Attenuation of Armanni-Ebstein lesions in a rat model of diabetes by a new anti-fibrotic, anti-inflammatory agent, FT011

AIMS/HYPOTHESIS

A key morphological feature of diabetic nephropathy is the accumulation and deposition of glycogen in renal tubular cells, known as Armanni-Ebstein lesions. While this observation has been consistently reported for many years, the molecular basis of these lesions remains unclear.

METHODS

Using biochemical and histochemical methods, we measured glycogen concentration, glycogen synthase and glycogen phosphorylase enzyme activities, and mRNA expression and protein levels of glycogenin in kidney lysates from control and transgenic (mRen-2)27 rat models of diabetes that had been treated with and without a new anti-fibrotic agent, FT011.

RESULTS

Diabetic nephropathy was associated with increased glycogen content, increased glycogen synthase activity and decreased glycogen phosphorylase activity. Glycogenin, the key protein responsible for initiating the synthesis of each glycogen particle, had very high levels in the diabetic kidney together with increased mRNA expression compared with control kidneys. Treatment with FT011 did not change glycogen synthase or glycogen phosphorylase enzyme activities but prevented both glycogenin mRNA synthesis and accumulation of Armanni-Ebstein lesions in the diabetic kidney.

CONCLUSIONS/INTERPRETATION

Armanni-Ebstein lesions found in diabetic nephropathy are due to aberrant glycogenin protein levels and mRNA expression, providing an explanation for the increased glycogen concentration found within the diabetic kidney. FT011 treatment in diabetic rats reduced glycogenin levels and, subsequently, renal glycogen concentration.

Dose-dependent pharmacokinetics of bulleyaconitine A in rats

This study was conducted to determine the pharmacokinetic characteristics of bulleyaconitine A (BLA) after oral gavage and intravenous administration of BLA at a single dose of 0.04, 0.12, 0.36 mg/kg (oral) or 0.02 mg/kg (i.v.) in male Sprague-Dawley rats. Plasma concentration profiles were analysed using a non-compartmental pharmacokinetic method. Following i.v. 0.02 mg/kg and oral administration 0.04, 0.12 or 0.36 mg/kg, the geometric mean Cmax values were 19.97, 2.11, 5.11 and 11.47 ng/ml, respectively; the corresponding geometric mean AUC(0-t) values were 10.50, 3.19, 9.59 and 18.10 ng x h/ml, respectively. The median Tmax values were 0.033, 0.167, 0.167 and 0.167 h, respectively. The terminal elimination half-lives (t1/2) were 1.23, 2.48, 1.93 and 2.17h, respectively. The results showed that Cmax and AUC(0-t) increased with increasing doses of BLA. The increase in exposure with increasing dose was lower than expected under conditions of strict proportionality.

HOXA1 drives melanoma tumor growth and metastasis and elicits an invasion gene expression signature that prognosticates clinical outcome

Metastatic melanoma is a highly lethal disease notorious for its aggressive clinical course and eventual resistance to existing therapies. Currently we possess a limited understanding of the genetic events driving melanoma progression, and much effort is focused on identifying pro-metastatic aberrations or perturbed signaling networks that constitute new therapeutic targets. In this study, we validate and assess the mechanism by which homeobox transcription factor A1 (HOXA1), a pro-invasion oncogene previously identified in a metastasis screen by our group, contributes to melanoma progression. Transcriptome and pathway profiling analyses of cells expressing HOXA1 reveals up-regulation of factors involved in diverse cytokine pathways that include the TGFβ signaling axis, which we further demonstrate to be required for HOXA1-mediated cell invasion in melanoma cells. Transcriptome profiling also shows HOXA1’s ability to potently down-regulate expression of microphthalmia-associated transcription factor (MITF) and other genes required for melanocyte differentiation, suggesting a mechanism by which HOXA1 expression de-differentiates cells into a pro-invasive cell state concomitant with TGFβ activation. Our analysis of publicly available datasets indicate that the HOXA1-induced gene signature successfully categorizes melanoma specimens based on their metastatic potential and, importantly, is capable of stratifying melanoma patient risk for metastasis based on expression in primary tumors. Together, these validation data and mechanistic insights suggest that patients whose primary tumors express HOXA1 are among a high-risk metastasis subgroup that should be considered for anti-TGFβ therapy in adjuvant settings. Moreover, further analysis of HOXA1 target genes in melanoma may reveal new pathways or targets amenable to therapeutic intervention.

Insulin promotes T cell recovery in a murine model of autoimmune myocarditis

Glucose-insulin-potassium (GIK) is a useful adjunct to myocarditis. Besides its essential action in energy metabolism, insulin also exerts an anti-inflammatory effect. This study investigated the effect of insulin on myocardial inflammation in experimental autoimmune myocarditis (EAM) in mice and its potential role in T cell regulation. Mice were divided randomly into a normal control group, a saline-treated EAM group and an insulin-treated EAM group. The histopathological changes of myocardium, α-myosin heavy chain (MyHCα)(614-629) antigen-specific autoantibody titre, the serum level of cardiac troponin I (cTnI), mitogen-activated protein kinase (MAPK) family members' activity and content were measured. Furthermore, the phenotype of T lymphocyte subsets in splenocytes was analysed to evaluate the immune status of mice. Insulin reduced serum cTnI of EAM mice on days 14 and 21 (P < 0·05) after immunization, with no changes in blood glucose and autoantibody production. Western blot revealed that extracellular signal-regulated protein kinase (ERK1/2) may be a determining factor in this process. Total ERK1/2 and phospho-ERK1/2 (p-ERK1/2) were both up-regulated in insulin-treated mice after immunization. We also found that insulin treatment promoted T cell recovery without changing the naive-to-memory T-cell ratio; in particular, CD3(+) T cells in insulin-treated mice proliferated more vigorously than in control mice (P < 0·05). We report here for the first time that insulin alleviates myocarditis in the EAM model. These data show that insulin has a direct effect on T cell proliferation in EAM. It is possible that GIK or insulin may assist T cell recovery towards normal in myocarditis, especially for diabetic or hyperglycaemic patients.

Characteristics and visual outcomes of eye trauma in the Chinese Armed services

OBJECTIVES

To outline the characteristics and outcomes of eye injuries in the Chinese People's Liberation Army.

METHODS

A retrospective review of military inpatient eye injuries, in one military region, population 250,000 soldiers, between January 2006 and December 2010.

RESULTS

There were 709 eye injury patients (759 eyes) during the 5-year period with an incidence of inpatient eye injuries of 57 per 100,000 person-years. The mean age of patients was 24 years, the vast majority male. The majority of eye injuries occurred during recreational time (62%), with the commonest causing being violence (46%). The immediate post-injury vision acuity of 48% of eyes was > 6/12; 93% of cases had mechanical ocular injuries and 7% had non-mechanical ocular injuries. 71% of patients were sent to an evacuation hospital within 24 hours and 75% had surgery within 24 hours of injury. The majority of cases (97%) were hospitalized for one visit. On discharge, there was a statistically significant improvement in visual outcomes with 85% of eyes achieving > 6/12.

CONCLUSIONS

Eye injuries secondary to violence were a frequent occurrence amongst young male PLA members, particularly during recreational time. Most injuries were not sight-threatening, with the majority of patients achieving an excellent visual outcome.

Myostatin induces mitochondrial metabolic alteration and typical apoptosis in cancer cells

Myostatin, a member of the transforming growth factor-β superfamily, regulates the glucose metabolism of muscle cells, while dysregulated myostatin activity is associated with a number of metabolic disorders, including muscle cachexia, obesity and type II diabetes. We observed that myostatin induced significant mitochondrial metabolic alterations and prolonged exposure of myostatin induced mitochondria-dependent apoptosis in cancer cells addicted to glycolysis. To address the underlying mechanism, we found that the protein levels of Hexokinase II (HKII) and voltage-dependent anion channel 1 (VDAC1), two key regulators of glucose metabolisms as well as metabolic stress-induced apoptosis, were negatively correlated. In particular, VDAC1 was dramatically upregulated in cells that are sensitive to myostatin treatment whereas HKII was downregulated and dissociated from mitochondria. Myostatin promoted the translocation of Bax from cytosol to mitochondria, and knockdown of VDAC1 inhibited myostatin-induced Bax translocation and apoptosis. These apoptotic changes can be partially rescued by repletion of ATP, or by ectopic expression of HKII, suggesting that perturbation of mitochondrial metabolism is causally linked with subsequent apoptosis. Our findings reveal novel function of myostatin in regulating mitochondrial metabolism and apoptosis in cancer cells.

Hypothermia protects against oxygen-glucose deprivation-induced neuronal injury by down-regulating the reverse transport of glutamate by astrocytes as mediated by neurons

Glutamate is the major mediator of excitotoxic neuronal death following cerebral ischemia. Under severe ischemic conditions, glutamate transporters can functionally reverse to release glutamate, thereby inducing further neuronal injury. Hypothermia has been shown to protect neurons from brain ischemia. However, the mechanism(s) involved remain unclear. Therefore, the aim of this study was to investigate the mechanism(s) mediating glutamate release during brain ischemia-reperfusion injury under hypothermic conditions. Neuron/astrocyte co-cultures were exposed to oxygen-glucose deprivation (OGD) at various temperatures for 2h, and cell viability was assayed 12h after reoxygenation. PI and MAP-2 staining demonstrated that hypothermia significantly decreased neuronal injury. Furthermore, [(3)H]-glutamate uptake assays showed that hypothermia protected rat primary cortical cultures against OGD reoxygenation-induced injury. Protein levels of the astrocytic glutamate transporter, GLT-1, which is primarily responsible for the clearance of extracellular glutamate, were also found to be reduced in a temperature-dependent manner. In contrast, expression of GLT-1 in astrocyte-enriched cultures was found to significantly increase following the addition of neuron-conditioned medium maintained at 37 °C, and to a lesser extent with neuron-conditioned medium at 33 °C. In conclusion, the neuroprotective effects of hypothermia against brain ischemia-reperfusion injury involve down-regulation of astrocytic GLT-1, which mediates the reverse transport of glutamate. Moreover, this process may be regulated by molecules secreted by stressed neurons.

Autologous dendritic cells combined with cytokine-induced killer cells synergize low-dose chemotherapy in elderly patients with acute myeloid leukaemia

OBJECTIVES

To investigate the possibility of culturing dendritic cells (DCs) and cytokine-induced killer (CIK) cells, obtained at initial diagnosis of AML in elderly patients, and to investigate the safety and efficacy of treatment with autologous DCs and CIK cells when administered to these patients in combination with low-dose chemo therapy.

METHODS

DCs and CIK cells obtained at initial diagnosis of AML in elderly patients were cultured and used in combination with low-dose chemo therapy to treat these patients (immunotherapy group). Elderly patients with AML treated only with low-dose chemotherapy served as the control. Before treatment and on day 7 after treatment with autologous DCs and CIK cells, T cell subsets and cytokine levels were evaluated in the immunotherapy group.

RESULTS

A total of 21 elderly patients with AML were included in the immunotherapy group and 23 in the control group. The clinical efficacy in the immunotherapy group was greater than in the control group. The percentages of T cell subsets and cytokine levels after immunotherapy treatment were significantly higher than before the treatment.

CONCLUSION

Immuno therapy with autologous DCs and CIK cells was found to be a promising candidate for treatment of AML in elderly patients.

Anatomical patterns and correlated MRI findings of non-perinatal hypoxic-ischaemic encephalopathy

Non-perinatal hypoxic-ischaemic encephalopathy (HIE) has varying anatomical patterns dependent on the type of insult, the degree and duration of cerebral hypoxia, or presence and degree of hypoperfusion. Profound insults can affect the entire cerebral cortex or just the perirolandic cortex, the cerebellum and the deep grey matter structures. Less severe insults may affect only the watershed regions. The objective of this article is to review the anatomical patterns of non-perinatal HIEs by MRI.

Impact of different particle size distributions on anaerobic digestion of the organic fraction of municipal solid waste

Particle size may significantly affect the speed and stability of anaerobic digestion, and matching the choice of particle size reduction equipment to digester type can thus determine the success or failure of the process. In the current research the organic fraction of municipal solid waste was processed using a combination of a shear shredder, rotary cutter and wet macerator to produce streams with different particle size distributions. The pre-processed waste was used in trials in semi-continuous 'wet' and 'dry' digesters at organic loading rate (OLR) up to 6kg volatile solids (VS) m(-3)day(-1). The results indicated that while difference in the particle size distribution did not change the specific biogas yield, the digester performance was affected. In the 'dry' digesters the finer particle size led to acidification and ultimately to process failure at the highest OLR. In 'wet' digestion a fine particle size led to severe foaming and the process could not be operated above 5kgVSm(-3)day(-1). Although the trial was not designed as a direct comparison between 'wet' and 'dry' digestion, the specific biogas yield of the 'dry' digesters was 90% of that produced by 'wet' digesters fed on the same waste at the same OLR.

Prediction for relapse and prognosis of newly diagnosed epilepsy

OBJECTIVE

The objective of this study was to investigate the timing of therapy initiation and other clinical factors as potential predictors for relapse and prognosis of epilepsy, based on hospital-based prospective observational data in China.

METHODS

One hundred and seventy-one newly diagnosed patients with one or more seizures were recruited and followed for at least 2 years. Kaplan-Meier survival analysis was used for calculating recurrence and remission rates. Univariate and multivariate analyses for risk factors were performed using Cox proportional hazards model.

RESULTS

Among the 171 patients analyzed, more patients had partial (54.4%) than generalized seizures (45.6%). The range of patients' age was 6-70 years, but 70% were under 16 years of age. Multiple seizure types (HR = 2.01; 95% CI, 1.31-3.10), epileptiform electroencephalogram (EEG) abnormality (HR = 1.95; 95% CI, 1.09-3.49), and >1 seizure monthly before treatment (HR = 2.74; 95% CI, 1.69-4.51) were predictors of seizure recurrence. The best negative predictors of remission were as follows: relapse (HR = 0.13; 95% CI, 0.07-0.23) and epileptiform EEG within 1 year of treatment (HR = 0.61; 95% CI, 0.39-0.97). Delayed treatment after three or more seizures did not significantly increase the risk of recurrence (P = 0.70) or remission (P = 0.31) compared with early treatment after one or two seizures.

CONCLUSIONS

Multiple seizure types, epileptiform EEG abnormality, and >1 seizure monthly before treatment predict seizure recurrence. Relapse and epileptiform EEG within 1 year of treatment predict adverse seizure outcome. Early treatment does not affect relapse or prognosis.

Carbon nanotubes enhance the internalization of drugs by cancer cells and decrease their chemoresistance to cytostatics

Etoposide is a semisynthetic, chemotherapeutic drug widely recommended to treat an extensive range of human cancers. Our studies indicate that, while etoposide is capable of killing human cancer cells, exposure to single-walled carbon nanotubes (SWCNTs) and etoposide results in enhanced cell death that appears to be synergistic and not merely additive. In this study, we used high pressure liquid chromatography and mass spectrometry to quantify the internal effective dose of etoposide when the human pancreatic cancer cell (PANC-1) was exposed to the combination of these agents. Our results unequivocally indicate that SWCNTs improve etoposide uptake and increase its capacity to kill cancer cells. We suggest that a combination of SWCNTs and etoposide may prove to be a more efficient chemotherapeutic protocol, especially because of the potential to lower toxic drug doses to levels that may be useful in decreasing adverse side effects, as well as in lowering the probability of inducing chemoresistance in exposed cancer cells.

Three-dimensional finite element analysis of mini-external fixation and Kirschner wire internal fixation in Bennett fracture treatment

OBJECTIVE

To analyze the mini-external fixation and percutaneous K-wire internal fixation for the treatment of Bennett fracture by using finite element analysis and to compare the biomechanical stability and postoperative impact of the two fixations on the fracture.

METHODS

Three-dimensional digital models of the first metacarpal bone, second metacarpal bone, and the trapezium were established using Mimics 10.01 software. A solid model and finite element models were created and analyzed using ANSYS 10.0. The same load of 100N was exerted on both the mini-external fixator and the Kirschner (K)-wire internal fixator for the treatment of Bennett fracture. Finally, the none-line solution was analyzed, and displacement nephograms were obtained.

RESULTS

The displacement nephograms of the distal and proximal fragments of the fracture obtained using the mini-external and K-wire models were established. The X/Y/Z (SUM)-component displacements of 15 nodes aligned with the articular surface fracture were obtained. The relative displacement of the distal and the proximal fragments of the fracture were calculated, and all digits of relative displacement were entered into SPSS 13.0 software. The difference between the X-component relative displacements was statistically significant. Moreover, the comparison of the Y-component, Z-component, and SUM-component relative displacements yielded statistical significance. The average relative displacement in the X-direction was 0.3214mm in the K-wire model.

CONCLUSION

Mini-external fixation is more effective than K-wire internal fixation for secure Bennett fracture stability. Both fixations have similar effects on postoperative traumatic arthritis and postoperative hand functions.

LEVEL OF EVIDENCE

1 Biomechanical studies.

Short communication: evaluation of Brucella infection of cows by PCR detection of Brucella DNA in raw milk

The collection of serum samples from cows is frequently difficult to implement in large-scale surveys, and may involve a high risk of occupational infection. This study assessed the potential of using raw milk sampling as a suitable method for use in a pilot survey of Brucella abortus infection status in cattle. Raw milk samples from 816 cows were examined. Polymerase chain reaction assays of raw milk, with primers derived from the IS711 element of the Brucella genome, were used. Of the cows, 55 were Brucella positive based on serum agglutination test (SAT) results. Polymerase chain reaction amplified Brucella DNA in 25 (45%) of the 55 SAT-positive cows. All of the 689 SAT-negative cows were found to be negative in PCR assays of their milk. Brucella infection status based on PCR results was then predicted for 72 cows from private h erds in which the brucellosis status was unknown. Subsequently, SAT verification of Brucella status was performed. There was no significant difference between predicted and actual SAT-positive rates in those 72 cows. This study indicates a relationship between Brucella detection levels obtained using milk-based PCR results and SAT results. The specific, rapid, and easy sampling procedure within milk-based PCR assaying for brucellosis detection makes the milk PCR method an attractive alternative for evaluation of B. abortus infection in cows, particularly if used as a routine screening and surveillance tool to reduce brucellosis outbreaks.

Postmenopausal hormone therapy and non-Hodgkin lymphoma: a pooled analysis of InterLymph case-control studies

BACKGROUND

Non-Hodgkin lymphoma (NHL) subtypes, diffuse large B-cell (DLBCL) and follicular lymphoma (FL) have different sex ratios and are diagnosed at ages over 60 years; DLBCL is more common in men and diagnosed at older ages than FL, which occurs more among women. This analysis of postmenopausal women examines the relationship between postmenopausal hormone therapy and NHL.

DESIGN

Self-reported use of postmenopausal hormone therapy from 2094 postmenopausal women with NHL and 2731 without were pooled across nine case-control studies (1983-2005) from North America, Europe and Japan. Study-specific odds ratios (OR) and 95% confidence intervals (CI) estimated using logistic regression were pooled using random-effects meta-analyses.

RESULTS

Postmenopausal women who used hormone therapy were at decreased risk of NHL (pooled OR = 0.79, 95% CI 0.69-0.90). Risks were reduced when the age of starting was 50 years or older. There was no clear trend with number of years of use. Current users were at decreased risk while those stopping over 2 years before diagnosis were not. Having a hysterectomy or not did not affect the risk. Favourable effects were present for DLBCL (pooled OR = 0.66, 95% CI 0.54-0.80) and FL (pooled OR = 0.82, 95% CI 0.66-1.01).

CONCLUSION

Postmenopausal hormone therapy, particularly used close to menopause, is associated with a decreased risk of NHL.