Partial and generalized epilepsy with febrile seizures plus and a novel SCN1A mutation

BACKGROUND

Generalized epilepsy with febrile seizures plus (GEFS+) is an autosomal dominant syndrome characterized by febrile seizures (FS) and a variety of afebrile generalized seizure types. GEFS+ has previously been linked to mutations in two genes encoding the voltage-gated sodium channel alpha-subunit (SCN1A) and beta1-subunit (SCN1B). We studied a large family with FS and partial as well as generalized seizure types.

METHODS

All but two living affected family members were interviewed and examined. Information on deceased affected family members was sought. EEG for 11 affected family members and one unaffected family member were obtained. Genetic linkage analysis and mutation screening of SCN1A were performed on blood samples from 16 affected individuals and their first-degree relatives.

RESULTS

There were 27 affected family members; 18 were alive at the time of the study. All affected family members had FS; seven had FS only, and 19 also had afebrile seizures. Eleven individuals continued to have FS beyond 6 years of age. FS were complex in 12 family members, usually with prolonged duration. The index patient had right temporal lobe epilepsy and hippocampal sclerosis. Four other patients had strong historical evidence of temporal lobe epilepsy, and three others had nonlocalizing evidence of partial epilepsy. Pedigree analysis indicated autosomal dominant transmission. All affected individuals who were tested and one asymptomatic individual had a sodium channel mutation of SCN1A, an A-->C transversion at nucleotide 3809 resulting in the substitution of lysine 1270 by threonine in the D3/S2 segment (designated as K1270T).

CONCLUSIONS

Our findings indicate that partial epilepsy preceded by FS can be associated with sodium channel mutations and may represent a variant of GEFS+.

Airway smooth muscle cell proliferation is increased in asthma

Increased airway smooth muscle (ASM) within the bronchial wall of asthmatic patients has been well documented and is likely to be the result of increased muscle proliferation. We have for the first time been able to culture ASM cells from asthmatic patients and to compare their proliferation rate with that of nonasthmatic patients. Asthmatic ASM cell cultures (n = 12) were established from explanted lungs and endobronchial biopsies. Nonasthmatic ASM cells (n = 10) were obtained from explanted tissue from patients with no airway disease, emphysema, carcinoma, and fibrosing alveolitis. Cell counts, tritiated thymidine incorporation, and cell cycle analysis were conducted over 7 d. Asthmatic ASM cell numbers at Days 3, 5, and 7 were significantly higher than corresponding values for nonasthmatic cells (p < 0.05). Tritiated thymidine incorporation was increased 3.2-fold in asthmatic cells compared with nonasthmatic cells within the first 24 h (p = 0.026). Flow cytometric analysis of DNA content on Days 1 and 2 revealed that a significantly greater percentage of asthmatic ASM cells were in the G2 + M phase (p < 0.05). This study shows for the first time that proliferation of ASM cells is increased in patients with asthma and provides evidence for an intrinsic abnormality in the ASM cell in this disease.

KEYWORDS

asthma; human airway smooth muscle; cell culture; cell proliferation; hyperplasia

Dislocation-controlled perforated layer phase in a PEO- b-PS diblock copolymer

Small angle x-ray analyses show that the shear-induced hexagonal perforated layer phase in a poly(ethylene oxide)- b-polystyrene diblock copolymer consists of trigonal (R3;m) twins and a hexagonal (P6(3)/mmc) structure, with trigonal twins being majority components. Transmission electron microscopy reveals that the hexagonal structure is generated through sequential intrinsic stacking faults on the second layer from a previous edge dislocation line, while the trigonal twins are formed by successive intrinsic stacking faults on neighboring layers due to the plastic deformation under mechanical shear.

Dependence of lymphopenia-induced T cell proliferation on the abundance of peptide/ MHC epitopes and strength of their interaction with T cell receptors

Factors that affect naive T cell proliferation in syngeneic lymphopenic hosts were investigated. 2C T cell receptor (TCR) transgenic T cells lacking both CD8 and CD4 survived but hardly proliferated. Proliferation of CD8(+) 2C cells was proportional to the abundance of cognate peptide/MHC complexes and was severely inhibited by injection of anti-CD8 antibody. Weakly reactive self-peptides slightly enhanced CD8(+) 2C cell proliferation whereas a potent agonist peptide promoted much more rapid proliferation, but inflammation-stimulating adjuvant had only a small effect on the rate of cell proliferation. The findings suggest that under uniform lymphopenic conditions, the widely different rates of proliferation of T cells expressing various TCR, or the same TCR in the presence or absence of CD8, reflect the strength of interaction between TCR and MHC associated with particular self-peptides.

The role of sexual related Y gene detection in the diagnosis of patients with gonadal dysgenesis

OBJECTIVE

To clarify the role of sexual related Y (SRY) gene detection in the diagnosis of gonadal dysgenesis.

METHODS

Sixteen cases of gonadal dysgenesis were included in this study: 5 with androgen insensitivity syndrome, 1 with 17-alpha-hydroxylase deficiency, 4 with true hermaphrodite, 2 with 45, X/46, XY gonadal dysgenesis, 1 with 45, X gonadal dysgenesis, 1 with XY pure gonadal dysgenesis, 1 with testicular regression, and 1 XY female who gave birth to a normal baby. SRY gene was detected by using polymerase chain reaction (PCR) in blood and gonad samples and by direct sequencing of the SRY motif.

RESULTS

Among the 16 cases, 15 were blood SRY positive, among which 13 (86.7%) showed the presence of testicular tissue, and 2 showed ovaries without testicular tissue. One SRY negative case showed the presence of testicular tissue. In 3 cases, SRY detection in gonadal tissue correlated with pathological findings but not with blood karyotype. The correlation between peripheral blood SRY and the pathology of the gonads was 81.25% and the correlation between the presence of peripheral blood Y chromosome and pathology of the gonads was 68.75%. Sequencing of the SRY motif in an XY female who gave birth to a normal baby showed no mutation.

CONCLUSIONS

SRY detection is more sensitive and specific than blood karyotype in the prediction of the presence of testicular tissue. Peripheral blood karyotype does not necessarily reflect gonadal type. There may be testicular related factors other than the SRY gene.

The production of extracellular matrix proteins by human passively sensitized airway smooth-muscle cells in culture: the effect of beclomethasone

Airway remodeling is a key feature of persistent asthma. Part of the remodeling process involves the laying down of extracellular matrix (ECM) proteins within the airways. In this study we compared the production of ECM proteins by human airway smooth-muscle (ASM) cells in culture after exposure to 10% serum from an asthmatic individual or 10% serum from a nonasthmatic individual with or without beclomethasone (0.01 to 100 nM). Enzyme-linked immunosorbent assays were done with antibodies to human fibronectin; perlecan; elastin; the laminin beta(1), gamma(1), beta(2), alpha(1) chains; thrombospondin; chondroitin sulfate; collagen types I, III, IV, and V; versican; and decorin. Serum from the asthmatic individual, when compared with that from the nonasthmatic individual, caused a significant increase in the production of fibronectin, perlecan, laminin gamma(1), and chondroitin sulfate. Beclomethasone caused a significant reduction in the number of cells exposed to serum from either the asthmatic or nonasthmatic individual, but did not reverse the increase in ECM protein induced by the former. These results suggest an interaction between the ASM and the allergic process that may alter components of the airway wall in asthma, and that corticosteroids may not prevent the fibrosis induced by resident cells within the airways.

[Application of mitotic index and proliferating cell nuclear antigen index in monitoring the change of rat endometrium after administration of estrogen and progestin]

OBJECTIVE

To investigate the mitotic index (MI) and proliferating cell nuclear antigen (PCNA) index in monitoring the rat endometrium during estrogen and progestin administration.

METHODS

One hundred and sixty Sprague-Dolly rats were randomly divided into seven groups. The 1st and 2nd group were normal estrous (E) and ovariectomized (OVX) control. The other groups received estradiol (E2V) only or combined with medroxyprogesterone(MPA) which imitated the clinical regimen in different dosage and different time before sacrificed. Uteri sections were stained with HE and immunohistochemical procedures to detect mitosis and PCNA.

RESULTS

The MI and PCNA index were similar in the luminal and glandular cells. Both markers were low in the two control groups and increased with the E2V dosage in the treatment group. But if E2V was given for 1 to 21 days, the MI increased during the first 3 days and then dropped to low level and kept to the end. PCNA index increased in the first 3 days and decreased to a low level on the 4th day and then increased gradually to a high level until the last day. In the continuous regimen, both markers decreased as the MPA dosage increased. In the cyclic regimen, The MI reached to a significant low level nearly to zero in almost each ratio. Addition of MPA for 10 days, PCNA index at the ratio of 1:4.0 could be reduced to a low level and addition for 5 days, PCNA index in each subgroup was still as high as the positive control even though the dosage of MPA increased several times to 1:8.0.

CONCLUSIONS

This study suggests that PCNA index can reflect both the effect of estrogen and progestogen. PCNA index is better than mitotic index in reflecting the change of endometrium.

Effect of murine thymic epithelial cell line (MTEC1) on the functional expression of CD4(+)CD8(-) thymocyte subgroups

To determine the effect of thymic stromal cells on the functional maturation of CD4 single-positive (SP) thymocytes, the functional status of isolated CD4 SP thymocyte subgroups was investigated by means of cell proliferation and cytokine production in response to concanavalin A (Con A) prior and after co-culturing with a murine thymic epithelial cell line (MTEC1). Mouse medullary CD4 SP thymocytes were phenotypically divided into seven discrete subgroups predicted to reflect the maturation pathway from newly emerging CD4 SP thymocytes to terminally differentiated cells. For functional analysis, six major subgroups (6C10(+)CD69(+), 6C10(-)CD69(+), 6C10(-)CD69(-)3G11(+)Qa-2(-), 6C10(-)CD69(-)3G11(+)Qa-2(+), 6C10(-)CD69(-)3G11(-)Qa-2(-) and 6C10(-)CD69(-)3G11(-)Qa-2(+)) cells were isolated and their functional status in response to Con A stimulation assessed. A functional hierarchy is revealed among these subgroups, consistent with their phenotypic maturation status, which may imply that these cells undergo a functional maturation process within thymic medulla. The function of cytokine production by CD4 SP thymocytes is acquired in a stepwise manner from a low to high level and characterized by T(h)0-type cytokines in the main stream of differentiation pathway. However, a minor subgroup that appeared at the late stage as 3G11(-)6C10(-) cells was biased to produce T(h)2-type cytokines. Nevertheless, the functional capacity of the final two Qa-2(+) subgroups of CD4 SP thymocytes was still significantly lower than that of spleen CD4(+) T cells. After co-cultivation with MTEC1 cells, four subgroups of TCRalphabeta(+)CD4(+)CD8(-) thymocytes exhibited significantly higher levels of proliferation capability and modulation in cytokine production capability. However, co-culturing with MTEC1 cells did not change the pattern of T(h)0- or T(h)2-like cytokine production by respectively medullary CD4 SP thymocyte subgroups nor could MTEC1 induce CD4 SP thymocytes to secrete T(h)1-type cytokines. The results suggest that MTEC1 can regulate the functional status of these thymocyte subgroups.

Apoptotic cells actively inhibit the expression of CD69 on Con A activated T lymphocytes

Although apoptosis is commonly viewed as a silent cell death without damage to adjacent tissues, the effect of apoptosis on immunity has been unclear. We have investigated the influence of apoptotic cells on T-cell activation. The K562 or HL-60 human leukemia cell lines that had been induced apoptosis by FTY720 or cycloheximide (CHX) were added into the culture of mouse spleen cells stimulated with Con A. Six to 20 h later, the expression of CD69, an early T-cell activation antigen, was detected using flowcytometry. Living cells and necrotic cells served as control groups. Apoptotic K562 or HL-60 cells induced by either FTY720 or CHX unanimously inhibited CD69 expression on the CD3+ mouse T cells while living and necrotic cells did not. The inhibition was proportional to the number of apoptotic cells and was different in the T-cell subsets, showing a rapid and transient inhibition on the CD3+CD8+ T-cell activation but with a slow and continuous inhibition on CD3+CD8- T-cell activation. In conclusion, the apoptotic cells actively inhibit a T-cell activation that is independent of the cell lines or the apoptotic inducers, indicating that the apoptotic cells dominantly regulate T-cell immunity.

Spontaneous activation of hamster oocytes in vitro

OBJECTIVES

To observe the time of spontaneous activation of hamster oocytes and to find out the early signs of hamster oocytes activation.

METHODS

First, 63 hamster oocytes including activated and non-activated oocytes (group A) and 51 non-activated oocytes (group B) were injected with human sperm and checked for fertilization after 16-18 hours. Then, 20 hamster oocytes were cultured in vitro in medium with or without calcium and examined under light microscope every half an hour up to 9 hours.

RESULTS

Under light microscope, hamster oocytes activation were observed to undergo 4 stages: metaphase II stage without meiotic spindle, appearance of meiotic spindle near the first polar body, protrusion of oolemma, and complete extrusion of second polar body with pronucleus formation. After culture for 1.5 hours in vitro, 30%-40% of the oocytes demonstrated meiotic spindle; but after 9 hours, 50% showed complete activation. Culture in medium without calcium showed a little delay in the process of activation. The earliest sign of spontaneous activation in hamster oocytes was the appearance of meiotic spindle near the first polar body. Although group A and B showed no difference, the damage rate was lower in group B (19.7% +/- 16.6%) than in group A (35.9% +/- 5.7%) (P = 0.08), whereas the fertilization rate (18.3% +/- 10.9%) was higher in group B than in group A (14.2% +/- 8.7%) (P = 0.135).

CONCLUSIONS

Hamster oocytes may be activated spontaneously early after their removal. It is important to recognize the earliest sign of spontaneous activation and perform intracytoplasmic sperm injection (ICSI) before it happens.

Phenotypic identification of the subgroups of murine T-cell receptor alphabeta+ CD4+ CD8- thymocytes and its implication in the late stage of thymocyte development

Phenotypic analysis of the medullary-type CD4+ CD8- [CD4 single-positive (SP)] thymocytes has revealed phenotypic heterogeneity within this cell population. The characteristic phenotype of mature peripheral T cells can be uniquely marked as Qa-2+ HSA- CD69-, whereas in the medullary-type CD4 SP thymocytes, the expression patterns of many markers were quite different. This suggests that there are many subgroups in the population, which reflects that medullary-type CD4 SP thymocytes may undergo phenotypic maturation. According to the results of two-colour flow cytometry, seven discrete phenotypes were identified by the expression capacity of Qa-2, HSA, CD69, 3G11 and 6C10 molecules. Consequently, the phenotypic precursor-progeny relationship can be envisaged as: 3G11- 6C10+ CD69+ HSAhi -->3G11+ 6C10+ CD69+ HSAhi --> 3G11+ 6C10- CD69+ HSAint -->3G11+ 6C10- CD69- HSAint Qa-2- -->3G11+ HSA-/lo Qa-2lo. At the stage of 3G11+ 6C10- CD69- HSAint Qa-2-, a branch pathway could be initiated, which gave rise to 3G11- HSAl degrees Qa-2- cells, which then, in turn, developed into 3G11- HSA-/loQa-2hi cells, a minor subgroup of the most mature CD4 SP cells. Consistent with this predicted pathway, experiments indicated that the first two subgroups were still cortisone sensitive, whereas the others were cortisone resistant. The cells in the last two Qa-2-positive subgroups are probably ready for emigration into the periphery.

[The effects of sex hormone on blood vessels]

OBJECTIVE

The protective mechanism of sex hormone on blood vessels was investigated to provide evidences for clinical use of hormone replacement therapy in postmenopausal women.

METHODS

To observe the effects of 17 beta-estradiol (E2), progesterone(P), testosterone (T) and E2 combined with P on the relaxation of umbilical arterial rings (UAR) as well as production of nitric oxide (NO) in cultured umbilical endothelial cells(HUVEC) in vitro.

RESULTS

The results showed that 10(-9)-10(-6) mol/L E2 dilation of UAR, but 10(-5) mol/L E2 showed vague effect. P or T had no relaxation effect, but releasing nitric oxide. When in combined trial P at 10(-5) mol/L inhibited the relaxation effect of E2 at 10(-7)-10(-5) mol/L but didn't inhibit E2 10(-9) mol/L. In HUVEC 10(-9)-10(-5) mol/L E2 stimulated the release of nitric oxide when cells incubated for 10 min and 30 min, but did not influence the NO release at 60 min. P and T have different effects on the release of nitric oxide at different concentrations and incubation time. P also inhibited the NO release induced by E2.

CONCLUSIONS

The results indicated that P actually inhibited the relaxation response and induction of NO release by E2, especially at the high concentration. Therefore, we suggested that to use low doses of E2 combined with low dose P for hormone replacement therapy in prevention and treatment of cardiovascular diseases in postmenopausal patient.

Comparison of bone mass in forearm, lumbar vertebra and hip by single and/or dual energy X-ray absorptiometry

OBJECTIVE

Bone mineral density (BMD) was measured in normal Chinese women with single X-ray absorptiometry (SXA) and dual energy X-ray absorptiometry (DEXA). These two methods were compared to evaluate the sensitivity in reflecting bone loss.

METHODS

Measurements were performed in 300 women aged 20 to approximately 79 (5 for each age). The 8mm distal, 1/4 distal, ultra distal site of the nondominant forearm were measured with SXA; the AP spine (L2-4), right femoral neck (Neck), Ward's triangle (Ward) and trochantor (Troch) were measured with DEXA. Ten women had 5 repeated measurements to evaluate the reproducibility of the equipments.

RESULTS

The BMD peak for Neck and Ward was found between age 20 to approximately 29, for ultra distal and L2-4 at age 30 to approximately 39, for 8mm distal, 1/4 distal and Troch at age 40 to approximately 49. After reaching the peak values, BMD at all sites decreased with increasing age. The highest rate of yearly loss of BMD was at 8mm distal. Results of measurement showed significant correlation between SXA and DEXA. Comparing with premenopausal women, the bone loss rate in postmenopausal women was faster and highest up to 11 to approximately 15 years and the highest rate was at the Ward.

CONCLUSION

The present study gives the normal values of BMD at seven sites for normal Chinese women. The ages of BMD peak were different at seven sites. The yearly loss of BMD was highest at 8mm distal, it seemed to be the sensitive region for bone loss with age. The postmenopausal women had highly significantly loss bone mass than the premenopausal women. Comparing with premenopause, postmenopause BMD for Ward's triangle with DEXA seemed to be most sensitive to the effect of menopause.

[Phenotypic analysis of TCR alpha beta+ CD4+CD8- medullary thymocytes]

Phenotypic analysis of the medullary-type CD4+CD8- (CD4SP) thymocytes have revealed phenotypic heterogeneity within these cells. The phenotype of mature peripheral T cells is Qa-2+ HSA- CD69-, whereas in the medullary-type CD4SP thymocytes, the expression pattern of many markers were quite different, suggesting that the medullary-type CD4SP thymocytes may undergo phenotypic maturation. According to the results of two-color cytometry, seven discrete phenotypes were defined by the relative expression of Qa-2, HSA, CD69, 3G11 and 6C10: 3G11-6C10+CD69+HSAhi-->3G11+6C10+CD69+ HSAhi-->3G11+6C10-CD69+HSAint-->3G11+6C10- CD69-HSAint Qa-2(-)-->3G11+HSAlo/-Qa-2lo, at the same time, 3G11+6C10-CD69-HSAint Qa-2(-)-->3G11-HSAlo Qa-2(-)-->3G11-HSAlo/- Qa-2hi, the last two Qa-2 positive subsets could exit the thymus and home into periphery.