Estrogen and microglia: A regulatory system that affects the brain

Sex hormones are involved in the physiological regulation of several aspects of behavior and neuroendocrine events. It has been accepted that such effects are mediated directly by steroid actions on neurons; however, new studies have shown that the glial cells are also affected by gonadal steroids. The microglia are one specialized brain glial cell type, which is a target for estrogen actions. In fact, we believe that many of the immune and nonimmune regulatory functions of microglia in the brain are influenced directly by estrogen via expression and secretion of cytokines, and growth factors by the microglia. The present review details only a section of the known aspects of microglial function, focusing mainly on nonimmune regulatory actions in the brain and their functional relationship with sex hormones. Moreover, we present evidence for the presence of estrogen receptor-beta (ERbeta) in rat microglial cells.

Predicting conduct problems: can high-risk children be identified in kindergarten and grade 1?

Externalizing behavior symptoms (EBS) in childhood are a strong predictor of future conduct problems. This study evaluated their predictive accuracy using logistic regression and receiver operating characteristic curve techniques. EBS, alone and in combination with other child and familial risk factors, were used to predict conduct problems 30 months later in a nonclinic population of kindergartners and Grade 1 children. The sensitivity (Sn) and positive predictive value (PPV) of EBS alone were below preset criteria of > or = 50% for each (prevalence < or = 15%). Sn and PPV increased when other child and familial factors were combined with symptoms but did not exceed the preset criteria. From a developmental perspective, substantial stability of EBS exists over time. However, from the perspective of prevention science, significant levels of misclassification will occur when EBS are used to designate high-risk status under the low-prevalence conditions of normal populations.

Characterization of two isoforms of the skeletal muscle LIM protein 1, SLIM1. Localization of SLIM1 at focal adhesions and the isoform slimmer in the nucleus of myoblasts and cytoplasm of myotubes suggests distinct roles in the cytoskeleton and in nuclear-cytoplasmic communication

We have cloned and characterized a novel isoform of the skeletal muscle LIM protein 1 (SLIM1), designated SLIMMER. SLIM1 contains an N-terminal single zinc finger followed by four LIM domains. SLIMMER is identical to SLIM1 over the first three LIM domains but contains a novel C-terminal 96 amino acids with three potential bipartite nuclear localization signals, a putative nuclear export sequence, and 27 amino acids identical to the RBP-J binding region of KyoT2, a murine isoform of SLIM1. SLIM1 localized to the cytosol of Sol8 myoblasts and myotubes. SLIMMER was detected in the nucleus of myoblasts and, following differentiation into myotubes, was exclusively cytosolic. Recombinant green fluorescent protein-SLIM1 localized to the cytoplasm and associated with focal adhesions and actin filaments in COS-7 cells, while green fluorescent protein-SLIMMER was predominantly nuclear. SLIMMER truncation mutants revealed that the first nuclear localization signal mediates nuclear localization. The addition of the proposed nuclear export sequence decreased the level of exclusively nuclear expression and increased cytosolic SLIMMER expression in COS-7 cells. The leucine-rich nuclear export signal was required for the export of SLIMMER from the nucleus of myoblasts to the cytoplasm of myotubes. Collectively, these results suggest distinct roles for SLIM1 and SLIMMER in focal adhesions and nuclear-cytoplasmic communication.

Estrogen and microglia: A regulatory system that affects the brain

Sex hormones are involved in the physiological regulation of several aspects of behavior and neuroendocrine events. It has been accepted that such effects are mediated directly by steroid actions on neurons; however, new studies have shown that the glial cells are also affected by gonadal steroids. The microglia are one specialized brain glial cell type, which is a target for estrogen actions. In fact, we believe that many of the immune and nonimmune regulatory functions of microglia in the brain are influenced directly by estrogen via expression and secretion of cytokines, and growth factors by the microglia. The present review details only a section of the known aspects of microglial function, focusing mainly on nonimmune regulatory actions in the brain and their functional relationship with sex hormones. Moreover, we present evidence for the presence of estrogen receptor-beta (ERbeta) in rat microglial cells.

A mutation in the second transmembrane region of the CB1 receptor selectively disrupts G protein signaling and prevents receptor internalization

We mutated a conserved aspartate in the second transmembrane domain of the cannabinoid CB(1) receptor to asparagine (D164N), stably transfected it into AtT20 cells, and examined the coupling of this mutant receptor to several intracellular effectors that are targets of wild-type CB(1) receptor activation. We found that the D164N receptor binds the CB(1) agonist WIN 55,212-2 with an affinity matching that of the wild-type CB(1) receptor and inhibits Ca(2+) currents and cAMP production with an equivalent potency and efficacy. This mutation, however, blocks coupling of the receptor to the potentiation of inwardly rectifying potassium channel (KIR) currents and prevents internalization of the receptor after exposure to agonist. Although the mutant receptor did not internalize, we found it was still capable of activating p42/44 MAP kinase. In addition, we made a reciprocal mutation that exchanged the aspartate with an asparagine in the seventh transmembrane region (D164N/N394D). In other seven-membrane-spanning receptors, this reciprocal mutation is known to restore functions disrupted by the mutation of the single conserved aspartate. However, activation of D164N/N394D did not potentiate KIR current, nor did it internalize. We conclude that D164 is necessary for potentiation of KIR current and internalization of receptor but not necessary for agonist binding, inhibition of cAMP production, inhibition of Ca(2+) currents, or activation of p42/44 MAP kinase. Furthermore, CB(1) receptor internalization is not necessary for MAP kinase activation.

The Melbourne Acuity Screening Test (MAST)

The Melbourne Acuity Screening Test (MAST) is a vision screening technique which combines the features of a linear presentation, incorporating a crowding effect with a pass/fail test protocol. It is a simple, quick screening test which can be used for both literate and illiterate people. This paper reports on the preliminary results of a comparison of the pass/fail method with that of the measurement of threshold linear acuity. The evaluation consisted of four parts: (1) test-retest and reliability of the MAST and Sheridan Gardiner (SG) linear test; (2) concurrent validity of the MAST compared with the SG linear test; (3) a limited negative predictive study, and (4) a comparison of the time taken to perform the MAST versus the measurement of threshold acuity. The test-retest reliability for both tests was high. The agreement, determined by Cohenthorn s kappa, ranged between 0.71 and 0.79. The agreement between the MAST and the SG linear test was also high, ranging between 0.88 and 0.89. The negative predictive value was 100%. The positive predictive value was 85.7%. The MAST was also significantly quicker to perform, taking approximately half the time of the SG linear test.

Patient and caregiver perceptions of cancer pain control

OBJECTIVES

This study measured the perceptions of cancer patients and caregivers in Utah concerning knowledge about and adequacy of pharmacologic cancer pain control.

MATERIALS AND METHODS

A descriptive survey was sent to a stratified random sample of adult cancer patients obtained from the Utah Tumor Registry. Questionnaires asked cancer patients and caregivers about their knowledge of pain control and about perceptions of the adequacy of pharmacologic cancer pain management.

RESULTS

The study had a 52% response rate (259 of 500) after two mailings. Eighty-five percent (219 of 259) of the respondents stated that they had no cancer pain. With the first mailing, a "no pain" response was not offered as an option. When the researchers realized that this might be a possible response, a second mailing was sent, which may be the reason for the high response rate.

CONCLUSIONS

Cancer literature indicates that much cancer pain is not effectively controlled. The majority of the respondents of this study reported no pain. Because this result is different than that reported in the literature, it may indicate that education of healthcare providers, patients, and families can improve cancer pain management and control. It may also indicate an inability of the study to obtain data from those patients having cancer pain. This study should be repeated with a focused population of advanced stage cancer patients with types of cancer typically producing high levels of cancer pain.

Efficacy of an International Exchange Via the Internet

Nursing education is lacking in international and computer experiences needed in the current global health care system. No nursing studies were found that use international exchanges together with computer use as a teaching strategy to help students become more culturally competent as well as more knowledgeable in electronic information communication. Knowles' adult learning theory, Kolb's experiential learning theory, and Campinha-Bacote's cultural competence model undergird this pilot study. The study used a one-group, posttest design to measure the effectiveness of an international exchange via the Internet, designed to enhance global awareness and computer use of 25 nursing students enrolled in a rural university in the southeastern United States. Data were obtained on a 24-item Internet Exchange Evaluation Questionnaire at the end of the course. Descriptive statistics were used to analyze the data. International exchange via the Internet was determined to be an effective strategy for heightening international awareness and increasing Internet use. This pilot study suggests fostering international exchanges and improving computer use can be developed further through more sophisticated approaches. A model of improving global health through shared knowledge and professional collaboration will be pursued further.

Hepatitis C: an economic evaluation of extended treatment with interferon

OBJECTIVES

To re-evaluate the cost effectiveness of treating hepatitis C virus (HCV) infection with interferon alfa (IF alpha) in Australia, taking into account changes in clinical practice.

DESIGN

A decision-analytic method (Markov model) was used to simulate the costs and effects of 6 months and 12 months of treatment with IF alpha versus no treatment (conventional management). Both costs and effects were modelled over 30 years.

DATA SOURCES

Published meta-analysis of the effectiveness of treatment, professional judgement about treatment protocols, scheduled medical fees, diagnosis-related costs for hospital admission, and a literature search for quality-of-life weights.

PATIENTS

A hypothetical cohort of 1000 patients with chronic HCV infection aged 40 years at the start of treatment.

MAIN OUTCOME MEASURES

Incremental costs per life-year gained and per quality-adjusted life-year (QALY) gained.

RESULTS

Compared with no treatment, IF alpha treatment for 6 months results in an extra 94.2 life-years or 320.1 QALYs at an extra cost of $1.8 million (after discounting at 3%) in a cohort of 1000 patients. Discounted cost per life-year gained is $19,110, which is about a quarter of the cost reported in 1994. The discounted cost per QALY gained is $5625. Extended treatment for another 6 months results in an additional 89.0 life-years saved or 170.8 QALYs gained at an incremental discounted cost of $15,835 per life-year gained and $8250 per QALY gained.

CONCLUSIONS

The cost effectiveness of IF alpha treatment for HCV infection has improved as a result of better patient selection, cost reductions and enhanced effectiveness of extended treatment. The results are sensitive to assumptions made about quality of life and the discount rate.

Internalization and recycling of the CB1 cannabinoid receptor

Tolerance develops rapidly to cannabis, cannabinoids, and related drugs acting at the CB1 cannabinoid receptor. However, little is known about what happens to the receptor as tolerance is developing. In this study, we have found that CB1 receptors are rapidly internalized following agonist binding and receptor activation. Efficacious cannabinoid agonists (WIN 55,212-2, CP 55,940, and HU 210) caused rapid internalization. Methanandamide (an analogue of an endogenous cannabinoid, anandamide) was less effective, causing internalization only at high concentration, whereas delta9-tetrahydrocannabinol caused little internalization, even at 3 microM. CB1 internalized via clathrin-coated pits as sequestration was inhibited by hypertonic sucrose. Internalization did not require activated G protein alpha(i), alpha(o), or alpha(s) subunits. A region of the extreme carboxy terminus of the receptor was necessary for internalization, as a mutant CB1 receptor lacking the last 14 residues did not internalize, whereas a mutant lacking the last 10 residues did. Steps involved in the recycling of sequestered receptor were also investigated. Recovery of CB1 to the cell surface after short (20 min) but not long (90 min) agonist treatment was independent of new protein synthesis. Recycling also required endosomal acidification and dephosphorylation. These results show that CB1 receptor trafficking is dynamically regulated by cannabimimetic drugs.

Predicting conduct problems: can high-risk children be identified in kindergarten and grade 1?

Externalizing behavior symptoms (EBS) in childhood are a strong predictor of future conduct problems. This study evaluated their predictive accuracy using logistic regression and receiver operating characteristic curve techniques. EBS, alone and in combination with other child and familial risk factors, were used to predict conduct problems 30 months later in a nonclinic population of kindergartners and Grade 1 children. The sensitivity (Sn) and positive predictive value (PPV) of EBS alone were below preset criteria of > or = 50% for each (prevalence < or = 15%). Sn and PPV increased when other child and familial factors were combined with symptoms but did not exceed the preset criteria. From a developmental perspective, substantial stability of EBS exists over time. However, from the perspective of prevention science, significant levels of misclassification will occur when EBS are used to designate high-risk status under the low-prevalence conditions of normal populations.

Anesthesia for Freeman-Sheldon syndrome using a laryngeal mask airway

PURPOSE

To present a case of Freeman-Sheldon syndrome (FSS) with a previously unreported technique of anesthetic management, consisting of a malignant hyperthermia free anesthetic and laryngeal mask airway.

CLINICAL FEATURES

Freeman-Sheldon syndrome (also known as whistling face syndrome, Windmill-Vane-Hand syndrome, cranio-carpo-tarsal dysplasia and distal arthrogryposis type 2) is a rare congenital disorder defined by facial and skeletal abnormalities. The three basic abnormalities are microstomia with pouting lips, camptodactyly with ulnar deviation of the fingers and talipes equinovarus. Patients with FSS frequently present for surgical correction of musculoskeletal or facial abnormalities. There are several anesthetic challenges including difficult airway, intravenous cannulation and regional technique. They may be at increased risk for malignant hyperthermia and postoperative pulmonary complications. We present a case of a two-year-old child with FSS undergoing elective unilateral inguinal hernia repair. A non-triggering anesthetic technique was used, consisting of 2 mg x kg(-1) propofol followed by a continuous infusion, nitrous oxide 50%/oxygen, and 3 microg x kg(-1) fentanyl. Intraoperative and postoperative analgesia was provided by an ilioinguinal nerve block with 10 ml bupivacaine 0.25% with epinephrine 1:200,000. The airway was maintained with a #2 laryngeal mask airway. The anesthetic was uneventful and there were no signs or symptoms of malignant hyperthermia. The patient was discharged home later the same day in good health.

CONCLUSION

The use of a laryngeal mask airway and non-triggering anesthetic technique should be considered as options for anesthetic management in patients with FSS for short procedures that do not require neuromuscular blockade.

Enhanced expression of recombinant dystrophin following intramuscular injection of Epstein-Barr virus (EBV)-based mini-chromosome vectors in mdx mice

Gene transfer by direct intramuscular injection of naked plasmid DNA has been shown to be a safe, simple but relatively inefficient method for gene delivery in vivo. Eukaryotic plasmid expression vectors incorporating the Epstein-Barr virus (EBV) origin of replication (oriP) and EBNA1 gene have been shown to act as autonomous episomally replicating gene transfer vectors which additionally provide nuclear matrix retention functions. Prolonged expression of a LacZ reporter gene and recombinant human dystrophin was shown using EBV-based plasmid vectors transfected into C2C12 mouse myoblast and myotube cultures. Intramuscular injection of EBV-based dystrophin expression plasmids into nude/mdx mice resulted in significant enhancement in the number of muscle fibres expressing recombinant dystrophin compared with a conventional vector. This effect was observed for over 10 weeks after a single administration. These results indicate the potential advantage of EBV-based expression vectors for focal plasmid-mediated gene augmentation therapy in Duchenne muscular dystrophy (DMD) and a range of other gene therapeutic applications.

Characterization of the Tribolium Deformed ortholog and its ability to directly regulate Deformed target genes in the rescue of a Drosophila Deformed null mutant

We have analyzed the Tribolium castaneum ortholog of the Drosophila homeotic gene Deformed (Dfd) and determined its expression pattern during embryogenesis in this beetle. Tc Deformed (Tc Dfd) is expressed in the blastoderm and the condensing germ rudiment in a region that gives rise to gnathal segments. During germ band extension Tc Dfd is expressed in the mandibular and maxillary segments, their appendages, and the dorsal ridge. Comparison of insect Dfd protein sequences reveals several highly conserved regions. To determine whether common molecular features reflect conserved regulatory functions we used the Gal4 system to express the Tribolium protein in Drosophila embryos. When Tc Dfd is expressed throughout embryonic ectoderm under the control of P69B, the beetle protein autoregulates the endogenous Dfd gene. In addition, the Drosophila proboscipedia gene (a normal target of Dfd) is ectopically activated in the antennal and thoracic segments. We also compared the ability of the beetle and fly proteins to rescue defects in Dfd- mutants by expressing each throughout the embryonic during embryogenesis. Both proteins rescued Dfd- defects to the same extent in that they each restore the development of mouth hooks and cirri, as well as cause gain-of-function abnormalities of posterior mouth parts. As before, pb was ectopically activated in the antennal segment. This is the first demonstration of the ability of a heterologous homeotic selector protein to directly regulate a target gene independent of an endogenous Drosophila autoregulatory loop.

The effect of 'non-critical' (<50%) stenosis on vein graft longitudinal resistance and impedance

OBJECTIVE

vein graft stenoses <50% cause minimal flow impairment, velocity elevation, or symptomatology and are therefore usually assumed to be "non-critical". The purpose of this study was to assess the effect of <50% vein graft stenosis on vein graft longitudinal impedance, as elevated impedance has been found to correlate with clinical graft failure.

METHODS

eight segments of non-reversed cryopreserved vein (mean length 23+/-1 cm; mean outer diameter 4.7+/-0.2 mm) were saline-perfused in vitro utilising a variable pulsatile perfusion pump, Windkessel, and clamp resistor simulating the haemodynamic conditions of arterial bypass. Proximal (Pprox) and distal (Pdist) pressure were continuously measured by fluid-filled catheter transduction, and flow (Q) by ultrasonic transit-time flowmetry. Waveforms were digitally recorded at 200 Hz at pulse rates ranging from 60-180 b.p.m. with mean flow (Q) of 154 ml/min and mean proximal pressure (Pprox) of 100 mmHg (max/min 120/90). Graded mid-graft stenoses of <50% were created using an inflatable vascular occluder and measured by the corresponding changes in mean pressure gradient (DeltaP=Pprox-Pdist) and Q (%stenosis=1-{DeltaPbaselineQstenosis/Delta PstenosisQbaseline}1/4). Vein graft longitudinal resistance (RL) was calculated as DeltaP/Q. After Fourier transformation, vein graft longitudinal impedance (ZL) was calculated as DeltaP/Q at each harmonic, with ZL determined by integration over 0-4 Hz. Results are reported as mean+/-S.E.M.

RESULTS

the desired levels of pressure and flow were established in all vein segments. Graded inflation of the occluder resulted in vein graft stenosis of 23+/-3% and 39+/-3%. This was accompanied by a mild reduction in Q (12% and 30%) and considerable increases in both RL (180% and 710%) and ZL (140% and 430%).

CONCLUSIONS

"non-critical" vein graft stenosis (<50%) causes minimal change in mean flow, but substantial elevations in longitudinal resistance and impedance. The contribution of "non-critical" stenosis to vein graft failure may be under-appreciated.

Nurse-mediated serum cholesterol reduction and health locus of control--a device for targeting health promotion?

Varying intensities of nurse-mediated health education advice were administered to subjects over a three-month period. Mean serum total cholesterol was calculated for each group at the outset and completion of the study. A multidimensional health locus of control (MHLC) scales questionnaire was self-completed by subjects at the outset. A highly significant association between internality and reduction in serum total cholesterol in the high-intensity intervention group was observed. The completion of a MHLC scale questionnaire may assist health professionals in identifying which subjects may most benefit from high-intensity health education advice when raised serum total cholesterol is prevalent.

Distinct domains of the CB1 cannabinoid receptor mediate desensitization and internalization

Desensitization of cannabinoid receptor signaling by a G-protein coupled receptor kinase (GRK) was examined using the Xenopus oocyte expression system. Application of a CB1 agonist, WIN 55,212-2, evoked a concentration-dependent increase in K+ conductance (Kir3) in oocytes coexpressing rat CB1 with the G-protein-gated, inwardly rectifying K+ channels Kir3.1 and Kir3.4. Desensitization was slight during continuous agonist application in the absence of GRK and arrestin. However, coexpression of GRK3 and beta-arrestin 2 (beta-arr2) caused profound homologous CB1 receptor desensitization, supporting the hypothesis that GRK3 and beta-arr2 effectively produce CB1 receptor desensitization. To identify the regions of the CB1 receptor responsible for GRK3- and beta-arr2-mediated desensitization, we constructed several CB1 receptor mutants. Truncation of the C-terminal tail of CB1 receptor at residue 418 (Delta418) almost completely abolished desensitization but did not affect agonist activation of Kir3. In contrast, truncation at residues 439 and 460 did not significantly affect GRK3- and beta-arr2-dependent desensitization. A deletion mutant (Delta418-439) did not desensitize, indicating that residues within this region are important for GRK3- and beta-arr2-mediated desensitization. Phosphorylation in this region was likely involved in desensitization, because mutation of either of two putative phosphorylation sites (S426A or S430A) significantly attenuated desensitization. CB1 receptors rapidly internalize after activation by agonist. Phosphorylation of S426 or S430 was not necessary for internalization, because the S426A/S430A CB1 mutant internalized when stably expressed in AtT20 cells. These studies establish that CB1 desensitization can be regulated by a GRK and that different receptor domains are involved in GRK- and beta-arrestin-dependent desensitization and CB1 internalization.

Trichome cell growth in Arabidopsis thaliana can be derepressed by mutations in at least five genes

Leaf trichomes in Arabidopsis are unicellular epidermal hairs with a branched morphology. They undergo successive endoreduplication rounds early during cell morphogenesis. Mutations affecting trichome nuclear DNA content, such as triptychon or glabra3, alter trichome branching. We isolated new mutants with supernumerary trichome branches, which fall into three unlinked complementation groups: KAKTUS and the novel loci, POLYCHOME and RASTAFARI. They map to chromosomes IV, II, and V, respectively. The trichomes of these mutants presented an increased DNA content, although to a variable extent. The spindly-5 mutant, which displays a constitutive gibberellin response, also produces overbranched trichomes containing more nuclear DNA. We analyzed genetic interactions using double mutants and propose that two independent pathways, defined by SPINDLY and TRIPTYCHON, act to limit trichome growth. KAKTUS and POLYCHOME might have redundant actions mediating gibberellin control via SPINDLY. The overall leaf polysomaty was not notably affected by these mutations, suggesting that they affect the control of DNA synthesis in a tissue- or cell type-specific manner. Wild-type tetraploids also produce overbranched trichomes; they displayed a shifted polysomaty in trichomes and in the whole leaf, suggesting a developmental program controlling DNA increases via the counting of endoreduplication rounds.

Screening methods for thyroid hormone disruptors

The U.S. Congress has passed legislation requiring the EPA to implement screening tests for identifying endocrine-disrupting chemicals. A series of workshops was sponsored by the EPA, the Chemical Manufacturers Association, and the World Wildlife Fund; one workshop focused on screens for chemicals that alter thyroid hormone function and homeostasis. Participants at this meeting identified and examined methods to detect alterations in thyroid hormone synthesis, transport, and catabolism. In addition, some methods to detect chemicals that bind to the thyroid hormone receptors acting as either agonists or antagonists were also identified. Screening methods used in mammals as well as other vertebrate classes were examined. There was a general consensus that all known chemicals which interfere with thyroid hormone function and homeostasis act by either inhibiting synthesis, altering serum transport proteins, or by increasing catabolism of thyroid hormones. There are no direct data to support the assertion that certain environmental chemicals bind and activate the thyroid hormone receptors; further research is indicated. In light of this, screening methods should reflect known mechanisms of action. Most methods examined, albeit useful for mechanistic studies, were thought to be too specific and therefore would not be applicable for broad-based screening. Determination of serum thyroid hormone concentrations following chemical exposure in rodents was thought to be a reasonable initial screen. Concurrent histologic evaluation of the thyroid would strengthen this screen. Similar methods in teleosts may be useful as screens, but would require indicators of tissue production of thyroid hormones. The use of tadpole metamorphosis as a screen may also be useful; however, this method requires validation and standardization prior to use as a broad-based screen.

The unhealthy lifestyle of people with schizophrenia

BACKGROUND

Schizophrenia has a high natural mortality of a largely environmental aetiology. There is, however, little research about possible risk factors. This study measured the diet, cigarette and alcohol use, exercise and obesity of a cohort of people with schizophrenia and compared results to general population rates.

METHODS

Semi-structured interview using validated research instruments on 102 middle-aged subjects with a diagnosis of schizophrenia, living in the community. Results were compared to general population norms using standard statistical tests.

RESULTS

The subjects ate a diet higher in fat and lower in fibre than the general population. They look little exercise but were not significantly more obese. They smoked heavily but drank less alcohol. Most differences remained significant after controlling for social class.

CONCLUSIONS

People with schizophrenia have an unhealthy lifestyle, which probably contributes to the excess mortality of the disease. They are therefore an appropriate target group for health promotion interventions.

Indirect evidence of human skeletal muscle damage and collagen breakdown after eccentric muscle actions

Indirect markers of muscle damage and collagen breakdown were recorded for up to 9 days after a bout of concentric, followed by a bout of eccentric, muscle actions. Nine untrained participants performed two bouts of 50 maximum effort repetitions on an isokinetic dynamometer (angular velocity 1.05 rad x s(-1), range of motion 1.75 rad). An initial concentric bout of muscle actions was followed by an eccentric bout 21 days later, using the same knee extensors. Concentric actions induced no changes in maximum voluntary isometric contraction force (MVC), nor induced any changes in the serum enzyme activities of creatine kinase, a lactate dehydrogenase isoenzyme (LDH-1), or alkaline phosphatase. Similarly, concentric actions induced no change in markers of collagen breakdown, namely plasma hydroxyproline and serum type 1 collagen concentration. In contrast, eccentric actions induced a 23.5+/-19.0% (mean+/-s) decrease in MVC immediately post-exercise (P < 0.05), and increased the serum enzyme activities of creatine kinase and LDH-1 to 486+/-792 and 90+/-11 IU.l(-1) respectively on day 3 post-exercise, and to 189+/-159 and 96+/-13 IU x l(-1) respectively on day 7 post-exercise (all P< 0.05). Eccentric actions induced no significant changes in plasma hydroxyproline, but increased collagen concentration on days 1 and 9 post-exercise (48.6% and 44.3% increases above pre-exercise on days 1 and 9 respectively; both P < 0.05). We conclude that eccentric but not concentric actions may result in temporary muscle damage, and that collagen breakdown may also be affected by eccentric actions. With caution, indices of collagen breakdown may be used to identify exercise-induced damage to connective tissue.