the onset and mid-stage of pupation and is responsible for the formation of the pupal cuticle during the larval-pupal metamorphosis. The gene consists of four exons and three introns and is present as a single copy in the genome. Its expression was up-regulated by 20-hydroxyecdysone (20E) and the 20E-induced expression was suppressed by juvenile hormone (JH) III. The upstream regulatory sequence region of the BmWCP4 gene was cloned and the regulatory elements responsible for 20E induction were identified. Two cis-regulatory elements (CREs) bound by the transcription factors BmPOUM2 and BmβFTZ-F1 were identified that mediated 20E-regulated expression of this gene. An electrophoretic mobility shift assay detected two nuclear proteins isolated from the epidermis and the BmN cell line that specifically bound to the POU and βFTZ-F1 CREs, respectively. BmPOUM2 recombinant protein explicitly bound to the POU CRE. Developmental and 20E-induced expression of the BmWCP4, BmPOUM2 and BmβFTZ-F1 genes showed that BmPOUM2 and BmβFTZ-F1 were initially expressed, followed by BmWCP4. These data suggest that the 20E-induced expression of BmWCP4 is mediated by the transcription factors BmPOUM2 and BmβFTZ-F1 binding to their CREs in the regulatory sequence region of the BmWCP4 gene.

EGFR, HER2 and HER3 expression in primary colorectal carcinomas and corresponding metastases: Implications for targeted radionuclide therapy

Members of the epidermal growth factor receptor, EGFR, family are interesting as targets for radionuclide therapy using targeting agents labeled with α- or β-emitting radionuclides, especially when EGFR-positive colorectal carcinomas, CRC, are resistant to EGFR inhibiting agents like cetuximab and various tyrosine kinase inhibitors. The expression of EGFR, HER2 and HER3 was therefore analyzed in CRC samples from primary tumors, corresponding lymph node metastases and, in a few cases, liver metastases. The expression of HER2 and EGFR was scored from immunohistochemical preparations using the HercepTest criteria 0, 1+, 2+ or 3+ for cellular membrane staining while HER3 expression was scored as no, weak or strong cytoplasm staining. Material from 60 patients was analyzed. The number of EGFR 2+ or 3+ positive primary tumors was 16 out of 56 (29%) and for lymph node metastases 8 out of 56 (14%) whereas only one out of nine (11%) liver metastases were positive. Thus, there was lower EGFR positivity in the metastases. Only one among 53 patients was strongly HER2 positive and this in both the primary tumor and the metastasis. Eight out of 49 primary tumors (16%) were strongly HER3 positive and the corresponding numbers for lymph node metastases were 9 out of 49 (18%) and for liver metastases 2 out of 9 (22%). The observed number of strongly EGFR positive cases was somewhat low but EGFR might be, for the cases with high EGFR expression in metastases, a target for radionuclide therapy. HER2 seems not to be of such interest due to rare expression, neither HER3 due to mainly expression in the cytoplasm. The requirements for successful EGFR targeted radionuclide therapy are discussed, as well as patient inclusion criteria related to radionuclide therapy.

Some results of our research on composite facial allograft transplantation in dogs

Composite facial allograft transplantation is a complicated surgical procedure, requiring evaluation of several questions. How should the facial allograft be preserved? What are the proper surgical skills to reduce surgery duration? Can composite facial allograft transplantation rebuild the motor functions of the facial muscles? In our research, University of Wisconsin (UW) solution was used to preserve canine facial tissue. We manipulated the surgical procedures of complete facial allograft transplantation on cadavers to improve surgery skills Canine facial allograft models with neuromuscular motor units were performed to evaluate nerve regeneration after allotransplantation. We observed that canine facial allografts could be preserved in UW solution for at least 18 hours. Superficial temporal artery and facial artery bipedicle flaps were safer and saved more time than single pedicle flaps from the external carotid artery. Facial neuromuscular activities were shown in the canine model by the blinking reflex.

Polymorphism in 3'-untranslated region of toll-like receptor 4 gene is associated with protection from hepatitis B virus recurrence after liver transplantation

BACKGROUND

Hepatitis B virus (HBV) recurrence is one of the more severe complications following liver transplantation. Toll-like receptors (TLRs) play a key role in human immunity by recognizing various bacteria, viruses, fungi, and parasites. Single nucleotide polymorphisms (SNPs) in the TLRs are thought to have an impact on the susceptibility to some pathogens. This study focused on the association between polymorphisms in the TLRs and HBV recurrence after liver transplantation in Han Chinese patients.

METHODS

A total of 41 tag SNPs in TLRs were detected by the snapshot technique in 125 patients with primary HBV-related diseases receiving liver transplantation in our center from 2004 to 2008.

RESULTS

By comparing the genetic variations and clinical data between the HBV recurrence patients and nonrecurrence patients, we found that the variant genotype of rs11536889 (TLR4) was significantly associated with HBV recurrence after liver transplantation (P = 0.040, odds ratio was 0.390, 95% confidence interval 0.159-0.957).

CONCLUSION

Our findings indicate that polymorphism in 3'-untranslated regions of the TLR4 gene may be related to protection from HBV recurrence after liver transplantation in Han Chinese patients.

A Comparison of Two Different Doses of Rectal Ketamine Added to 0.5 mg.kg-1 Midazolam and 0.02 mg.kg-1 Atropine in Infants and Young Children

In some circumstances, a high degree of sedation that results in a child being unconscious at the time of parental separation is desirable. We set out to investigate the efficacy and safety of a rectal premedication regimen designed to produce this increased level of sedation.

Sixty-seven children aged two to 24 months were randomised into two groups. Group MK received 4 mg.kg-1 ketamine, 0.5 mg.kg-1 midazolam and 0.02 mg.kg-1 atropine and group MKK received 8 mg.kg-1 ketamine, 0.5 mg.kg-1 midazolam and 0.02 mg.kg-1 atropine per rectum. The sedation score at the time of parental separation 30 minutes after drug administration and the response to intravenous cannulation were evaluated on a four-point scale. Respiratory rate, heart rate and arterial oxygen saturation were recorded immediately before parental separation.

More patients in group MKK were asleep during separation (62 vs 35%, P <0.05). Fewer patients in group MKK cried during intravenous cannulation (37 vs 68%, P <0.05). Sedation scores were significantly increased at both time points. There was no difference between groups in vital signs at the time of parental separation and no adverse respiratory events occurred during the study period.

In cases where a high degree of sedation following premedication in infants and toddlers is desired, the addition of 8 mg.kg-1 ketamine to 0.5 mg.kg-1 midazolam and 0.02 mg.kg-1 atropine administered rectally is more efficacious than 4 mg.kg-1 ketamine.

Activation of Akt and MAPK pathways enhances the tumorigenicity of CD133+ primary colon cancer cells

Cancer stem cells (CSCs) play an important role in carcinogenesis, resistance to treatment and may lead to cancer recurrence and metastasis. However, the molecular mechanism of CSC involved in these events needs to be further elucidated. In this study, CD133(+) colon cancer cells were cultured, which showed CSC properties both in vitro and in vivo from metastatic tissue. Upstream molecules in Akt and mitogen-activated protein kinase (MAPK) pathways were preferentially expressed in these CD133(+) cells, as revealed by a global gene chip. The kinase activities of Akt and extracellular signal-regulated kinase (Erk)1/2 were also significantly upregulated in CD133(+) cells. In addition, the clonogenic growth of CD133(+) cell was reduced greatly by inhibiting the activity of Akt and Erk1/2. The results revealed the Akt and MAPK pathways were involved in the tumorigenesis of CD133(+) colon cancer cells, suggesting that molecules in these two pathways might be potential targets in the future therapy.

Bone marrow-derived mesenchymal stem cells inhibit acute rejection of rat liver allografts in association with regulatory T-cell expansion

Bone marrow-derived mesenchymal stem cells (MSCs) exhibit immunosuppressive functions in vitro and in vivo. We investigated the immunoregulatory effects of rat MSCs in a model of allogeneic liver transplantation. Brown Norway rats received livers from inbred Lewis rats, and at designated intervals, infusions of MSCs derived from recipient, donor, or third-party rats. Allograft rejection and recipient survival rates were recorded. In particular, changes in circulating regulatory T cells (Tregs) were measured. After administration of MSCs derived from each of the 3 strains, allograft recipients demonstrated markedly longer survival compared with control animals. Histologic analysis revealed significant inhibition of allograft rejection. The MSCs induced generation of CD4+CD25+Foxp3+ Tregs. We concluded that MSCs inhibit acute rejection of allografts after liver transplantation, and propose that the immunoregulatory effects of MSCs are associated with expansion of Tregs.

Meta-analysis of dose-response characteristics of hydrochlorothiazide and chlorthalidone: effects on systolic blood pressure and potassium

BACKGROUND

Evidence supporting the benefit of low-dose thiazide-based regimens to reduce cardiovascular events is primarily derived from studies using chlorthalidone, yet low-dose hydrochlorothiazide (HCTZ) (12.5-25 mg) remains more widely prescribed. We sought to describe their comparative dose-response relationships for changes in systolic blood pressure (SBP) and potassium.

METHODS

PubMed from 1948 to July 2008 was systematically searched to identify clinical trials using either HCTZ or chlorthalidone monotherapies. A total of 108 clinical trials with HCTZ and 29 with chlorthalidone were analyzed. Data were pooled to evaluate the effects on SBP and potassium of both drugs throughout their respective dose-response curves. Equivalence analysis was performed for the clinically recommended low-dose range of 12.5-25 mg, grouped by study duration, using the two one-sided tests procedure described by Schuirmann.

RESULTS

When evaluated on a milligram-per-milligram basis using pooled data, chlorthalidone generally produces slightly greater reductions in SBP and potassium than HCTZ. In the low-dose range of 12.5-25 mg, equivalence analysis reveals that the reductions in SBP are not equivalent between the two drugs, using upper and lower equivalence bounds of 4 mm Hg. Within the same dosing range, the mean changes in potassium were determined to be equivalent when upper and lower equivalence bounds of 0.29 mEq/l are used.

CONCLUSIONS

Equivalence analysis using data from several studies suggests that the SBP reductions achieved with HCTZ and chlorthalidone cannot be considered equivalent within the low-dose range currently recommended. However, within this dosing range, reductions in potassium can be considered equivalent.

Screening of heterogeneous surfaces: charge renormalization of Janus particles

Nonlinear ionic screening theory for heterogeneously charged spheres is developed in terms of a mode decomposition of the surface charge. A far-field analysis of the resulting electrostatic potential leads to a natural generalization of charge renormalization from purely monopolar to dipolar, quadrupolar, etc, including 'mode couplings'. Our novel scheme is generally applicable to large classes of surface heterogeneities, and is explicitly applied here to Janus spheres with differently charged upper and lower hemispheres, revealing strong renormalization effects for all multipoles.

Diagnosis of C4d+ Renal Allograft Acute Humoral Rejection by Urine Protein Fingerprint Analysis

This study aimed to develop urine protein fingerprint models for the diagnosis of acute rejection (AR) and complement split product positive (C4d+) acute humoral rejection (AHR) following renal allograft transplantation. Urine samples from 101 renal transplant recipients were analysed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry combined with bioinformatics. The patients comprised 36 with stable allograft function (stable group), 10 with acute tubular necrosis (ATN) and 55 with AR (20 with C4d- acute cellular rejection [ACR] and 15 with C4d+ AHR). The ATN group was differentiated from the stable group with a sensitivity and specificity of 100% (pattern 1). The stable group was differentiated from the AR group with a specificity of 86.4% and a sensitivity of 85.4% (pattern 2). The C4d- ACR subgroup was differentiated from the C4d+ AHR subgroup with a specificity and sensitivity of 95% and 80%, respectively (pattern 3). It is concluded that urine protein fingerprint analysis can provide a noninvasive tool to diagnose AR and C4d+ AHR.

Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study

M. Winkler, J. Pratschke, U. Schulz, S. Zheng, M. Zhang, W. Li, M. Lu, D. Sgarabotto, G. Sganga, P. Kaskel, S. Chandwani, L. Ma, J. Petrovic, M. Shivaprakash. Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study. Transpl Infect Dis 2010: 12: 230–237. All rights reserved