Roles of translesion synthesis DNA polymerases in the potent mutagenicity of tobacco-specific nitrosamine-derived O2-alkylthymidines in human cells

The tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is a potent human carcinogen. Metabolic activation of NNK generates a number of DNA adducts including O(2)-methylthymidine (O(2)-Me-dT) and O(2)-[4-(3-pyridyl)-4-oxobut-1-yl]thymidine (O(2)-POB-dT). To investigate the biological effects of these O(2)-alkylthymidines in humans, we have replicated plasmids containing a site-specifically incorporated O(2)-Me-dT or O(2)-POB-dT in human embryonic kidney 293T (HEK293T) cells. The bulkier O(2)-POB-dT exhibited high genotoxicity and only 26% translesion synthesis (TLS) occurred, while O(2)-Me-dT was less genotoxic and allowed 55% TLS. However, O(2)-Me-dT was 20% more mutagenic (mutation frequency (MF) 64%) compared to O(2)-POB-dT (MF 53%) in HEK293T cells. The major type of mutations in each case was targeted T → A transversions (56% and 47%, respectively, for O(2)-Me-dT and O(2)-POB-dT). Both lesions induced a much lower frequency of T → G, the dominant mutation in bacteria. siRNA knockdown of the TLS polymerases (pols) indicated that pol η, pol ζ, and Rev1 are involved in the lesion bypass of O(2)-Me-dT and O(2)-POB-dT as the TLS efficiency decreased with knockdown of each pol. In contrast, MF of O(2)-Me-dT was decreased in pol ζ and Rev1 knockdown cells by 24% and 25%, respectively, while for O(2)-POB-dT, it was decreased by 44% in pol ζ knockdown cells, indicating that these TLS pols are critical for mutagenesis. Additional decrease in both TLS efficiency and MF was observed in cells deficient in pol ζ plus other Y-family pols. This study provided important mechanistic details on how these lesions are bypassed in human cells in both error-free and error-prone manner.

DNA polymerases κ and ζ cooperatively perform mutagenic translesion synthesis of the C8-2'-deoxyguanosine adduct of the dietary mutagen IQ in human cells

The roles of translesion synthesis (TLS) DNA polymerases in bypassing the C8-2'-deoxyguanosine adduct (dG-C8-IQ) formed by 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), a highly mutagenic and carcinogenic heterocyclic amine found in cooked meats, were investigated. Three plasmid vectors containing the dG-C8-IQ adduct at the G1-, G2- or G3-positions of the NarI site (5'-G1G2CG3CC-3') were replicated in HEK293T cells. Fifty percent of the progeny from the G3 construct were mutants, largely G→T, compared to 18% and 24% from the G1 and G2 constructs, respectively. Mutation frequency (MF) of dG-C8-IQ was reduced by 38-67% upon siRNA knockdown of pol κ, whereas it was increased by 10-24% in pol η knockdown cells. When pol κ and pol ζ were simultaneously knocked down, MF of the G1 and G3 constructs was reduced from 18% and 50%, respectively, to <3%, whereas it was reduced from 24% to <1% in the G2 construct. In vitro TLS using yeast pol ζ showed that it can extend G3*:A pair more efficiently than G3*:C pair, but it is inefficient at nucleotide incorporation opposite dG-C8-IQ. We conclude that pol κ and pol ζ cooperatively carry out the majority of the error-prone TLS of dG-C8-IQ, whereas pol η is involved primarily in its error-free bypass.

A male person of 55 years with hypothyroidism, ascites and heart failure

Primary hypothyroidism is a common clinical condition but ascites caused by hypothyroidism is rare. Concurrent exudative ascites with heart failure even rarer. So its diagnosis is often delayed and patients frequently receive unnecessary procedures such as liver biopsies and exploratory laparotomies. We report a male person of 55 years with hypothyroidism with ascites and heart failure who responded well with thyroid hormone replacement therapy with complete resolution of ascites. Analyses of ascites from patients in this condition usually shows exudative ascites with high protein (>2.5gm/dl) and SAAG <1.1gm/dl. High index of suspicion is required to reach at such diagnosis. Though it is a rare but prognosis is excellent with replacement therapy.

Maternal periodontal disease as a significant risk factor for low birth weight in pregnant women attending a secondary care hospital in South India: a case-control study

CONTEXT

Periodontal disease (PD) is a common infection in the community; however, its relationship with low birth weight (LBW) has not been well-established.

AIMS

The aim was to determine the association between maternal PD and LBW.

SETTINGS AND DESIGN

A case-control (1:1) study.

MATERIALS AND METHODS

The study population comprised of women who delivered at the hospital during the study period (September 2011 to February 2012).Women between 18 and 35 years of age, who delivered singleton, live infants during study period with at least 18 teeth were enrolled. Those with pregnancy induced hypertension, gestational diabetes, blood-borne viral infections, periodontal treatment within the past 6 months and valvular heart disease were excluded. Control population was parity matched to the cases.

STATISTICAL ANALYSIS USED

Chi-square test, t-test and univariant and multivariant logistic regression were used to analyze various study findings, and level of significance was set at 5% (P<0.05).

RESULTS

PD was independently associated with LBW (odds ratio: 4.94, 95% confidence interval: 1.03-23.65, P=0.045). Additionally, conventional risk factors such as maternal height (P=0.029), secondary schooling (<8 years of schooling) (P=0.001), socio-economic status (P=0.046), type of family (joint) (P=0.008), number of ante-natal visits (P=0.028) and gestational age at birth (<37 weeks) (P=0.045) showed significant association with LBW.

CONCLUSIONS

There seems to be an association between PD and LBW independent of conventional risk factors. Women who had PD were 5 times more likely to deliver LBW infants.

Mutational analysis of the C8-guanine adduct of the environmental carcinogen 3-nitrobenzanthrone in human cells: critical roles of DNA polymerases η and κ and Rev1 in error-prone translesion synthesis

3-Nitrobenzanthrone (3-NBA), a potent mutagen and suspected human carcinogen, is a common environmental pollutant. The genotoxicity of 3-NBA has been associated with its ability to form DNA adducts, including N-(2′-deoxyguanosin-8-yl)-3-aminobenzanthrone (C8-dG-ABA). To investigate the molecular mechanism of C8-dG-ABA mutagenesis in human cells, we have replicated a plasmid containing a single C8-dG-ABA in human embryonic kidney 293T (HEK293T) cells, which yielded 14% mutant progeny. The major types of mutations induced by C8-dG-ABA were G → T > G → A > G → C. siRNA knockdown of the translesion synthesis (TLS) DNA polymerases (pols) in HEK293T cells indicated that pol η, pol κ, pol ι, pol ζ, and Rev1 each have a role in replication across this adduct. The extent of TLS was reduced with each pol knockdown, but the largest decrease (of ∼55% reduction) in the level of TLS occurred in cells with knockdown of pol ζ. Pol η and pol κ were considered the major contributors of the mutagenic TLS, because the mutation frequency (MF) decreased by 70%, when these pols were simultaneously knocked down. Rev1 also is important for mutagenesis, as reflected by the 60% reduction in MF upon Rev1 knockdown, but it probably plays a noncatalytic role by physically interacting with the other two Y-family pols. In contrast, pol ζ appeared to be involved in the error-free bypass of the lesion, because MF increased by 60% in pol ζ knockdown cells. These results provide important mechanistic insight into the bypass of the C8-dG-ABA adduct.

Inhibitory feedback promotes stability in an oscillatory network

Reliability and variability of neuronal activity are both thought to be important for the proper function of neuronal networks. The crustacean pyloric rhythm (∼1 Hz) is driven by a group of pacemaker neurons (AB/PD) that inhibit and burst out of phase with all follower pyloric neurons. The only known chemical synaptic feedback to the pacemakers is an inhibitory synapse from the follower lateral pyloric (LP) neuron. Although this synapse has been studied extensively, its role in the generation and coordination of the pyloric rhythm is unknown. We examine the hypothesis that this synapse acts to stabilize the oscillation by reducing the variability in cycle period on a cycle-by-cycle basis. Our experimental data show that functionally removing the LP-pyloric dilator (PD) synapse by hyperpolarizing the LP neuron increases the pyloric period variability. The increase in pyloric rhythm stability in the presence of the LP-PD synapse is demonstrated by a decrease in the amplitude of the phase response curve of the PD neuron. These experimental results are explained by a reduced mathematical model. Phase plane analysis of this model demonstrates that the effect of the periodic inhibition is to produce asymptotic stability in the oscillation phase, which leads to a reduction in variability of the oscillation cycle period.

Therapeutic effectiveness of intratumorally delivered dendritic cells engineered to express the pro-inflammatory cytokine, interleukin (IL)-32

Interleukin-32 (IL-32) is a pro-inflammatory cytokine conditionally produced by T cells, natural killer (NK) cells, monocytes, epithelial cells and keratinocytes, which has an important role in host resistance against infectious disease. Interestingly, elevated levels of IL-32 transcripts in fine needle aspirates of tumor tissue have also been correlated with objective clinical responses in cancer patients receiving immunotherapy. To evaluate the antitumor impact of IL-32 gene therapy, we treated BALB/c mice bearing established subcutaneous CMS4 sarcomas with intratumoral (i.t.) injections of syngenic dendritic cells (DCs) engineered to express human IL-32β complementary DNA (that is, DC.IL32). Although ectopic expression of IL-32β by DC resulted in only modest phenotypic changes in these antigen-presenting cells, DC.IL32 produced higher levels of IL-12p70 than control DC. DC.IL32 were more potent activators of type-1 T-cell responses in vitro and in vivo, with i.t. administration of DC.IL32 leading to the CD8(+) T-cell-dependent (but CD4(+) T-cell- and NK cell-independent) suppression of tumor growth. Effective DC.IL32-based therapy promoted infiltration of tumors by type-1 (that is, CXCR3(+)VLA-4(+)GrB(+)) CD8(+) T cells and CD11b(+)CD11c(+) host myeloid DC, but led to reductions in the prevalence of CD11b(+)Gr1(+) myeloid-derived suppressor cells and CD31(+) blood vessels.

Synthesis and evaluation of 1,3 di-substituted schiff, mannich bases and spiro isatin derivatives

Schiff bases of isatin with aminothiazole, its N-mannich bases and Spiro isatin derivatives were synthesized. Their chemical structures were confirmed by Infrared, 1H-Nuclear Magnetic Resonance data and elemental analysis. Antimicrobial evaluation was performed by the agar diffusion method against four pathogenic bacteria and two pathogenic fungi. Anti-inflammatory activity was tested by carragenin-induced rat paw edema and compounds were evaluated for analgesic action by the acetic acid-induced writhing method; Compounds Aa, Ab and A5, A6 were found to be active against bacteria and fungi. The compounds A3, A6, Aa and Ab showed anti-inflammatory activity, having a percentage protection value of 34.69, 32.65, 38.77 and 36.73 as compared with that of indomethacin, with % protection of 46.93. Similarly, the compounds Aa, Ab and A6 showed analgesic activity, with % protection of 67.51, 64.78 and 49.81 as compared with the standard with % protection of 79.56.

Simple spectrophotometric methods for estimation of aceclofenac from bulk and formulations

Two simple, precise and accurate visible spectrophotometric methods were developed for the estimation of Aceclofenac in bulk drug and in pharmaceutical formulations. The proposed methods were indirect and based on determination of aceclofenac after its reaction with either (p-dimethylaminocinnamaldehyde or 3-Methyl-2-benzothiazolinone hydrazine hydrochloride and measuring the chromogen at the λmax by 658 and 592, respectively. Beers law obeyed in the concentration range of 1-200 μg/ml for method A and 1-100 μg/ml for method B. The accuracy of the methods was determined by recovery studies. The methods showed good reproducibility and recovery with relative standard deviation (in %) less than 2. The methods were found to be simple, economical, accurate and reproducible and can be used for routine analysis of Aceclofenac in bulk drug and in pharmaceutical formulations.

Evaluation of Bioequivalence of Two Formulations Containing 100 Milligrams of Aceclofenac

The bioequivalence of two oral formulations containing aceclofenac 100 mg was determined in 24 healthy Indian male volunteers. The study was designed as a single dose, fasting, two-period two-sequence crossover study with a washout period of 1 week. The content of aceclofenac in plasma was determined by a validated HPLC method with UV detection. The preparations were compared using the parameters area under the plasma concentration-time curve (AUC0-t), area under the plasma concentration-time curve from zero to infinity (AUC0-infinity), peak plasma concentration (Cmax), and time to reach peak plasma concentration (tmax). No statistically significant difference was observed between the logarithmic transformed AUC0-infinity and Cmax values of the two preparations. The 90% confidence interval for the ratio of the logarithmic transformed AUC0-t, AUC0-infinity, and Cmax were within the bioequivalence limit of 0.80-1.25.

Infant morbidity in an Indian slum birth cohort

OBJECTIVE

To establish incidence rates, clinic referrals, hospitalisations, mortality rates and baseline determinants of morbidity among infants in an Indian slum.

DESIGN

A community-based birth cohort with twice-weekly surveillance.

SETTING

Vellore, South India.

SUBJECTS

452 newborns recruited over 18 months, followed through infancy.

MAIN OUTCOME MEASURES

Incidence rates of gastrointestinal illness, respiratory illness, undifferentiated fever, other infections and non-infectious morbidity; rates of community-based diagnoses, clinic visits and hospitalisation; and rate ratios of baseline factors for morbidity.

RESULTS

Infants experienced 12 episodes (95% confidence interval (CI) 11 to 13) of illness, spending about one fifth of their infancy with an illness. Respiratory and gastrointestinal symptoms were most common with incidence rates (95% CI) of 7.4 (6.9 to 7.9) and 3.6 (3.3 to 3.9) episodes per child-year. Factors independently associated with a higher incidence of respiratory and gastrointestinal illness were age (3-5 months), male sex, cold/wet season and household involved in beedi work. The rate (95% CI) of hospitalisation, mainly for respiratory and gastrointestinal illness, was 0.28 (0.22 to 0.35) per child-year.

CONCLUSIONS

The morbidity burden due to respiratory and gastrointestinal illness is high in a South Indian urban slum, with children ill for approximately one fifth of infancy, mainly with respiratory and gastrointestinal illnesses. The risk factors identified were younger age, male sex, cold/wet season and household involvement in beedi work.

The Penumbra System: a mechanical device for the treatment of acute stroke due to thromboembolism

BACKGROUND AND PURPOSE

Data from recent reports have indicated that mechanical thrombectomy may have potential as a treatment for acute ischemic stroke. The purpose of this study was to assess the safety and performance of the Penumbra System (PS): a novel mechanical device designed to reduce clot burden in acute stroke due to large-vessel occlusive disease.

MATERIALS AND METHODS

A prospective, single arm, independently monitored and core laboratory adjudicated trial enrolled subjects with an acute neurologic deficit consistent with acute stroke, presenting within 8 hours of symptom onset and an angiographically verified occlusion (Thrombolysis in Myocardial Infarction [TIMI] grade 0 or 1) of a treatable intracranial vessel. The primary end point was revascularization of the target vessel to TIMI grade 2 or 3. Secondary end points were the proportion of subjects who achieved a modified Rankin Scale (mRS) score of 2 or less or a 4-point improvement on the National Institutes of Health Stroke Scale (NIHSS) score at 30-day follow-up, as well as all-cause mortality.

RESULTS

Twenty-three subjects were enrolled, and 21 target vessels were treated in 20 subjects by the PS. At baseline, mean age was 60 years, mean mRS score was 4.6, and mean NIHSS score was 21. Postprocedure, all 21 of the treated vessels (100%) were successfully revascularized by the PS to TIMI 2 or 3. At 30-day follow-up, 9 subjects (45%) had a 4-point or more NIHSS improvement or an mRS of 2 or less. The all-cause mortality rate was 45% (9 of 20), which is lower than expected in this severe stroke cohort, where 70% of the subjects at baseline had either an NIHSS score of more than 20 or a basilar occlusion.

CONCLUSION

Thus, early clinical experience suggests that the PS allows revascularization in certain subjects experiencing acute ischemic stroke.

Safety and reactogenicity of a low dose diphtheria tetanus acellular pertussis vaccine (Boostrix) in pre-school Indian children

OBJECTIVE

To evaluate the safety and reactogenicity of a reduced-antigen-content combined Diphtheria Tetanus Acellular Pertussis (dTpa) vaccine in Indian preschool children.

METHODS

GlaxoSmithKline Biologicals combination dTpa vaccine was administered as a single booster dose to 347 children aged 46 years in seven centers across India. All children were subsequently followed up for two weeks for safety and reactogenicity assessment.

RESULTS

A total of 345 subjects completed the study and two subjects were lost to follow-up. One serious adverse event (head injury) unrelated to vaccination was reported. Otherwise, all subjects were in good health throughout the study period. Three subjects (0.9%) reported transient general symptoms (such as irritability and drowsiness), which prevented normal activity. Pain at injection site, swelling and redness was reported in 31.1%, 18.2% and 8.9% subjects respectively. Five subjects (1.4%) reported severe pain preventing normal movement. This resolved within 48 hours in all cases. There were no other severe local reactions including large injection site reactions.

CONCLUSION

The reduced antigen content combined dTpa vaccine is safe and well tolerated in Indian pre-school children.

Endovascular treatment of intracranial aneurysms with parent vessel reconstruction using balloon and self expandable stents

BACKGROUND AND PURPOSE

To assess the feasibility and results of parent vessel stent reconstruction with balloon expandable and self-expandable stents in the treatment of intracranial aneurysms.

METHODS

In a total of 18 aneurysms balloon expandable (group A) and self expandable (group B) stents were used in 9 cases each. Stent implantation alone was used in 3 cases, and additional coil packing in the other 15.

RESULTS

Stents were successfully deployed in 8 out of 9 in group A and in 9 out of 9 cases in group B. Nearly complete occlusion was achieved in all but one case. At 3 or 6 months stable occlusion was found in 4 group A and 2 group B patients, progressive thrombosis in 3 cases in both groups, and recanalisation in 1 case in group B. Late follow up at 1-4 years demonstrated one progressive thrombosis one recanalisation and 1 stable occlusion in 3 group A, and 2 stable occlusions in 2 group B. patients. Complications included one aneurysm perforation in group A, one in-stent thrombosis and a distal arterial perforation in group B and one groin hematoma in both groups.

CONCLUSION

Stent reconstruction of intracranial arteries harbouring aneurysms is feasible and may result in aneurysm thrombosis without coil packing in some cases. Self expanding stents seem to provide a higher rate of success. Aggressive antiplatelet treatment increases the risk of hemorrhagic complications.

Endovascular coil occlusion of intracranial aneurysms assisted by a novel self-expandable nitinol microstent (neuroform)

SUMMARY

Endovascular treatment of wide neck intracranial aneurysms is technically difficult and leads to less favorable treatment results and long term outcome. We participated in a multicenter prospective study to evaluate the safety and performance of a new self-expandable nitinol micro stent (Neuroform) in stent assisted coil occlusion of wide neck intracranial aneurysms. Eighteen patients were enrolled in the study in a single center. The anatomy of the target aneurysm and the parent vessel, technical details of the procedure, device functionality, anatomic and clinical results were evaluated. All enrolled aneurysms were either wide necked or showed an unfavorable neck-to-fundus ratio. In 16 out of 18 patients the Neuroform device allowed stent assisted coil occlusion of the aneurysm. The occlusion rate was 95% in eight patients and 100% in eight patients. The two failures were both due to anatomic reasons. Flexibility of the stent, behavior during deployment and subsequent ability to retain coils within the aneurysmal sac were considered as good as or better than the properties of previous balloon expandable stents. No device-related adverse events were encountered. Procedure-related clinical complications occurred in seven patients but caused no severe permanent neurological deficit. The Neuroform neurovascular stenting system is a safe and effective adjunct for the stent-assisted coil occlusion of wide necked intracranial aneurysms. The major advantages of this device are its self-expanding property and very high flexibility which allows safe navigation, easy sizing, as well as accurate positioning of the stent while providing sufficient bridging of the aneurysm neck for subsequent coil placement.