Atypical splicing of the latency-associated transcripts of herpes simplex type 1

We previously have shown that two latency-associated transcripts (LATs) of herpes simplex type 1 (HSV-1) are probably lariats, produced during splicing. By RNaseH digestion analysis, we now show that the major branchpoint of the 2.0-kb LAT was within 46 nt 5' of the splice acceptor site. A more detailed mapping by primer extension revealed the branchpoint as an adenosine 29 nt 5' of the splice acceptor site. Introduction of two branchpoint sequences with good matches to the consensus at position -25 had no effect on the splicing efficiency but reduced the accumulation of the 2.0-kb LATs at least 90-fold. The second focus of our studies was the 1.5-kb LAT. It was not detected by Northern analyses in either productively infected or transfected cultured cells or even in cells of neuronal origin. However, it was detected in the trigeminal ganglia of mice experimentally infected with HSV-1 after 10 days. Moreover, its abundance relative to that of the 2.0-kb species increased 4-fold from 10 to 30 days after infection, consistent with an interpretation that the 1.5-kb species, once formed, was more stable than the 2.0-kb species.

A 437-base-pair deletion at the beginning of the latency-associated transcript promoter significantly reduced adrenergically induced herpes simplex virus type 1 ocular reactivation in latently infected rabbits

In this study we used a herpes simplex virus type 1 (HSV-1) deletion mutant to identify a segment of the genome necessary for epinephrine-induced reactivation in the rabbit eye model of herpetic recurrent disease. In HSV-1 latently infected neural tissue, the only abundant viral products are the latency-associated transcripts (LATs). At least one promoter of LAT has been identified, and mutations in the LAT domain have been used to investigate HSV-1 reactivation. We used an ocular rabbit model of epinephrine-induced HSV-1 reactivation to study the effects of deleting a 437-bp region beginning 796 bp upstream of the LAT CAP site. Specifically, the 437-bp deletion is located between genomic positions 118006 and 118443 of the parent 17Syn+, and the construct is designated 17 delta S/N. This region also controls a portion of the genome encoding two transcripts (1.1 and 1.8 kb) from the LAT domain. A rescuant, 17 delta S/N-Res, was constructed from 17 delta S/N. Following ocular infection, all three viruses produced similar acute dendritic lesions in rabbits. Five weeks after infection, rabbits received transcorneal iontophoresis of epinephrine. The parent, 17Syn+, and the rescuant, 17 delta S/N-Res, underwent a high frequency of HSV-1 ocular reactivation as determined by recovery of infectious virus in the tear film. Rabbits infected with 17 delta S/N had a significantly lower frequency of ocular reactivation. Analysis of the trigeminal ganglia from all three groups of latently infected rabbits revealed (i) similar amounts of HSV DNA (genomic equivalents), (ii) accumulation of 2.0- and 1.45-kb LATs, and (iii) explant reactivation at the same high frequency. Therefore, these studies indicate that the 437-bp deleted region in 17 delta S/N is essential for epinephrine-induced reactivation and could implicate the 1.1- and 1.8-kb transcripts in the mechanisms controlling HSV-1 reactivation.

Correlation between herpes simplex virus type 1 rate of reactivation from latent infection and the number of infected neurons in trigeminal ganglia

The presence of wild-type herpes simplex virus type 1 (HSV-1) and several latency associated transcript (LAT) region mutants within the trigeminal ganglia (TG) of latently infected mice was examined. A combination of methods including conventional in situ hybridization to detect viral LAT and an in situ DNA polymerase chain reaction (PCR) to detect viral DNA was used. These data show that, for all virus strains in which a comparison was possible, the population of neurons expressing detectable levels of LAT was approximately one-third the total number of viral DNA-containing cells. In addition, in situ PCR analysis revealed that mutants such as 17 delta Sty. 17 delta BstE, and 17 delta S/N, which contain deletions within the LAT locus which do not affect the kinetics of viral reactivation from explanted murine TG, are present in as many neurons as wild-type virus. This was true regardless of the ability to induce accumulation of intact 2.0-kb LAT. On the other hand, mutant 17 delta N/H, which contains a deletion removing the LAT promoter and surrounding genomic region and reactivates slowly from explanted TG, was present in only one-sixth as many neurons as wild-type virus. These data show that detection of mutants unable to synthesize or accumulate 2.0-kb LAT (such as 17 delta N/H) is possible with in situ DNA PCR and that the slow reactivation phenotype of 17 delta N/H correlates with a reduced number of HSV DNA-containing neurons.

In vivo epinephrine reactivation of ocular herpes simplex virus type 1 in the rabbit is correlated to a 370-base-pair region located between the promoter and the 5' end of the 2.0 kilobase latency-associated transcript

A rabbit ocular model of epinephrine-induced herpes simplex virus type 1 reactivation was employed to study the effect of a deletion in the latency-associated transcript domain. A viral construct derived from 17Syn+, designated 17deltaSty, has a deletion of 370 nucleotides between genomic positions 118880 and 119250. 17deltaSty has been shown to reactivate with wild-type virus kinetics from explants of trigeminal ganglia from latently infected mice. To determine the behavior of this mutant in an in vivo, inducible reactivation system, rabbit corneas were infected with 17Syn+, 17deltaSty, or its rescuant, 17detlaSty-Res. After viral latency was established, transcorneal epinephrine iontophoresis was performed. The rabbits latently infected with 17deltaSty exhibited a significantly reduced ability to undergo adrenergically induced reactivation, i.e., viral shedding in the tears, compared with rabbits infected with either 17Syn+ or 17deltaSty-Res. However, quantitative PCR demonstrated similar numbers of viral genomes in the trigeminal ganglia from rabbits latently infected with all three viruses, and all three viruses reactivated in vitro with wild-type kinetics in an explant cocultivation assay. These studies indicate that the 370-bp region deleted in the 17deltaSty construct plays a role in epinephrine-induced reactivation.

Evidence that two latency-associated transcripts of herpes simplex virus type 1 are nonlinear

The latency-associated transcripts (LATs) of herpes simplex virus type 1 (HSV-1) are the only viral gene products that accumulate to abundant levels in latently infected cells. Others have reported species of 2.0, 1.50, and 1.45 kb; only the 2.0-kb species is seen in productively infected cells, and there is evidence that it behaves as an intron. We examined the LATs both in trigeminal ganglia of latently infected mice and in productively infected cultures of monkey CV-1 cells. After glyoxalation, RNA was subjected to high-resolution agarose gel electrophoresis and Northern (RNA) analysis, a procedure capable of resolving linear and nonlinear RNA species. Under these conditions, we resolved the 2.0-kb LAT into two species; the slower species was much more abundant and had a mobility significantly slower than expected for a linear RNA. To test the hypothesis that this RNA was in fact nonlinear, we used partial hydrolysis by sodium carbonate and oligonucleotide-directed RNase H digestion. These procedures changed the mobility of the slower species into that of the faster species. Similarly, the mobility of the 1.50-kb LAT, which was much more abundant than the 1.45-kb LAT, was changed by these procedures to that of the 1.45-kb LAT. Our data show that the two major LAT species are nonlinear, and they support an interpretation of stable lariat structures.

Wedge resection to improve insulin resistance in polycystic ovary syndrome: a study among Chinese women

OBJECTIVE

To investigate the relation between androgen excess and insulin resistance in nonobese Chinese women with polycystic ovary syndrome.

DESIGN

A prospective, controlled study.

SETTING

School of Clinical Medicine, Nanjing University.

SUBJECTS

There were three groups: Group 1 (n = 15) comprised nonobese women with polycystic ovary syndrome; Group 2 comprised 12 of these 15 women in whom bilateral wedge resection had been performed six months to one year before enrolling in the study. Group 3 was a control group comprised of 15 normally menstruating women of similar age and body mass index.

METHODS

An oral glucose (100 g) tolerance test was performed in all women in each group. The areas under the response curve of serum glucose, insulin, C-peptide (C-P), insulin/glucose (I/G) and C-P/insulin (C/I) were calculated by trapezoid rule.

RESULTS

When fasting the three groups had similar levels of glucose, insulin, C-P, I/G and C/I. During the oral glucose tolerance test women of Group 1 had a significantly higher mean serum area of the curve of glucose, insulin, C-P and I/G levels and lower C/I values, compared with the other two groups. Women of Group 2 and those in the control group showed similar levels of these indices during the oral glucose tolerance test.

CONCLUSIONS

Androgen excess in women with polycystic ovary syndrome may be responsible for a defect in peripheral insulin sensitivity and hepatic extraction which could be reversed by removing excessive androgens with wedge resection.

Protective antibody therapy is associated with reduced chemokine transcripts in herpes simplex virus type 1 corneal infection

Herpes simplex virus type 1 (HSV-1) infection on the murine cornea induces an intense inflammatory response which can lead to blindness. This disease, known as herpes stromal keratitis, can be prevented by the timely passive transfer of monoclonal antibody specific for viral glycoprotein D (gD). Precisely how antibody treatment prevents excessive corneal inflammation is not known. In this study we investigated whether chemokine mRNA expression is inhibited by antibody treatment. Total cellular RNAs isolated from normal corneas and at various times after virus infection were analyzed via reverse transcription-PCR for mRNA coding for seven different chemokines. Constitutive levels of IP-10, KC, MIP-2, MCP-1, MIP-1 beta, and RANTES mRNA were detected in uninfected corneas of BALB/c mice. When the cornea was mechanically traumatized, message for all six chemokines was transiently elevated above constitutive levels. In contrast, HSV-1 infection resulted in prolonged enhanced chemokine message expression. The kinetics of mRNA accumulation was distinctive for each chemokine analyzed. MIP-1 alpha message, not detected constitutively, was not evident until day 7 postinfection. Administration of anti-HSV gD monoclonal antibody 1 day after infection was associated with reduced message for MIP-2, MCP-1, MIP-1 alpha, and MIP-1 beta. IP-10, KC, and RANTES messages were not altered. Collectively, our results suggest that anti-gD treatment may protect, at least in part, by inhibiting production of chemokines believed to promote inflammation.

Early cytokine synthesis in the excised mouse cornea

Corneas excised from normal BALB/c mice and incubated in vitro were analyzed for the production of "early-warning" cytokines via reverse transcription-polymerase chain reaction and ELISA. It was found that the trauma of excision stimulated rapid IL-1 alpha synthesis, with peak protein accumulation occurring at 6 h, whereas IL-6 synthesis was maximal at 18 h. Neither IL-1 beta protein nor message was detected at any point, and TNF-alpha synthesis never increased above constituted levels. Antibody neutralization of endogenous IL-1 alpha blocked IL-6 synthesis. Addition of exogenous IL-1 alpha induced IL-1 alpha and IL-6 synthesis in vitro. Inoculation of IL-1 alpha into the cornea induced IL-6 synthesis in vivo. Addition of IL-1 alpha could stimulate IL-1R, IL-1 alpha, and IL-6 mRNA synthesis in the epithelial, stromal, and endothelial components of the cornea. However, protein production was readily detected only in the epithelial layer. We concluded that mechanical trauma to the mouse cornea triggers the enhanced synthesis of IL-1 alpha and IL-1R, which in turn results in the production of IL-6 and more IL-1 alpha. That corneal excision did not stimulate the synthesis of IL-1 beta or TNF-alpha indicates that there is a selective induction of early cytokine expression in this specialized tissue.

Responses of somatostatin, beta-endorphin and dynorphin A to a glucose load in two groups of women with polycystic ovarian syndrome

To investigate the relationship between elevated LH, hyperinsulinemia and neuropeptides in polycystic ovarian syndrome (PCOS), we measured the endogenous levels of insulin, somatostatin (SS), beta-endorphin (beta-EP) and dynorphin A (Dyn A) before and after a glucose load in three groups: group 1 (LH/ FSH > or = 3, n = 30); group 2 (LH/FSH < 3, n = 25), and controls (n = 15). In the basal state, significantly negative correlations were found between LH and SS (r = -0.51, p < 0.05) in group 1 and between LH and beta-EP (r = -0.49, p < 0.05) in group 2. After a glucose load, PCOS women had greater beta-EP and Dyn A responses in group 1 and impaired SS response in group 2 as compared with the control. The data suggest endogenously lower SS, higher beta-EP and Dyn A may contribute to the elevation of LH and insulin secretions in PCOS.

[Protective effect of "wei tong ling" on gastric mucosa and influence on quality of gastric ulcer healing]

The acute gastric ulcer rat models were induced by dehydrated alcohol, 0.6 N hydrochloric acid and 0.6 N sodium hydroxide, and the chronic gastric ulcer rat models were established by means of acetic acid, the protective effect of Chinese medicine "Wei Tong Ling" (WTL) on gastric mucous membrane was studied. Using histochemical mucin stain, AgNOR stain and immunohistochemical technique the regenerated mucosa of healed gastric ulcer induced by acetic acid in rats was observed quantitatively. They were compared with that of WTL. The results showed that the regenerated mucosa of healed gastric ulcer might be the morphological basis for the recurrence of gastric ulcer and be associated with canceration. WTL could not only accelerate the healing of ulcer but also raise the quality of gastric ulcerous healing which was beneficial for the prevention of ulcer recurrence and canceration. The protective effect of WTL on gastric mucosa was confirmed by various assays.

[Light and electron microscopic histochemical studies of alkaline phosphatase (ALP) isoenzymes in gastric cancer]

By using light and electron microscopic histochemical techniques, the activities and distributions of ALP isoenzymes in gastric cancers and benign gastric diseases were examined. The results showed: Nagao, Regan and Kasahara isoenzymes, which were not expressed in normal gastric mucosae and non-malignant lesions, may be considered as the tumor markers of gastric cancer. The epithelium of intestinal metaplasia exhibited intestinal-type ALP only, which was one of the markers of well-differentiated intestinal metaplasia. In the view-point of the gene expression of ALP isoenzymes, two mutation hypothesis and recessive-gene mutation hypothesis may be proper for gastric cancer.

Video-polygraphic analysis of myoclonic seizures in juvenile myoclonic epilepsy

We studied myoclonic seizures (MS) in 5 patients with juvenile myoclonic epilepsy (JME) using video polygraphic recordings to investigate the clinical characteristics of MS in this epileptic syndrome. The total number of MS analyzed was 302 (range 27-125, mean 60) seizures per patient. MS occurred either singly or repetitively (37 vs. 63%) and corresponded to generalized bilaterally synchronous single or multispike-and-wave complexes at 3-5 Hz. Video analysis of the myoclonic jerks demonstrated that either distal or proximal muscle involvement predominated. In the former, there was mild bilateral flexion and some external rotation of the forearms. In the latter, flexion of both arms at the elbow, flexion and abduction of the thighs, and extension of the back was observed. Asymmetry of MS was noted in 4 of 5 patients. Facial involvement of MS occurred infrequently in 2 patients. When the patients kept both arms outstretched, the arms dropped or there was sudden interruption of ongoing electromyographic (EMG) potentials immediately after myoclonic jerks (postmyoclonic inhibition) in all patients. One should inquire about these clinical characteristics of MS in JME when taking a thorough history in patients with primary generalized tonic-clonic seizures (GTC).

Mapping the genetic region coding for herpes simplex virus resistance to mouse interferon alpha/beta

Herpes simplex virus (HSV) ocular virulence has been associated with strain sensitivity to mouse interferon (IFN)-alpha/beta. To identify the region of the virus genome associated with heightened resistance to this cytokine, intertypic recombinants were constructed using the intact genome of avirulent, IFN-sensitive HSV type 1 (strain 35) and XbaI-digested DNA from virulent, IFN-resistant HSV type 2 (strain 186). An intertypic recombinant, designated HSV-R4, was isolated which grew to titres 10- to 100-fold higher than HSV-1(35) in mouse ocular tissue in vivo, and induced stromal keratitis. The recombinant which was several orders of magnitude more resistant to mouse IFN-alpha/beta than HSV-1(35) had a genome composed of HSV-1(35) DNA except for a 12 kb fragment (0.15 to 0.23 map units) derived from HSV-2(186). To define the IFN resistance locus further, three overlapping subclones of this 12 kb fragment were constructed from the HSV-2(186) genome and subjected to marker rescue experiments. The cloned BamHI D fragment was the only subclone that promoted HSV-1(35) ocular growth in vivo. An intertypic recombinant, designated HSV-R(BD), was isolated from the 35 x 186 BamHI D transfection progeny pool. This recombinant, in contrast to HSV-1(35), was several orders of magnitude more resistant to mouse IFN-alpha/beta inhibition in vitro, grew 10- to 100-fold better in mouse ocular tissue in vivo, and caused severe necrotizing stromal keratitis in BALB/c mice. Analysis of the recombinant genome indicated that the HSV-2 genetic information responsible for IFN resistance of HSV-R(BD) was located within the BamHI D fragment, most likely mapping to that region containing three partial open reading frames designated UL14, UL15 and UL16. The products encoded by this region remain to be identified.

Seizure threshold in juvenile myoclonic epilepsy with Graves disease

Thyroxine lowers the seizure threshold in experimental animals and humans. We report juvenile myoclonic epilepsy (JME) in two female patients with Graves' disease who had exophthalmos at age 11 (patient 1) and age 12 years (patient 2) but remained untreated until onset of seizures at ages 15 and 13 years, respectively. Seizures were not controlled well despite administration of antiepileptic drugs (AEDs) during the periods of excess serum thyroid hormones in Graves disease. When the serum levels of T3 were reduced to < 220 ng/dl with antithyroid drug treatment, both clinical seizures and paroxysmal EEG abnormalities disappeared despite discontinuation of AEDs and sleep deprivation. JME was noted only during periods of excess thyroid hormone and low compliance with antithyroid drug treatment. The excessively high level of thyroid hormones may have been a factor in precipitating the onset of JME.

[Autoimmune reaction factors of infertility in patients with endometriosis]

The presence of immunoprotein depositions in endometrium and antiendometrial autoantibodies in serum was detected in 59 infertile patients with endometriosis, 45 infertile patients without endometriosis and 11 fertile women by the methods of immunohistochemistry determination and immunodiffusion assay. The immunoprotein depositions in endometrium of endometriosis were significantly increased. The antiendometrial auto-antibodies in serum were positive in 32.2% for infertile patients with endometriosis, 6.7% for infertile patients without endometriosis and 0% for fertile women. This suggested that an autoimmune response might be an etiologic factor of infertility in patients with endometriosis.

Evidence endogenous interferon production contributed to the lack of ocular virulence of an HSV intertypic recombinant

An intertypic recombinant isolated from rabbit kidney cells following co-transfection of HSV-1(17) and HSV-2(186) DNA failed to induce overt ocular pathology when inoculated onto the murine sacrificed cornea at concentrations as high as 10(7) PFU per eye. In contrast, both parents induced corneal disease at a 1000-fold lower dose. The reason(s) for the failure of the intertypic recombinant, designated RO25X, to induce corneal pathology was investigated. It was found that the recombinant was 100-fold more sensitive to the inhibitory effects of interferon (IFN) alpha/beta than the parent strains in corneal button growth studies in vitro. R025X readily grew in cultured mouse corneal fibroblasts at a low multiplicity of infection. However, the peak titer was approximately 8-fold lower than that of strain 17. Addition of rabbit anti-IFN alpha/beta to the culture medium resulted in a 4 to 5-fold increase in infectious titer compared to its growth in the absence of antiserum. Most significantly, when mice were pre-treated in vivo with anti-IFN alpha/beta 24 hours prior to virus corneal infection, 67% of the recipients developed moderate to severe stromal keratitis, whereas none of the controls developed corneal pathology. Blepharitis was also significantly increased in incidence and severity in the antiserum treated hosts. We conclude that the inability of R025X to induce ocular disease was due, at least in part, to the inhibitory effects of interferon produced in response to infection.

Ocular avirulence of a herpes simplex virus type 1 strain is associated with heightened sensitivity to alpha/beta interferon

BALB/c mice infected on the scarified cornea with herpes simplex virus type 1 strain 35 [HSV-1(35)] rarely developed ocular disease even at challenge doses as high as 10(7) PFU per eye. In contrast, HSV-1(RE) consistently induced stromal keratitis at an inoculum of 2 x 10(4) PFU. The goal of this study was to determine the reason for the difference in virulence between the two HSV strains. Both HSV-1 strains replicated to similar titers in excised corneal "buttons." However, after in vivo infection of the cornea, the growth of strain 35 was evident only during the first 24 h postinfection, whereas the replication of strain RE persisted for at least 4 days. In vitro tests revealed that HSV-1(35) was greater than 10 times more sensitive to alpha/beta interferon (IFN-alpha/beta) than HSV-1(RE). Both strains induced comparable serum levels of IFN after intraperitoneal inoculation. The kinetics of HSV-1(35) clearance from the eye was markedly altered by treatment with rabbit anti-IFN-alpha/beta. Virus titers exceeding 10(4) PFU per eye could be demonstrated 4 to 5 days postinfection in mice given a single inoculation of antiserum 1 h after infection. Furthermore, anti-IFN treatment in 3-week-old mice infected with HSV-1(35) led to the development of clinically apparent corneal disease which subsequently progressed to stromal keratitis in the majority of recipients. These results indicate that the striking difference in the capacity of HSV-1(35) and HSV-1(RE) to induce corneal disease was related to the inherently greater sensitivity of strain 35 to IFN-alpha/beta produced by the host in response to infection.

[Pulmonary plasma cell granuloma: report of one case]

Pulmonary plasma cell granuloma is very rare in pediatric field. Most of them are asymptomatic, and are usually found to have lung tumor accidentally by chest X-ray examination. The granuloma is characterized by the proliferation of plasma cells along with other mesenchymal elements. We report a case of 10-year-old boy who suffered from dry cough, pale face and body weight loss for a long time. Chest X-ray and CT scan revealed a lung tumor which was proved to be plasma cell granuloma after wedge biopsy. He was regularly followed up at OPD with stationary status. He may receive surgical resection in future.