Etanercept induces improvement of arthropathy in chronic infantile neurological cutaneous articular (CINCA) syndrome

Chronic infantile neurological cutaneous articular (CINCA) syndrome is a rare disorder of unknown aetiology with neonatal onset, characterized by severe arthropathy, persistent skin rash and central nervous system disease. Joint involvement may vary from minimal swelling to destructive arthritis, with inability to stand or walk. The most striking findings of CINCA syndrome are cartilage anomalies with epiphyseal modifications and abnormal ossification, for which a pathogenetic role of tumour necrosis factor-alpha (TNF-alpha) is postulated. We describe a 4-year-old child affected with CINCA syndrome and presenting progressive joint disease, in whom non-steroidal anti-inflammatory drugs (NSAID) and systemic corticosteroidal therapy had been ineffective. Etanercept, anti-TNF-alpha therapy, was administered over a 6-month-period resulting in a dramatic improvement of the arthropathy. This good response to anti-cytokine treatment supports our hypothesis that TNF-alpha might play an important role in the pathogenesis of CINCA syndrome, which needs to be evaluated and confirmed in further studies.

Cystatin B and its EPM1 mutants are polymeric and aggregate prone in vivo

Progressive myoclonus epilepsy type 1 (EPM1) is a neurodegenerative disease correlating with mutations of the cystatin B gene. Cystatin B is described as a monomeric protein with antiprotease function. This work shows that, in vivo, cystatin B has a polymeric structure, highly resistant to SDS, urea, boiling and sensitive to reducing agents and alkaline pH. Hydrogen peroxide increases the polymeric structure of the protein. Mass spectrometry analysis shows that the only component of the polymers is cystatin B. EPM1 mutants of cystatin B transfected in cultured cells are also polymeric. The banding pattern generated by a cysteine-minus mutant is different from that of the wild-type protein as it contains only monomers, dimers and some very high MW bands while misses components of MW intermediate between 25 and 250 kDa. Overexpression of wild-type or EPM1 mutants of cystatin B in neuroblastoma cells generates cytoplasmic aggregates. The cysteine-minus mutant is less prone to the formation of inclusion bodies. We conclude that cystatin B in vivo has a polymeric structure sensitive to the redox environment and that overexpression of the protein generates aggregates. This work describes a protein with a physiological role characterized by highly stable polymers prone to aggregate formation in vivo.

Neurotrophin and Trk neurotrophin receptors in the inner ear of Salmo salar and Salmo trutta

Neurotrophins (NTs) and their signal transducing Trk receptors play a critical role in the development and maintenance of specific neuronal populations in the nervous system of higher vertebrates. They are responsible for the innervation of the inner ear cochlear and vestibular sensory epithelia. Neurotrophins and Trks are also present in teleosts but their distribution in the inner ear is unknown. Thus, in the present study, we used Western-blot analysis and immunohistochemistry to investigate the expression and cell localization of both NTs and Trk receptors in the inner ear of alevins of Salmo salar and Salmo trutta. Western-blot analysis revealed the occurrence of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), but not nerve growth factor (NGF), as well as all three Trk receptors, i.e. TrkA, TrkB and TrkC, the estimated molecular weights of which were similar to those expected for mammals. Specific immunoreactivity for neurotrophins was detected mainly in the sensory epithelia. In particular, BDNF immunoreactivity was found in the maculae of the utricle and saccule, whereas NT-3 immunoreactivity was present in the sensory epithelium of the cristae ampullaris. As a rule the sensory epithelia of the inner ear lacked immunoreactivity for Trks, thus excluding possible mechanisms of autocrinia and/or paracrinia. By contrast, overlapping subpopulations of neurons in the statoacoustic ganglion expressed TrkA (about 15%), TrkB (about 65%) and TrkC (about 45%). The present results demonstrate that, as in mammals and birds, the inner ear of teleosts expresses the components of the neurotrophin-Trk system, but their roles remain to be elucidated.

Postnatal developmental changes in the expression of ErbB receptors in murine Pacinian cospucles

Neuregulins and their signaling ErbB receptors play a critical role during the development of the mammalian peripheral nervous system, including some kinds of mechanoreceptors such as the Pacinian corpuscles which become structurally and functionally mature postnatally. In this study, we investigated whether or not ErbBs in Pacinian corpuscles undergoes developmental changes, as well as if their expression depends on the innervation. Pacinian corpuscles from 7-day- and 3-month-old mice were assessed for the immunohistochemical detection of EGFR or ErbB1, ErbB2, ErbB3 and ErbB4. The effect of denervation on the expression of ErbBs in mature Pacinian corpuscles was also analyzed. Developing 7-day-old Pacinian corpuscles express ErbB2 and ErbB3 immunoreactivity in the inner-core (regarded as modified Schwann cells), whereas the mature 3-month-old Pacinian corpuscles exclusively displayed ErbB4 immunoreactivity in the outer core and the capsule (regarded as endoneurial and perineurial cells). Denervation was without effect on the ErbB expression. Present results demonstrate maturational related changes and cell segregation in the expression of ErbB receptors by murine Pacinian corpuscles, and that this expression is independent of the innervation.

Evaluation of the antioxidant properties and bioavailability of free and bound phenolic acids from Trichilia emetica Vahl

Trichilia emetica Vahl. is commonly used in folk medicine of Mali for the treatment of various diseases. In this study, the content and the antioxidant activity of phenolic acids from Trichilia emetica root were evaluated. Free phenolic acids were extracted with a mixture of methanol and 10% acetic acid. Bound phenolic acids were released using first alkaline and then acid hydrolysis. All fractions were quantified separately by HPLC. After alkaline hydrolysis, a remarkable increase in caffeic acid, ferulic acid, p-coumaric acid, syringic acid, vanillic acid, protocathecuic acid and gallic acid content was observed, showing that most of phenolic acids in the drug are present as bound forms. Moreover, the extracts submitted to alkaline hydrolysis showed high antioxidant properties in two in vitro assays: autooxidation of methyl linoleate (MeLo) and ascorbate/Fe(2+)-mediated lipid peroxidation in rat microsomes. An in vivo study was also performed to investigate the intestinal absorption of phenolic acids after oral administration of Trichilia emetica extracts. Results showed high levels of phenolic acids, free or conjugated to glucuronide, in the plasma of rats treated with the hydrolyzed extract. Due to the absence of chlorogenic acid in plasma samples, the presence of caffeic acid seems to be derived from hydrolysis of chlorogenic acid in the gastrointestinal tract.

The inclusion complexes of hesperetin and its 7-rhamnoglucoside with (2-hydroxypropyl)-beta-cyclodextrin

The effect of (2-hydroxypropyl)-beta-cyclodextrin (HP-beta-CyD) on the solubility properties and spectroscopic features of hesperetin and its 7-rhamnoglucoside, hesperidin, was qualitatively and quantitatively investigated in water, by means of UV-vis absorption and fluorescence spectroscopy. The stoichiometric ratios and stability constants describing the extent of formation of the complexes have been determined by phase-solubility measurements; in both cases type-A(L) diagrams have been obtained (soluble 1:1 complexes). The higher degree of interaction showed by hesperetin may be attributed to the higher hydrophobicity and smaller size of the aglycone molecule, which therefore exhibits a greater affinity for the CyD and fits better into the cavity. The effect of molecular encapsulation on the two flavanones antioxidant activity was afterwards evaluated by means of different biological assays, concerned to the different mechanisms of in vivo action. The protection efficacy was in all cases higher for the complexed drugs, with respect to the free ones; these results are of great interest for their potential usefulness in pharmaceutics.

Hepatoprotective and antibacterial effects of extracts from Trichilia emetica Vahl. (Meliaceae)

Trichilia emetica Vahl. (Meliaceae) is a tree widely distributed in Tropical Africa. It has been used in Mali folk medicine for the treatment of various illnesses. The aim of this work was to study the hepatoprotective and antibacterial effects of a crude aqueous extract from Trichilia emetica root. An ethyl ether fraction from the aqueous extract was also prepared and studied. We have examined the hepatoprotective activity of the extracts on CCl4-induced damage in rat hepatocytes, their toxicity using the brine shrimp bioassay and their antibacterial activity against clinical isolated bacterial strains, which are commonly responsible for respiratory infections. A preliminary phytochemical analysis showed a high polyphenolic content in the aqueous extract and the presence of limonoids in the ethyl ether fraction. These latter compounds may be considered responsible for the good activity against the bacterial strains tested. Trichilia emetica extracts exerted also a significant (P<0.05) hepatoprotective effect at a dose of 1000 microg/ml both on plasma membrane and mitochondrial function as compared to silymarin used as a positive control. These activities may be a result of the presence of either polyphenols or limonoids. Finally, both the aqueous extract and its ethyl ether fraction did not show toxicity (LC50>1000 microg/ml) in the brine shrimp bioassay.

The rutin/β-cyclodextrin interactions in fully aqueous solution: spectroscopic studies and biological assays

In the present work the feasibility of beta-cyclodextrin complexation was explored, as a tool for improving the aqueous solubility and antioxidant efficacy of rutin. By means of 1H NMR, UV-vis and circular dichroism spectroscopy the single aromatic ring of rutin was found to be inserted into the beta-cyclodextrin cavity to form a 1:1 inclusion complex. The effect of beta-cyclodextrin on the spectral features of rutin was quantitatively investigated, in fully aqueous medium, by holding the concentration of the guest constant and varying the host concentration. The associated binding constants were estimated to be 142+/-20 and 153+/-20 M(-1), respectively, on the basis of the observed UV-vis absorption and circular dichroism intensities. The antioxidant activity of rutin was also investigated, as affected by molecular encapsulation within beta-cyclodextrin (batophenanthroline test; comet assay; lipid peroxidation); the inclusion complex revealed improved antioxidant efficacy that may be in part explained by an increased solubility in the biological moiety.

Effects of alpha- and beta-cyclodextrin complexation on the physico-chemical properties and antioxidant activity of some 3-hydroxyflavones

Inclusion complexes of some flavonols (3-hydroxyflavone, morin and quercetin) have been obtained with alpha- and beta-cyclodextrins, by the co-evaporation method. Different analytical techniques (DSC, XRPD, FT-IR, 1H-NMR, UV-Vis) have been employed for a throughout investigation of the structural characteristics of such supramolecular aggregates, which exhibited distinct spectroscopic features and properties from both "guest" and "host" molecules. The stoichiometric ratios and stability constants describing the extent of formation of the complexes have been determined by phase-solubility studies; in all cases type-AL diagrams have been obtained (soluble 1:1 complexes). The effect of molecular encapsulation on the flavonols antioxidant activity has been afterwards evaluated, by means of different biological assays (Bathophenanthroline test; Comet assay; Lipid peroxidation). Complexation with cyclodextrins further improved the antioxidant activity, increasing drugs solubility in the biological moiety.

Cytotoxicity evaluation after coexposure to perchloroethylene and selected peroxidant drugs in rat hepatocytes

There is evidence of hepatotoxic effects caused by Perchloroethylene (PCE), presumably due to reactive metabolic intermediates; lipid peroxidation is under study as a potential mechanism of toxicity. We aimed to verify if PCE levels comparable to those reached in the blood of exposed subjects can cause cell damage and lipid peroxidation. The association of PCE with lipid peroxidation inducing drugs (cyclosporine A, valproic acid and amiodarone) was also tested on rat isolated hepatocytes. AST and LDH release, MTT test and lipid peroxidation assay showed that PCE determines dose-dependent effects on rat isolated hepatocytes. The toxic potential resulting from our data would be valproic acid < cyclosporine A < amiodarone. While valproic acid and cyclosporine caused a mild toxicity, the effects of amiodarone were more severe; in particular, the association of PCE with amiodarone showed a clear additive effect. The role of lipid peroxidation in the liver toxicity exerted by the tested compounds was confirmed by our data, and resulted relevant after treatment of cells with amiodarone and PCE. Extrapolating these results to human, we can suggest that a subject professionally exposed to PCE, who chronically assumes a lipid peroxidation inducing drug like amiodarone, may be potentially exposed to a higher risk of liver toxicity.

Neurotrophin receptors in taste buds of adult zebrafish (Danio rerio)

TrkB plays crucial roles in the development and maintenance of taste buds in mammals. In this study we investigated the presence and cell localization of Trks (TrkA, TrkB and TrkC) in taste buds of the zebrafish (Danio rerio) using Western blot and immunohistochemistry. Proteins of 140 and 145 kDa, identified as full-length TrkA and TrkB, were detected. Conversely, the anti-TrkC antibody recognized a protein lower than expected (100 kDa). In agreement with these results the sensory cells of taste buds, displayed TrkA- and TrkB-like, but not TrkC-like, immunoreactivity. TrkA and TrkB co-existed in the same taste buds, but remains to be clarified whether or not they are co-expressed in the same cells. Present results demonstrate that as for mammals neurotrophins might play a role in sensory cells of the teleostean taste buds.

The crypt neurons in the olfactory epithelium of the adult zebrafish express TrkA-like immunoreactivity

The olfactory neurons of vertebrates, including teleosts, regenerate through adult life. This ability seems to depend partially on neurotrophic factors, which include some neurotrophins, mainly nerve growth factor (NGF), and their cognate Trk receptors. Zebrafish is an ideal model for studying neurogenesis in the olfactory system, but what kinds of olfactory sensory neurons (ciliated, microvillous or crypt neurons) are under the control of neurotrophins during adult life is unknown. Here we examined the expression of Trk proteins in the olfactory epithelium of adult zebrafish using immunohistochemistry. TrkA-like immunoreactivity was the only Trk detected, and it was restricted to the somata of crypt sensory neurons, their central processes being apparently unreactive. These results provide indirect evidence for a possible role of NGF-like molecules (i.e. neurotrophin-6 and neurotrophin-7) in the peripheral olfactory system of adult zebrafish, acting on TrkA-like receptor expressing crypt neurons. It remains to be established whether or not TrkA-like receptors and their ligands play a function in the neurogenesis or differentiation of these cells.

[Genotoxicity and activation of organophosphate and carbamate pesticides by cytochrome P450 2D6]

The role of the polymorphic cytochrome P450 (CYP) 2D6 isoform in catalysing the oxidative biotransformation of the organophosphate pesticide chlorpyriphos and the carbamate aldicarb into structures that inhibit cholinesterase and induce genotoxicity has been investigated in microsomal fraction, using quinine as a specific chemical inhibitor of CYP 2D6. Pesticides were incubated with rat liver microsomes and production of anticholinergic active metabolites was investigated by the inhibition of human serum cholinesterase. Compared to microsomes incubated without quinine, where cholinesterase activity was inhibited to a mean 53% (chlorpyriphos) and 57% (aldicarb) of control, the introduction of P450 2D6 inhibitor quinine into microsomal incubation mixture reduced cholinesterase activity to 72% of control for chlorpyriphos and to 27% for aldicarb, suggesting that P450 2D6 is involved in the activation of chlorpyriphos but does not influence aldicarb toxicity on acetylcholinesterase. Moreover, the potential genotoxicity of these compounds was evaluated by single cell gel electrophoresis (comet assay) on human leucocytes. DNA fragmentation compared to control was markedly increased after incubation with aldicarb plus quinine, confirming that the parent compound is more toxic than the products of CYP metabolism; conversely, DNA damage after incubation with chlorpyriphos was sensibly reduced by quinine indicating the metabolic activation of this pesticide by CYP 2D6. These data suggest that polymorphism of CYP 2D6 can influence the toxicity of organophosphate but not of carbamate pesticides.

S-100 protein is a selective marker for sensory hair cells of the lateral line system in teleosts

The distribution of S100 protein in the neuromast of the lateral line system (LLS) was investigated immunohistochemically in alevins of three species of teleosts (Salmo trutta, Salmo salar and Dicentrarchus labrax), using a polyclonal antibody. In both the neuromasts of the canals, as well as in the pit organs, the hair cells, regarded as the specific sensory cells, displayed cytoplasmic immunoreactivity for S100 protein. Conversely, the supporting cells, mantle cells and basal cells were devoid of immunoreaction. These results demonstrate for the first time the occurrence of S100 in the LLS of teleosts. Due to the cell specific localization, this protein might serve as a marker for sensory hair cells in neuromasts.

Immunohistochemical localization of BDNF-, TrkB- and TrkA-like proteins in the teleost lateral line system

The lateral line system, formed of both superficial (pit organs) and canal neuromasts, is one of the major mechanosensory systems in fish. It has always been assumed that this system depends on neurotrophins and their cognate Trk receptors for development and maintenance, as has been shown in other mechanosensitive systems of vertebrates. However, until nowthis issue has not been specifically addressed. In this study we used immunohistochemistry to investigate the occurrence and localization both of neurotrophins (NGF-, BDNF- and NT-3-like) and of Trk-like proteins (TrkA-, TrkB-, TrkC-like) in alevins of Salmo salar and S. trutta. All cells in the pit organs of S. salar displayed strong immunoreactivity for TrkB-like and BDNF-like, whereas they were restricted to the hair cells in S. trutta. The hair, supporting and mantle cells of S. salar, and the mantle cells of S. trutta, also expressed TrkA-like immunoreactivity. In the canal neuromasts BDNF-, TrkA- and TrkB-like proteins were present in all cells, without differences between species. NGF-, NT-3- and TrkC-like immunoreactivity were never detected. The present results suggest that mechanoreceptive hair cells, as well as supporting cells, in the lateral line system are under the control of the BDNF-TrkB-like complex, and probably of ligands of TrkA-like receptors.

[Breast inflammations: clinical observations and principles of treatment]

In this study some clinical and etiopathogenetic principles, and the most appropriate treatment for breast inflammation are discussed. In the majority of cases, differential diagnosis is made not only through clinical diagnosis but also through cytological examination and ultrasonography. Of the forms reported, we considered the different inflammatory, glandular and extraglandular, peripheral and central mastites; among the latter in particular periductal mastitis and duct ectasia. Medical treatment is the answer for some forms, while for others, as for example mammillary fistula, we prefer, in agreement with some authors, the surgery of fistulectomy and healing by first intention; for the peripheral abscesses we prefer US-guided percutaneous drainage. This article stresses the importance of clinical diagnosis, pathogenetic history, and adequate treatment in efforts to improve both the knowledge of the surgeon and the quality of life of the patient.

Treatment of dystonic clenched fist with botulinum toxin

Fourteen patients with "dystonic clenched fist" (three with Corticobasal Ganglionic Degeneration, seven with Parkinson's disease, and four with Dystonic-Complex Regional Pain Syndrome) were treated with botulinum toxin A (BTXA, Dysport). The muscles involved were identified by the hand posture and EMG activity recorded at rest and during active and passive flexion/extension movements of the finger and wrist. EMG was useful in distinguishing between muscle contraction and underlying contractures and to determine the dosage of BTX. All patients had some degree of flexion at the proximal metacarpophalangeal joints and required injections into the lumbricals. The response in patients depended on the severity of the deformity and the degree of contracture. All patients had significant benefit to pain, with accompanying muscle relaxation, and palmar infection, when present, was eradicated. Four patients with Parkinson's disease and one patient with Dystonia-Complex Regional Pain Syndrome obtained functional benefit.

Neurotrophin receptor-like proteins in the bovine (Bos taurus) lymphoid organs, with special reference to thymus and spleen

Increasing evidence suggests that neurotrophins could regulate immune functions acting directly or indirectly on immunocompetent cells. The indirect pathway involves stromal cells of the primary and secondary lymphoid organs. In the present study the occurrence of Trk proteins (TrkA, TrkB and TrkC), regarded as the high-affinity signal-transducing receptors for neurotrophins, was investigated in cow lymphoid organs using immunohistochemistry. The thymus and spleen of both fetal and adult animals, and the palatine tonsils, lymph nodes and Peyer's patches of adult animals, were analysed. Unidentified cells displaying TrkA-like immunoreactivity were found in the fetal thymus, whereas those expressing this protein in the adult gland were identified as epithelial cells. In the spleen, immunoreactive TrkA was observed in cells of the white pulp. TrkB immunoreactivity in both fetal and adult thymus and spleen was localized in monocyte/macrophage cells. As a rule, TrkC was absent from the thymus and the spleen independent of the animal's age. Different types of stromal cells, but never the lymphocytes themselves, displayed TrkA, TrkB, or TrkC immunoreactivity in the other lymphoid organs analysed. As in other vertebrate species, Trk proteins in the lymphoid organs of the cow were localized in the stromal, non-lymphoid cells, thus suggesting that neurotrophins might regulate the immune function acting indirectly on lymphocytes.

Cellular and noncellular components of bronchoalveolar lavage fluid in HIV-1-infected children with radiological evidence of interstitial lung damage

Children with acquired immune deficiency syndrome (AIDS) commonly have recurrent infectious and noninfectious lung complications that ultimately end in death. To study the intensity of alveolar inflammation and to evaluate the clinical utility of bronchoalveolar lavage (BAL) in children with HIV-1 infections, we retrospectively analyzed differential cell counts, lymphocyte subsets, and fibronectin and hyaluronic acid concentrations in BAL fluid of 18 HIV-1-positive children (9 boys, mean age 3.5 years, range 5 months-8 years) with radiological evidence of interstitial lung disease, and 19 control children who had undergone BAL for clinical indications not involving the lung parenchyma (13 boys, mean age 3 years, range 2 months-14 years). BAL fluid from 89% of the HIV-1 infected children showed CD8+ve lymphocytic alveolitis expressing HLA-DR, CD54, and CD 69 antigens. BAL fluid from HIV-infected patients typically contained markedly increased percentages and numbers of lymphocytes (P < 0.0001) and eosinophils (P < 0.04) and significantly higher concentrations of albumin (P < 0.05) and fibronectin (P < 0.0006) than fluids from control children. Whereas BAL cellular components did not differ in P. carinii-positive and P. carinii-negative HIV-1-infected children, fibronectin concentrations were significantly higher in P. carinii-positive than negative children. BAL cell differentials and noncellular components were related neither to severity of disease nor to patients' disease progression. These findings indicate that BAL is useful in studying the intensity of lung inflammation in children with HIV-1 infections and radiologically documented interstitial lung disease, but provides no information on the subsequent clinical course.

Trk neurotrophin receptor-like proteins in the teleost Dicentrarchus labrax

In recent years, data have accumulated suggesting that the role of neurotrophins and Trk receptors may not be limited to the nervous system, and the presence of these substances has been detected in a variety of vertebrate and invertebrate non-nervous tissues. This study was designed to map the expression of immunoreactivity (IR) for Trk-like proteins in alevins of the teleost Dicentrarchus labrax, with particular emphasis on non-nervous structures. We used antibodies against specific epitopes of the intracellular domain of these proteins, a region that is highly conserved in phylogeny. Trk-like IR was seen in segregate cell populations of the nervous system, and non-nervous tissues. In the central nervous system TrkA-like and TrkC-like IR was abundant, whereas TrkB-like IR was restricted to a low number of brain areas. Expression of Trk-like protein IR was observed in the peripheral nervous system and sensory organs, with the exception of the lateral line organ. Outside the nervous system, TrkA-like IR was mainly found in different epithelia, TrkB-like IR in the endocrine and digestive system, and TrkC-like IR in the cardiovascular and immune systems. The gills showed IR for all three Trk-like proteins, whereas they were absent from the gonads. Furthermore, scattered cells positive for Trk-like proteins were found in most of the investigated tissues. The distribution of Trk-like IR in this teleost is compared with that of mammals and birds, which it often paralleled, and the possible role of neurotrophins and Trk-like receptor proteins in different non-neuronal tissues is discussed.

Paradoxic reaction to lamotrigine in a child with benign focal epilepsy of childhood with centrotemporal spikes

A girl aged 5 years developed nocturnal seizures (mouth twitching, salivation, anarthria, with right arm jerking and occasional secondary generalisation), with frequent focal sharp waves over the left centrotemporal region in her EEG, suggesting benign childhood epilepsy with centrotemporal spikes (BECTS). Seizures became diurnal and frequent, not modified by carbamazepine (CBZ) or valproate (VPA) but responding to VPA and lamotrigine (LTG) with recommended dosage schedules for this combination. Her school performance then deteriorated insidiously, with poor memory and concentration, clumsiness, stuttering, and emotional lability. After 4 months, new episodes, < or =10 per day, occurred. These lasted a few seconds; she stared into space, her jaw dropped, her head dropped to the right, and her eyelids flickered. She usually maintained awareness. Attacks were often provoked by blowing or sneezing. Ictal EEG showed anterior-predominant 3/s sharp-slow wave complexes lasting < or =8 s, with bilateral rolandic discharges interictally. Withdrawal of LTG resulted in rapid improvement in cognitive function and gradual remission of the new attacks.

CONCLUSIONS

This appears to be a paradoxic reaction to LTG in the setting of BECTS.