Developmental and sensory-dependent changes of group II metabotropic glutamate receptors

Metabotropic glutamate receptors (mGluRs) are potential participants of sensory-dependent modification of neural connections. Here, we examined the involvement of cAMP-linked mGluRs (mGluR2/3) in sensory-dependent plasticity by studying the correlation of mGluR2/3 changes with the critical period of ocular dominance plasticity, a form of sensory-dependent plasticity, and exploring the effects of dark rearing on mGluR2/3 in the primary visual cortex of cats. Immunohistochemistry showed that the laminar distribution of mGluR2/3 changed with the critical period and was sensitive to dark rearing. The mGluR2/3 immunostaining became most intense in layer IV at the beginning of the critical period and was reduced in layer IV but became intense in layers I-III at the peak of the period, then was concentrated primarily in layers I-upper III at the end of the critical period. Dark rearing delayed these pattern changes for weeks and elevated the normally declining mGluR2/3 quantity shortly after the peak of the critical period. The effects of dark rearing and the correlation of early mGluR2/3 laminar changes with geniculocortical afferent segregation indicate that mGluR2/3 circuitry in the visual cortex is influenced by visual inputs. Our data suggest that mGluR2/3 together with another sensory-influenced mGluR, mGluR5, may participate in the sensory-dependent modification of neural connections in the visual cortex.

Interleukin-6 serum level correlates with survival in advanced gastrointestinal cancer patients but is not an independent prognostic indicator

Interleukin-6 (IL-6) is a pleiotropic cytokine that has been shown to regulate immune defense mechanisms and hematopoiesis. In addition, IL-6 may also be involved in malignant transformation and tumor progression. A poor prognosis in patients with multiple myeloma, renal cell carcinoma, ovarian cancer, or prostate cancer has been associated consistently with elevated IL-6 serum levels. The aim of this study was, therefore, to assess IL-6 serum levels in 68 advanced gastrointestinal cancer patients and to correlate them with prognosis. IL-6 serum levels were found to be significantly elevated in cancer patients with respect to controls. Moreover, patients with disseminated cancer displayed significantly higher IL-6 serum levels than patients without apparent metastases. On univariate analysis, both overall survival (OS) and time to disease progression (TTP) were shown to be affected by IL-6 serum levels. However, multivariate analysis failed to demonstrate an independent prognostic significance for IL-6 serum levels while confirming the role of previously established variables, such as performance status, carcinoembryonic antigen (CEA) serum levels, and distant metastases. In conclusion, this study showed that IL-6 serum levels were elevated in advanced gastrointestinal cancer patients and correlated with both OS and TTP. However, they were shown not to be an independent prognostic factor.

Rubinstein-Taybi syndrome with epidermal nevus: a case report

We describe an 8-year-old boy with Rubinstein-Taybi syndrome, a multiple congenital anomaly/mental retardation syndrome characterized by broad thumbs and great toes, peculiar facies, and mental retardation caused by mutations in the transcriptional coactivator CREB binding protein (CBP). He had on his right side yellowish papular lesions organized in narrow bands according to Blaschko lines, later confirmed by histology as an epidermal nevus. Epidermal nevus syndrome has been ruled out because the patient failed to meet the criteria for inclusion under this designation. This association may be coincidental.

Covalent and noncovalent interactions mediate metabotropic glutamate receptor mGlu5 dimerization

Some, perhaps all, G protein-coupled receptors form homo- or heterodimers. We have shown that metabotropic glutamate receptors are covalent dimers, held together by one or more disulfide bonds near the N terminus. Here we report how mutating cysteines in this region affect dimerization and function. Covalent dimerization is preserved when cysteines 57, 93, or 99 are mutated but lost with replacement at 129. Coimmunoprecipitation under nondenaturing conditions indicates that the C[129]S mutant receptor remains a dimer, via noncovalent interactions. Both C[93]S and C[129]S bind [3H]quisqualate, whereas binding to C[57]S or C[99]S mutants is absent or greatly attenuated. The C[93]S and C[129]S receptors have activity similar to wild-type when assayed by fura-2 imaging of intracellular calcium in human embryonic kidney cells or electrophysiologically in Xenopus laevis oocytes. In contrast, C[57]S or C[99]S are less active in both assays but do respond with higher glutamate concentrations in the oocyte assay. These results demonstrate that 1) covalent dimerization is not critical for mGlu5 binding or function; 2) mGlu5 remains a noncovalent dimer even in the absence of covalent dimerization; and 3) high-affinity binding requires Cys-57 and Cys-99.

Unusual polyarthritis as a unique clinical manifestation of coeliac disease

This report describes a patient who presented with an unusual polyarthritis accompanied by myalgia, fever and anxiety. After extensive clinical and serological evaluation, duodenal biopsy and serological tests provided evidence for the diagnosis of coeliac disease (CD). The patient was promptly put on a gluten-free diet, which led to an improvement in the clinical abnormalities.

Cardiovascular malformations and other cardiovascular abnormalities in neurofibromatosis 1

Although it is well recognized that a peripheral vasculopathy may occur in patients with neurofibromatosis 1 (NF1), it is unclear whether cardiovascular abnormalities are more common. We reviewed the frequency of cardiovascular abnormalities, in particular, cardiovascular malformations (CVMs), among 2322 patients with definite NF1 in the National Neurofibromatosis Foundation International Database from 1991-98. Cardiovascular malformations were reported in 54/2322 (2.3%) of the NF1 patients, only 4 of whom had Watson syndrome or NF1-Noonan syndrome. There was a predominance of Class II "flow" defects [Clark, 1995: Moss and Adams' Heart Disease in Infants, Children, and Adolescents Including the Fetus and Young Adult. p 60-70] (43/54, 80%) among the NF1 patients with CVMs. Pulmonic stenosis, that was present in 25 NF1 patients, and aortic coarctation, that occurred in 5, constitute much larger proportions of all CVMs than expected. Of interest was the paucity of Class I conotruncal defects (2 patients with tetralogy of Fallot), and the absence of atrioventricular canal, anomalous pulmonary venous return, complex single ventricle and laterality defects. Besides the 54 patients with CVMs, there were 27 patients with other cardiac abnormalities (16 with murmur, 5 with mitral valve prolapse, 1 with intracardiac tumor, and 5 with electrocardiogram abnormalities). No patient in this study had hypertrophic cardiomyopathy. There were 16 patients who had a peripheral vascular abnormality without an intracardiac CVM, plus an additional 4 patients among those with a CVM who also had a peripheral vascular abnormality.

Dermatophytosis due to Trichophyton violaceum in Tuscany from 1985 to 1997

We describe 45 cases of dermatophytosis due to Trichophyton violaceum diagnosed in Tuscany from 1985 to 1997. Diagnosis was based on direct microscope mycological examination and culture. Nine of the 45 patients were Italian, eight of whom were born and resident in Tuscany; the others were Africans who contracted the infection in their country of origin. The first case in a non-European was observed in 1985, but since 1991 isolation from foreigners has become more frequent. The increase in cases of infection by T. violaceum in our region is certainly linked to immigration. The cases of epidermomycosis in Tuscans suggests that the fungus has already become autochthonous.

Case report. Primary cutaneous histoplasmosis in an immunosuppressed patient

A case of cutaneous histoplasmosis is reported in an 80-year-old man with rheumatoid arthritis who had been treated with steroid therapy for 15 years. The patient developed a large ulcerative lesion on the back of the left hand and on the distal third of the left dorsal forearm after a slight trauma. Diagnosis was based on histological and mycological examination. Systemic involvement was not found. The lesions healed after 2 months of therapy with 100 mg day-1 fluconazole, confirmed at follow-up 1 year later.

Reducing conditions differentially affect the functional and structural properties of group-I and -II metabotropic glutamate receptors

We have examined the influence of reducing conditions on the activity of group-I or -II metabotropic glutamate receptors. In cultured cerebellar granule cells or in hippocampal slices, the reducing agent dithiothreitol (DTT) inhibited the stimulation of polyphosphoinositide (PPI) hydrolysis elicited by group-I mGlu receptor agonists without affecting responses to norepinephrine or carbamylcholine. Similarly, DTT reduced the increase in intracellular free Ca(2+) induced by glutamate in HEK-293 cells expressing mGlu5 receptors. In adult hippocampal slices, the selective group-II mGlu receptor agonist, (2S,1'R,2'R,3'R)-2-(2, 3-dicarboxycyclopropyl)glycine (DCG-IV) had no effect per se on PPI hydrolysis, but potentiated the response to quisqualate. Although DTT substantially attenuated the action of quisqualate, it did not affect the potentiation by DCG-IV, suggesting that group-II mGlu receptors are resistant to extracellular reduction. Accordingly, DTT did not affect the inhibition of forskolin-stimulated cAMP formation induced by maximally effective concentrations of group-II mGlu receptor agonists in hippocampal slices or in CHO cells expressing mGlu2 receptors. At structural level, DTT differentially affected the aggregation state of mGlu1a, -2/3 or -5 receptors. In immunoblots performed under non-reducing conditions, mGlu1a, -2/3 or -5 antibodies labeled exclusively a high-molecular weight band, corresponding to receptor dimers. Under reducing conditions, mGlu1a or -5 receptors were detected as monomers, whereas a large proportion of mGlu2/3 receptors was still present in a dimeric form. We conclude that reducing conditions differentially influence the aggregation state of group-I and -II mGlu receptors and suggest that dimerization affects the functional activity of native mGlu receptors.

A new family with Papillon-Lefèvre syndrome: effectiveness of etretinate treatment

Papillon-Lefèvre syndrome is characterized by the association of palmoplantar hyperkeratosis, severe periodontitis, and early loss of deciduous and permanent teeth. We report two patients from the same family, aged 21 and 30 years, who were unaware of their pathology; one was successfully treated with etretinate.

A case of allergy to globe artichoke and other clinical cases of rare food allergy

We describe herein four unusual clinical cases of rare allergy to foods in patients affected by allergic rhinitis and asthma. The patients were skin tested both with commercial food extracts and using prick-prick procedure with fresh foods. Total and specific IgE in serum were determined by REAST. Grapes, lupine seeds, black mulberry and artichoke resulted positive in the patients under study. This is the first time allergy to ingested artichoke has been described.

Comparison of three probiotics in the treatment of acute diarrhea in mentally retarded children

BACKGROUND

This article aims to compare the use of VIS-01 (Yovis) with two other probiotics (lactic acid bacteria), such as Lactogèrmine and Codex in the treatment of acute diarrhea in children with mental retardation. A recent paper highlights the superiority of the first drug, claiming new perspectives in probiotic therapy.

METHODS

The authors perform a prospective study on 33 mentally retarded children (mean age 10.3 years), divided in three groups, each treated with a different probiotic (VIS-01, Lactogèrmine and Codex) at the beginning of an acute diarrhea. These children were admitted at the Pediatric Unit of the Oasi Maria SS. Institute in Troina. The dosage was suited to the technical record of the drug. During the clinical course the following items have been recorded: number of evacuations; time of alvine normalization; presence, quality, and length of fever; other associated features or side effects.

RESULTS

The time of alvine normalization did not show statistically significant differences between the three groups.

CONCLUSIONS

In conclusion, the use of Yovis does not modify in a statistically significant way with respect to the remaining drugs the clinical course of acute diarrhea in the mentally retarded children of the present study.

Semiallogeneic cell hybrids as therapeutic vaccines for cancer

The authors have engineered a cell line that can be used in human studies as a universal donor cell for the formation of semiallogeneic cell hybrids after fusion with patient-derived tumor cells. These hybrids can be irradiated and injected as a patient-tailored therapeutic vaccine in patients affected by virtually any type of cancer. A crucial step in this research effort has been the derivation of an allogeneic cell line (FO1-12) that expresses both a dominant selectable marker (neomycin resistance) and a recessive selectable marker (sensitivity to hypoxanthine, aminopterin, and thymidine), which allows easy selection of semiallogeneic cell hybrids derived from the fusion of FO1-12 cells with patient-derived tumor cells. Tumor-infiltrating lymphocytes derived from select patients with melanoma and exposed to semiallogeneic cell hybrids from the same patient were better able to specifically lyse autologous tumor cells. Furthermore, FO1-12 cells express carcinoembryonic antigen, which is ubiquitous in adenocarcinomas, and fusion of FO1-12 cells with various patient-derived adenocarcinoma cells showed that the hybrid cells also express carcinoembryonic antigen. Because of the results of these preclinical studies, the authors were given permission to use semiallogeneic cell hybrids for immunotherapy of patients with metastatic melanoma or metastatic adenocarcinoma who had not responded to standard treatment regimens. Treatment with semiallogeneic vaccines is associated with minimal or no toxicity and can induce a specific anti-tumor immune response.

A case of acral Darier's disease

A sporadic case of acral Darier's disease in a 20-year-old woman is reported. The disease was diagnosed on the basis of clinical, histological and ultrastructural data. Only few cases of exclusively acral clinical manifestations of Darier's disease have been described in the literature.

New mutations in XNP/ATR-X gene: a further contribution to genotype/phenotype relationship in ATR/X syndrome. Mutations in brief no. 176. Online

The molecular causes of ATR-X syndrome reside in mutations involving the XNP/ATR-X gene, which maps in the Xq13.3 region. Mutational analysis of this gene in two unrelated affected patients allowed us to identify two new molecular defects in two distinct regions of the gene. The first is a A-->G splice mutation in the acceptor site of the intron 11 that removes most of the 3' part of the protein, including the helicase domains and the glutamic acid stretch. Three cryptic acceptor splice sites are activated by this point mutation with consequent production of three types of abnormal mRNA: two with intronic insertions and a smaller one, approximately 10% of the total transcript, which is shorter than normal mRNA by one amino acid residue (E). Since the physiopathological characteristics of the patient carrying the splice mutation do not exhibit severe urogential abnormalities despite the lack of the -COOH end of the protein, a residual function of this third transcript is to be suspected. The second encountered nucleotide change (G-->T) leads to an R246L amino acid substitution in the putative zinc finger DNA-binding domain in the -NH2 terminal part of the protein.

Serum interleukin-10 levels as a prognostic factor in advanced non-small cell lung cancer patients

STUDY OBJECTIVE

To investigate the prognostic significance of interleukin (IL)-10 serum levels in advanced non-small cell lung cancer (NSCLC) patients.

DESIGN

IL-10 serum levels were measured before chemotherapy, on completion of therapy, and at follow-up by means of a commercially available enzyme-linked immunoassay. The results were then analyzed in comparison with other prognostic variables, and a model predicting overall survival (OS) and time to treatment failure (TTF) was finally generated.

SETTING

University hospital.

PATIENTS

Sixty consecutive patients with TNM stage III or IV NSCLC undergoing conventional platinum-based regimens.

RESULTS

Elevated levels of serum IL-10 were found in cancer patients with respect to healthy control subjects (17.7 +/- 4.4 vs 9.2 +/- 1.5 pg/mL, respectively; p < 0.05), with patients with metastatic disease showing significantly higher levels than patients with undisseminated cancer (21.0 +/- 4.2 vs 14.3 +/- 1.2 pg/mL, respectively; p < 0.05). Following completion of treatment, patients were classified as responders if they had achieved either one of the following: complete response, partial response, or stable disease; and nonresponders, in case of progressive disease. Retrospective analysis of basal IL-10 serum levels in these two subgroups showed a significant difference between responders and nonresponders (15.2 +/- 2.2 vs 21.4 +/- 4.2 pg/mL, respectively; p < 0.05). Moreover, a further significant increase in IL-10 serum levels was observed in nonresponders at the end of therapy (21.4 +/- 4.2 vs 26.0 +/- 4.3 pg/mL, prechemotherapy and postchemotherapy, respectively; p < 0.05), whereas values in responders were found to have significantly decreased (15.2 +/- 2.2 vs 14.8 +/- 2.2 pg/mL, prechemotherapy and postchemotherapy, respectively; p < 0.05). Using univariate and multivariate analyses, both OS and TTF were shown to be affected by the mean pathologic levels of IL-10. Stepwise regression analysis identified IL-10 serum level and stage as the prognostic factors related to OS, and IL-10 serum level and performance status as the prognostic factors related to TTF.

CONCLUSIONS

In conclusion, this study shows that the measurement of pretreatment IL-10 serum levels is of independent prognostic utility in patients with NSCLC and may be useful for detection of disease progression.

Relation of left ventricular diastolic properties to systolic function in arterial hypertension

BACKGROUND

It is unclear whether impairment of left ventricular (LV) diastolic characteristics is independent of systolic dysfunction.

METHODS AND RESULTS

To address this issue, 159 consecutive hypertensive patients (44+/-11 years, 78 obese, 96 women) and 165 normotensive subjects (32+/-11 years, 84 obese, 110 women) were studied with the use of Doppler echocardiography. After adjustment for age, body mass index (BMI), and sex, we found that ejection fraction (EF; M-mode, z-derived) was higher in hypertensive (66. 6+/-5.2%) than in normotensive (63.9+/-4.4%, P<0.0001) subjects, whereas midwall shortening (MS) was lower (hypertensive patients 16. 9+/-2.0%, normotensive subjects 17.8+/-2.2%, P<0.02), even after correction for end-systolic wall stress (P<0.05). Isovolumic relaxation time (IVRT) was greater in hypertensive patients (103+/-14 ms) than in normotensive subjects (78+/-19 ms), as was deceleration time of E velocity and peak A velocity (all P<0.0001). In multivariate analysis, IVRT was unrelated to EF, but a negative relation was found with MS (P<0.001), independent of age, BMI, presence of arterial hypertension, LV geometry, and load (multiple R(2)=0.58). For comparable age, sex distribution, BMI, and blood pressure values, hypertensive patients with lower afterload-adjusted MS exhibited longer IVRT than patients with normal MS (P<0.005). However, IVRT remained higher than in normotensive control subjects after control for LV geometry and load.

CONCLUSIONS

Doppler indices of delayed LV relaxation can be detected in the presence of normal or supranormal EF but are independently related to impaired MS. A less severely abnormal relaxation, however, can be also detected in the presence of normal midwall function, independent of LV geometry and load. Thus, diastolic abnormalities may occur before systolic dysfunction even when it is measured at the midwall.

Tinea incognito due to Microsporum gypseum in three children

Tinea incognito is a dermatophytosis of atypical clinical character due to the absence of classic features of ringworm. It is caused by prolonged use of topical steroids, sometimes prescribed as a result of incorrect diagnosis. The cases reported in the literature have different clinical presentations and have generally been in adults. We report three children with tinea incognito in whom the lesions were psoriasis-like, eczema-like, and lichenoid, respectively. Diagnosis was confirmed by mycologic examination, which led to the identification of Microsporum gypseum, a geophilic dermatophyte which is an infrequent agent of mycotic infection in humans.

Tinea capitis in Siena, Italy. An 18-year survey

In the period 1980-1998, 181 cases of tinea capitis out of a total of 1480 cases of dermatophytosis were observed in Siena, Italy; 176 cases were children (mean age 6 years, range 45 days to 14 years; 91 boys, 85 girls) and the other five cases were postmenopausal women. Diagnosis was made on the basis of culture which was positive in 179 cases, and direct microscopic observation which was positive in 155 of 179 cases. In two cases, positive direct microscopic results were not confirmed by the culture. The most frequently isolated mycete was Microsporum canis (162 cases, 90.5%) and the main source of infection was the cat, which was often a healthy carrier. The second most frequent mycete was Trychophyton mentagrophytes. Trichophyton violaceum, a dermatophyte practically absent from our province since the 1960s, was isolated in five patients. All patients were successfully treated. One adult was treated with oral ketoconazole and the other four with oral itraconazole. The children were all treated with griseofulvin and topical antimycotics. Two children, observed in 1997-1998, who did not respond to griseofulvin, achieved clinical and mycological recovery with oral itraconazole.

Serum interleukin-10 levels in patients with advanced gastrointestinal malignancies

BACKGROUND

Interleukin-10 (IL-10) is a cytokine with immunosuppressive properties. In this study, the authors investigated the prognostic significance of IL-10 levels in the sera of 58 patients with advanced gastric or colorectal carcinoma.

METHODS

IL-10 serum levels were measured before chemotherapy, on completion of chemotherapy, and at follow-up by means of a commercially available enzyme-linked immunoadsorbent assay kit. The results then were analyzed in comparison with other prognostic variables and a model predicting overall survival (OS) and time to disease progression (TTP) was generated.

RESULTS

Elevated levels of serum IL-10 were found in carcinoma patients compared with healthy controls (19.6 +/- 6.8 pg/mL vs. 9.2 +/- 1.5 pg/mL; P < 0.0001), with those patients with metastatic disease showing significantly higher levels than patients with undisseminated disease (21.9 +/- 6. 7 pg/mL vs. 15.5 +/- 3.6 pg/mL; P = 0.0003). Retrospective analysis of prechemotherapy IL-10 serum levels showed a significant difference between responders and nonresponders (15.8 +/- 2.5 pg/mL vs. 21.6 +/- 7.6 pg/mL; P < 0.0001). Moreover, a further significant increase in IL-10 serum levels was observed in nonresponders at the end of therapy (21.6 +/- 7.6 pg/mL prechemotherapy vs. 31.3 +/- 11.6 pg/mL postchemotherapy; P < 0.0001) whereas no significant differences were observed in responders. Using univariate analysis, both OS and TTP were shown to be affected by the median pathologic levels of IL-10; multivariate analysis related to OS and TTP identified performance status and IL-10 serum level as the relevant prognostic factors, respectively. Finally, stepwise regression analysis identified IL-10 serum level and metastases as the prognostic factors related to both OS and TTP.

CONCLUSIONS

The results of the current study show that measurement of pretreatment serum levels of IL-10 is of independent prognostic utility in patients with advanced gastrointestinal carcinoma and may be useful for the detection of disease progression.

Interdigital intertrigo of the feet due to therapy-resistant Fusarium solani

We report a case of bilateral intertrigo of the third and fourth interdigital spaces of the feet in a 34-year-old immunocompetent Senegalese male. A diagnosis of Fusarium solani infection was made. Systemic and topical therapy with terbinafine led to clinical but not mycological recovery. As this mould is potentially dangerous for immunodepressed subjects, early diagnosis and rigorous follow-up of skin diseases caused by this agent are advisable.

Excitotoxic cell death dependent on inhibitory receptor activation

Although excitotoxic cell death is usually considered a Ca(2+)-dependent process, in certain neuronal systems there is strong evidence that excitotoxic cell death is independent of Ca2+ and is instead remarkably dependent on extracellular Cl-. We have shown (in isolated chick embryo retina) that at least some of the lethal Cl- entry is through GABA and glycine receptors. Here we show that when all the GABA and glycine receptors are blocked by using an appropriate cocktail of inhibitors, agonist-induced excitotoxic cell death can be completely prevented. To determine if ligand-gated Cl- channels contribute to excitotoxic cell death in other neurons, we examined KA-induced cell death in cultured rat cerebellar granule cells. GABA receptor blockade with either a competitive or noncompetitive antagonist provides complete neuroprotection. KA stimulates Cl- uptake by the granule cells, and this is blocked by the GABA antagonists. Granule cell cultures take up [3H]GABA and release it in response to KA treatment. A subpopulation of neurons in the cultures is shown to have GAD and high concentrations of GABA, and this presumably is the source of the GABA that leads to receptor activation and lethal Cl- entry. Finally, we show that retinal cell death due to 1 h of simulated ischemia (combined oxygen and glucose deprivation) is completely prevented by blocking the inhibitory receptors. These results indicate that, paradoxically, excitotoxic cell death is completely dependent on activation of inhibitory receptors, in at least some neuronal systems, and this pathological process may contribute to disease.