16alpha-Bromoepiandrosterone (HE2000) limits non-productive inflammation and stimulates immunity in lungs

16alpha-Bromoepiandrosterone (HE2000) is a synthetic steroid that limits non-productive inflammation, enhances protective immunity and improves survival in clinical studies of patients with human immunodeficiency virus (HIV), malaria and tuberculosis infections. We now show that HE2000 decreased nitric oxide production by lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Treatment with HE2000 also reduced non-productive inflammation associated with carrageenan-induced pleurisy and LPS-induced lung injury in mice. In the hapten-carrier reporter antigen popliteal lymph node assay, HE2000 increased absolute numbers of lymphocytes, antigen-presenting cells, hapten-specific immunoglobulin (Ig)M antibody-forming cells and shifted the interferon (IFN)-gamma/interleukin (IL)-4 balance towards IFN-gamma production. In the cystic fibrosis transmembrane conductance regulator (CFTR(-/-)) mouse model of acute Pseudomonas aeruginosa infection, treatment with HE2000 consistently reduced bacterial burden in lungs. All HE2000 effects were dose-dependent. In H1N1 infection in mice, HE2000 was safe but not effective as a monotherapy, as treatment did not effect survival. HE2000 reduced mortality related to excessive inflammation and opportunistic lung infections in animals and patients, and this might extend to those with H1N1 influenza infection.

Identification and characterization of the bovine G protein-coupled receptor GPR41 and GPR43 genes

Volatile fatty acids (VFA), including acetate, propionate, and butyrate, are not only a primary source of energy, but also regulate rumen development, insulin and glucagon secretion, and other physiological processes in cattle and sheep. The mechanism underlying the regulatory effects of VFA is unknown. Recent "reverse pharmacology" studies identified human G protein-coupled receptors GPR41 and GPR43 as receptors for short-chain fatty acids. It is possible that proteins similar to human GPR41 and GPR43 mediate the regulatory effects of VFA in cattle. In this study, we determined first, whether the bovine genome contains genes similar to the human GPR41 and GPR43 genes; second, whether and where these genes are expressed in cattle; and third, if the proteins encoded by these genes can be activated by acetate, propionate, and butyrate. A search of GenBank revealed bovine genomic sequences and expressed sequence tags highly similar to the human GPR41 and GPR43 DNA and cDNA sequences. The protein-coding and 5' untranslated regions of the bovine GPR41 and GPR43 mRNA were cloned and sequenced from spleen tissue. Based on these sequences, the bovine GPR41 gene contains 3 exons and its transcription is initiated at 2 leader exons, generating 2 GPR41 mRNA variants differing in the 5' untranslated region. The bovine GPR43 gene contains 2 exons and transcription of this gene is initiated from a single start site. The amino acid sequences deduced from the bovine GPR41 and GPR43 mRNA sequences are more than 75% identical to those of the human GPR41 and GPR43 and are predicted to encode 7 transmembrane domains, typical of G protein-coupled receptors. Both bovine GPR41 and GPR43 mRNA were detected in a variety of tissues including rumen and pancreas. In a cell system, interaction of the overexpressed bovine GPR41 or GPR43 protein with acetate, propionate, or butyrate inhibited luciferase reporter expression from a cyclic AMP-responsive promoter, suggesting that the bovine GPR41 and GPR43 proteins couple to Galpha(i/11). In total, these results demonstrate that the bovine genome encodes functional GPR41 and GPR43 genes and suggest that GPR41 and GPR43 may play a role in the regulatory effects of VFA in cattle.

Clinicopathological Variables Associated with Lymph Node Metastasis and Prognostic Factors in pT2 Gastric Cancer

This retrospective study investigated the clinicopathological variables associated with lymph node metastasis and prognosis in 325 patients with pT2 gastric cancer in order to set out a foundation for the surgical management of this condition. Univariate and multivariate analyses identified factors that were predictive of lymph node metastasis. Cox regression analysis evaluated the effect of prognostic factors on survival. Tumour location, maximum tumour diameter, lymphatic invasion and total retrieved lymph nodes (tLN) were revealed as independent factors for lymph node metastasis in pT2a gastric cancer, whereas histological type, lymphatic invasion and tLN were associated with lymph node metastasis in patients with pT2b gastric cancer. Maximum tumour diameter, lymphatic invasion and metastatic lymph node (mLN) ratio, but not tLN, were independent prognostic factors in pT2a cancer. Maximum tumour diameter and mLN ratio, but not tLN, were independent prognostic factors in pT2b cancer. Overall, it is concluded that maximum tumour diameter and mLN ratio are important prognostic factors in pT2 gastric cancer.

Cryopreservation of embryogenic callus of Dioscorea bulbifera by vitrification

Cryopreservation of callus of Dioscorea bulbifera by vitrification was optimized. Calli of Dioscorea bulbifera were pretreated in liquid Murashige and Skoog (MS) medium supplemented with 2 mg L(-1) kinetin (KT), 0.5 mg L(-1) NAA, 0.5 mg L(-1) 2,4-D and 0.2 M sucrose for 5 d under continuous light (36 microM m(-2) s(-1)) at 25 + or - 1 degree C. The material was then loaded with 60 percent vitrification solution (PVS2) for 20 min at room temperature and dehydrated with 100 percent PVS2 for 30 min at 0 degree C. After changing the solution with fresh PVS2, the calli were directly immersed in liquid nitrogen and conserved for 1- 360 d. After rapid thawing in a water-bath at 35 degree C, the calli were washed three times with liquid MS medium supplemented with 2 mg L(-1) KT, 0.5 mg L(-1) NAA, 0.5 mg L(-1) 2, 4-D and 1.2 M sucrose and then transferred onto solid MS medium supplemented with KT 2 mg L(-1), NAA 0.5 mg per liter, 0.09 M sucrose and 0.75 percent agar. The cultures were kept in the dark for 2 days prior to exposure to the light (12 h light-dark cycle). The TTC test showed that 80-90 percent of the calli survived this cryoprocedure and there was a 60-70 percent regeneration of plantlets from the calli. The regenerated material did not exhibit any morphological variations.

Notched stress-strain behavior of a conventional and a sequentially annealed highly crosslinked UHMWPE

Contemporary total joint replacement designs contain stress-risers such as fillets, grooves, and undercuts; therefore, it is of interest to analyze the behavior of UHMWPEs in the presence of such design-related stress-risers. This study examined the engineering and true axial stress-strain behavior of smooth cylindrical and notched cylindrical test specimens, under applied axial tensile loading (2 displacement rates, 37 degrees C) for a conventional and a highly crosslinked second generation UHMWPE. Both materials were prepared from ram extruded GUR 1050. The conventional material (30 kGy) was gamma sterilized at 30 kGy in an inert N(2) environment. The sequentially annealed material (SA) was gamma irradiated at 30 kGy and annealed for 8h at 130 degrees C. The irradiation-annealing process was repeated two more times for an overall irradiation dose of 90 kGy. Differential scanning calorimetry (DSC) was utilized to investigate changes in crystallinity and lamellar thickness distributions upon loading. Fractographic analysis of scanning electron microscope (SEM) images of fracture surfaces was performed to investigate changes in fracture micromechanism with notching. Both the 30 kGy and SA materials, in the smooth condition, demonstrated substantial ductility and orientation hardening. With the introduction of a notch, both materials demonstrated an elevation in the yield stress (notch strengthening) and a reduction in the ultimate stress and ultimate strain at both displacement rates. Additionally, it was found that the uniaxial stress-state (smooth condition) allowed for greater changes in crystallinity and the lamellar thickness distributions, when compared to the untested materials, than the triaxial stress-state induced by the notched geometry.

The long-term impact of ferritin level on treatment and complications of type 2 diabetes

AIM

To investigate if high-serum ferritin has long-term impact on response to treatment and the development of diabetic complications in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

We analysed the record of 90 consecutive type 2 diabetic subjects who had serum ferritin level determined soon after diagnosis of diabetes and who also had long-term follow-up data.

RESULTS

Patients with higher serum ferritin level had slightly worse triglyceride, blood pressure and liver enzyme levels at the end of follow up. However, ferritin level had no impact on the initial or final requirements for diabetic medication and the development of diabetic complications.

CONCLUSIONS

Although elevated serum ferritin is a marker of insulin resistance and chronic inflammation, it is not necessarily a bad prognostic indicator that should affect the clinician's approach to management.

Over 4000 nm bandwidth of mid-IR supercontinuum generation in sub-centimeter segments of highly nonlinear tellurite PCFs

We report broad bandwidth, mid-IR supercontinuum generation using a sub-cm (8 mm) length of highly nonlinear tellurite microstructured photonic crystal fiber (PCF). We pump the fiber at telecommunication wavelengths by using 1550 nm, 100 fs pulses of energy E=1.9 nJ. When coupled in the PCF, these pulses result in a supercontinuum (SC) bandwidth of 4080 nm extending from 789 to 4870 nm measured at 20 dBm below the peak spectral power. This bandwidth is comparable or in excess of previously reported spectra for other nonlinear glass fiber formulations despite the significantly shorter fiber length. In addition, besides offering a convenient pump wavelength, short fiber lengths enable smoother SC spectra, lower dispersion, and reduced material absorption at longer wavelengths making the use of this PCF particularly interesting.

Molecular characterization of the bovine chromodomain Y-like genes

The human chromodomain protein, Y-like (CDYL) gene family consists of three members, one on the Y chromosome (CDY) and two on autosomes (CDYL and CDYL2). Studies in the human and mouse showed that genes in the CDYL family are abundantly expressed in testis and play an important role in spermatogenesis. In this study, we have characterized the bovine CDYL (bCDYL) and CDYL2 (bCDYL2) genes. We found that bCDYL and bCDYL2 are very similar to the human orthologues at both mRNA (79% and 85%) and protein (89% and 93%) levels. However, the similarity between the bCDYL and bCDYL2 proteins is low (41%). The bCDYL gene is composed of nine exons, and the bCDYL2 has seven exons. The bCDYL and bCDYL2 genes were mapped by radiation hybrid mapping to bovine chromosomes (BTA) 24 and 18 respectively. The bCDYL gene has four transcript variants that produce four protein isoforms. RT-PCR expression analysis in 12 bovine tissues showed that bCDYL variant 2 was expressed in the testis only, bCDYL variants 1, 3 and 4 were expressed predominantly in the testis and at very low or undetectable levels in the remaining tissues and bCDYL2 was expressed ubiquitously. Examination of bovine testis with in situ hybridization revealed that the bCDYL and bCDYL2 transcripts were found mainly in spermatids, though the amounts of transcripts varied among genes/variants. In addition, antisense transcripts were detected in bCDYL variants 2/3 and 4, as well as in the bCDYL2 gene.

NOD2-expressing bone marrow-derived cells appear to regulate epithelial innate immunity of the transplanted human small intestine

BACKGROUND

Intestinal allograft rejection resembles Crohn's disease clinically and pathologically. An understanding of its mechanism could impact this life-saving procedure, as well as provide insight into the pathophysiology of inflammatory bowel disease. The NOD2 protein has been implicated as a key player in intestinal immune health, as a consequence of the discovery of three polymorphisms linked with Crohn's disease. An investigation was carried out to determine whether epithelial immune function and graft survival were influenced by NOD2 mutations in an intestinal transplant population.

METHODS

The NOD2 genotypes of 34 transplants performed consecutively over the past 3 years were determined. The NOD2 genotypes were related to clinical outcomes and the expression of certain intestinal antimicrobial peptides (AMPs) believed to protect the epithelium.

RESULTS

An unexpectedly high percentage of recipients, 35%, possessed NOD2 polymorphisms, while 8.6% of donors had comparable mutations. The likelihood of allograft failure was about 100-fold higher in recipients with mutant NOD2 alleles compared with recipients with wild-type NOD2 loci. Rejection in NOD2 mutant recipients was characterised by decreased expression of certain Paneth cell and enterocyte AMPs, prior to the onset of epithelial injury and inflammation.

CONCLUSIONS

Crohn's disease-associated polymorphisms in the NOD2 gene in the recipient represent a critical immunological risk factor for intestinal allograft rejection. Compromised epithelial defences precede visible epithelial injury and inflammatory infiltration. The association of impaired epithelial immunity with the recipient's genotype suggests that certain NOD2-expressing cells of haematopoietic origin play a role in the process, perhaps by regulating expression of certain epithelial AMPs within the allograft.

Pathogens in Crassostrea ariakensis and other Asian oyster species: implications for non-native oyster introduction to Chesapeake Bay

With the drastic decline of eastern oyster Crassostrea virginica populations in the Chesapeake Bay due to over-fishing, diseases and habitat destruction, there is interest in Maryland and Virginia in utilizing the non-native oyster species Crassostrea ariakensis for aquaculture, fishery resource enhancement, and ecological restoration. The International Council for the Exploration of the Sea (ICES) recommends that non-native species be examined for ecological, genetic and disease relationships in the native range prior to a deliberate introduction to a new region. Therefore, a pathogen survey of C. ariakensis and other sympatric oyster species was conducted on samples collected in the PR China, Japan and Korea using molecular diagnostics and histopathology. Molecular assays focused on 2 types of pathogens: protistan parasites in the genus Perkinsus and herpesviruses, both with known impacts on commercially important molluscan species around the world, including Asia. PCR amplification and DNA sequence data from the internal transcribed spacer region of the rRNA gene complex revealed the presence of 2 Perkinsus species not currently found in USA waters: P. olseni and an undescribed species. In addition, 3 genetic strains of molluscan herpesviruses were detected in oysters from several potential C. ariakensis broodstock acquisition sites in Asia. Viral gametocytic hypertrophy, Chlamydia-like organisms, a Steinhausia-like microsporidian, Perkinsus sp., Nematopsis sp., ciliates, and cestodes were also detected by histopathology.

Improved COBAS TaqMan hepatitis C virus test (Version 2.0) for use with the High Pure system: enhanced genotype inclusivity and performance characteristics in a multisite study

We have evaluated the COBAS TaqMan hepatitis C virus (HCV) test (version 2.0) for use with the High Pure system (HCVHPS V2), a new, revised real-time reverse transcription-PCR assay developed to improve the genotype quantitation of version 1.0 (HCVHPS V1). Revisions were made in the wash buffer and in the reverse transcription temperature. The genotype inclusivity of HCVHPS V2 was evaluated at three different sites, using HCVHPS V2, HCVHPS V1, and the COBAS AMPLICOR HCV MONITOR test (version 2.0) (CAHCM). The fully automated COBAS Ampliprep/COBAS TaqMan HCV test was also used in one of the participating laboratories. The mean differences in HCV RNA values between HCVHPS V2 and CAHCM and between HCVHPS V2 and HCVHPS V1 ranged from -0.21 to 0.13 log and from 0.24 to 1.27 log, respectively, with >0.5-log differences for genotypes 2, 3, 4, and 5. With a NIBSC panel of HCV genotypes 1 through 6, the measured HCVHPS V2 values were within 0.25 log of the nominal values for all 6 genotypes. When serial dilutions of genotype-specific clinical HCV specimens were tested, the assay showed a limit of detection between 10 and 20 IU/ml and a linear range of 25 IU/ml to 3.91 x 10(8) IU/ml. Clinical and analytical specificities of 100% were demonstrated with 100 HCV-seronegative specimens as well as with 12 non-HCV members of Flaviviridae and 22 additional microorganisms. These data indicate that HCVHPS V2 is a robust and accurate test for the quantitation of all six HCV genotypes and useful in monitoring viral load in all clinical HCV specimens.

Validation of an RT-PCR multi-gene prognostic signature for distant metastasis in node negative (N-), ER positive (ER+) breast cancer patients using FFPE sections

21009

Background: We sought to validate a previously developed 14-gene prognostic signature and a metastasis score (MS) that predicted distant metastasis in N-, ER+ breast cancer patients in an independent sample set of patients without systemic treatment. The genes consisted primarily of proliferation genes involved in p53 and TNF signaling pathways. Methods: : A cohort of 294 N-, ER+ breast cancer patients from Guy's Hospitals, London, UK without systemic therapy were tested. The cohort had a mean age of 55.5 yrs with 49% > 55 yrs, mean tumor size of 1.93 (max. 3) cm, and a median follow up of 14.3 yrs. The primary endpoint was distant metastasis free survival. RT-PCR was carried out on fixed sections. The MS was calculated. Results: The mean MS (SD) was 0.44 (0.59) with a range of -1.31 to 2.0. Hazard of distant metastasis increased 3.02 fold (95% CI 1.91–4.76, p <0.0001) per unit increase in MS from Cox model. The pre-determined cut point of zero was used to stratify patients into low- and high-risk groups. The 5-yr distant-metastasis-free survival rate (DMFSR) for low- and high-risk groups were 1 and 0.86 (SE 0.024); the 10-yr DMFSR were 0.97 (0.021) and 0.77 (0.030), respectively. Univariate Cox regression analyses indicated that MS (hazard ratio (HR) 5.65, 95% CI 2.05–15.56, p=0.008), tumor size (HR 1.62, p=0.0047) and tumor grade (HR 2.52, p=0.036) were significant but age was not. Multivariate Cox regression indicated that the signature had independent prognostic value with a HR of 4.71 (1.42–15.61, p=0.011) after adjusting for age, tumor size and grade. AUC of MS at 5-and 10-yr were 0.78 (0.71–0.85, p<0.001) and 0.73 (0.66–0.80, p<0.001) with sensitivities of 1 and 0.96 and specificities of 0.31 and 0.31 at zero cut point, respectively. The differential risk between the median MS scores of the lowest and highest deciles was 8-fold. Conclusions: A previously defined RT-PCR prognostic signature for N-, ER+ patients has been confirmed. A metastasis score that quantifies distant metastasis risk, not confounded with treatment effect can complement treatment response predictors. Insight on natural history of tumors is critical for evaluating impact of therapy.

No significant financial relationships to disclose.

Echocardiographic risk stratification for early surgery with endocarditis: a cost-effectiveness analysis

BACKGROUND

Despite widespread acceptance of echocardiography for diagnosis of infective endocarditis, few investigators have evaluated its utility as a risk-stratification tool to aid therapeutic decision-making.

METHODS

A decision tree and Markov analysis model were constructed using published and institutional data to estimate the cost-effectiveness of an echocardiographic risk-stratification strategy for infective endocarditis. The models compared surgery for high-risk patients based on clinical factors ("standard care") and surgery for high-risk patients based on echocardiographic findings ("echocardiography-guided").

RESULTS

The cost per patient for standard care and echocardiography-guided strategies was $47,766 and $53,669, respectively. The expected quality-adjusted life years (QALY) for standard care and echocardiography-guided strategies were 5.86 years and 6.10 years, respectively. Compared with standard care, the echocardiography-guided strategy cost an additional $23,867 per QALY saved. In one-way sensitivity analyses, the incremental cost of this strategy remained <$50,000/QALY across a broad range of scenarios. Baseline stroke risk had the greatest effect on cost-effectiveness. For populations with stroke risk less than 3.65%, the echocardiography-guided strategy was not cost-attractive (ICER >$50,000/QALY). At stroke risk between 3.65% and 14%, the ICER for the echocardiography-guided strategy was attractive (<$50,000 /QALY). The echocardiography-guided strategy became economically dominant at any baseline stroke risk greater than 18.3%.

CONCLUSION

Echo-guided risk stratification for early surgery in patients with large vegetations is a cost-attractive treatment strategy for IE, as it improves outcome for an incremental cost <$50,000/QALY.

'Mild Uncoupling' does not decrease mitochondrial superoxide levels in cultured cerebellar granule neurons but decreases spare respiratory capacity and increases toxicity to glutamate and oxidative stress

Cultured rat cerebellar granule neurons were incubated with low nanomolar concentrations of the protonophore carbonylcyanide-p-trifluoromethoxyphenyl hydrazone (FCCP) to test the hypothesis that 'mild uncoupling' could be neuroprotective by decreasing oxidative stress. To quantify the uncoupling, respiration and mitochondrial membrane potential (Deltapsi(m)) were determined in parallel as a function of FCCP concentration. Deltapsi(m) dropped by less than 10 mV before respiratory control was lost. Conditions for the valid estimation of matrix superoxide levels were determined from the rate of oxidation of the matrix-targeted fluorescent probe MitoSOX. No significant change in the level of matrix superoxide could be detected on addition of FCCP while respiratory control was retained, although cytoplasmic superoxide levels measured by dihydroethidium oxidation increased. 'Mild uncoupling' by 30 nmol/L FCCP did not alleviate neuronal dysregulation induced by glutathione depletion and significantly enhanced that due to menadione-induced oxidative stress. Low protonophore concentrations enhanced N-methyl-d-aspartate receptor-induced delayed calcium deregulation consistent with a decrease in the spare respiratory capacity available to match the bioenergetic demand of chronic receptor activation. It is concluded that the 'mild uncoupling' hypothesis is not supported by this model.

Multicenter evaluation of a new disk agar diffusion method for susceptibility testing of filamentous fungi with voriconazole, posaconazole, itraconazole, amphotericin B, and caspofungin

The purpose of this study was to correlate inhibition zone diameters, in millimeters (agar diffusion disk method), with the broth dilution MICs or minimum effective concentrations (MECs) (CLSI M38-A method) of five antifungal agents to identify optimal testing guidelines for disk mold testing. The following disk diffusion testing parameters were evaluated for 555 isolates of the molds Absidia corymbifera, Aspergillus sp. (five species), Alternaria sp., Bipolaris spicifera, Fusarium sp. (three species), Mucor sp. (two species), Paecilomyces lilacinus, Rhizopus sp. (two species), and Scedosporium sp. (two species): (i) two media (supplemented Mueller-Hinton agar [2% dextrose and 0.5 microg/ml methylene blue] and plain Mueller-Hinton [MH] agar), (ii) three incubation times (16 to 24, 48, and 72 h), and (iii) seven disks (amphotericin B and itraconazole 10-microg disks, voriconazole 1- and 10-microg disks, two sources of caspofungin 5-microg disks [BBL and Oxoid], and posaconazole 5-microg disks). MH agar supported better growth of all of the species tested (24 to 48 h). The reproducibility of zone diameters and their correlation with either MICs or MECs (caspofungin) were superior on MH agar (91 to 100% versus 82 to 100%; R, 0.71 to 0.93 versus 0.53 to 0.96 for four of the five agents). Based on these results, the optimal testing conditions for mold disk diffusion testing were (i) plain MH agar; (ii) incubation times of 16 to 24 h (zygomycetes), 24 h (Aspergillus fumigatus, A. flavus, and A. niger), and 48 h (other species); and (iii) the posaconazole 5-microg disk, voriconazole 1-microg disk, itraconazole 10-microg disk (for all except zygomycetes), BBL caspofungin 5-microg disk, and amphotericin B 10-microg (zygomycetes only).