HLA-A, HLA-B, HLA-DRB1 allele and haplotype frequencies in 6384 umbilical cord blood units and transplantation matching and engraftment statistics in the Zhejiang cord blood bank of China

Umbilical cord blood (UCB) is a widely accepted source of progenitor cells, and now, many cord blood banks were established. Here, we analysed the HLA-A, HLA-B and HLA-DRB1 allele and haplotype frequencies, HLA matching possibilities for searching potential donors and outcome of UCB transplantations in Zhejiang cord blood bank of China. A total of 6384 UCB units were characterized for 17 HLA-A, 30 HLA-B and 13 HLA-DRB1 alleles at the first field resolution level. Additionally, B*14, B*15 and B*40 were typed to the second field level. A total of 1372 distinct A-B-DRB1 haplotypes were identified. The frequencies of 7 haplotypes were more than 1%, and 439 haplotypes were <0.01%. A*02-B*46-DRB1*09, A*33-B*58-DRB1*03 and A*30-B*13-DRB1*07 were the most common haplotypes, with frequencies of 4.4%, 3.3%, and 2.9%, respectively. Linkage disequilibrium(LD) analysis showed that there were 83 A-B, 106 B-DRB1, 54 A-DRB1 haplotypes with positive LD, in which 51 A-B, 60 B-DRB1, 32 A-DRB1 haplotypes exhibited a significant LD (P < 0.05). In 682 search requests, 12.9%, 40.0% and 42.7% of patients were found to have 6 of 6, 5 of 6 and 4 of 6 HLA-A, HLA-B and HLA-DRB1 matching donors, respectively. A total of 30 UCB units were transplanted to 24 patients (3 patients not evaluated due to early death); 14 of 21 patients (66.7%) engrafted. This study reveals the HLA distribution and its transplantation application in the cord blood bank of Zhejiang province. These data can help to select potential UCB donors for transplantation and used to assess the scale of new cord blood banking endeavours.

Variations in circulating sex steroid levels in metastatic prostate cancer patients with combined androgen blockade: observation and implication

Testosterone is the major precursor of estradiol (E2) in men. We hypothesized that, in metastatic prostate cancer, androgen deprivation therapy suppression of serum androgen to the castration level may also disrupt serum E2 level, and variation in serum E2 level might play a role in the development of castration-resistant prostate cancer. Our investigation was designed to observe the variation in circulating oestrogen and androgen levels in metastatic prostate cancer patients after combined androgen blockade, and to explore the possible clinical significance. We recruited 105 consecutive metastatic prostate cancer patients who were treated with combined androgen blockade from June to August 2011, and divided them into three groups according to different hormone-sensitivity status, including 58 hormone-sensitive prostate cancers, 27 after failure of first-line hormone therapy (androgen-independent prostate cancer) and 20 castration-resistant prostate cancers. Another 36 consecutive patients with treatment-naive metastatic prostate cancer during the same period were used as controls. Serum testosterone, E2 and E2/testosterone (E2/T) ratio were analysed and compared between the groups. After combined androgen blockade, testosterone was suppressed to a low level, regardless of different hormone sensitivity (p > 0.05). Mean serum testosterone was 4.07, 0.15, 0.11 and 0.09 ng/mL in treatment-naive, hormone-sensitive, androgen-independent and castration-resistant prostate cancer respectively. For each group, mean E2 was 33.06, 9.23, 9.13 and 15.05 pg/mL respectively. Mean E2/T was 9.58, 269.29, 292.06 and 996.67 respectively. Recovery of E2 and increased E2/T ratio were more significantly associated with combined androgen blockade failure, especially in castration-resistant prostate cancer (p < 0.001). This study indicated that metabolism of oestrogen might change during combined androgen blockade in metastatic prostate cancer patients, and oestrogen-related pathways might play a role in the development of castration-resistant prostate cancer.

Overexpression of the DMP1 C-terminal fragment stimulates FGF23 and exacerbates the hypophosphatemic rickets phenotype in Hyp mice

Dentin matrix protein-1 (DMP1) or phosphate-regulating gene with homologies to endopeptidases on the X chromosome (PHEX) inactivation results in elevation of the phosphaturic hormone fibroblast growth factor (FGF)-23, leading to hypophosphatemia, aberrant vitamin D metabolism, and rickets/osteomalacia. Compound mutant Phex-deficient Hyp and Dmp1(ko) mice exhibit nonadditive phenotypes, suggesting that DMP1 and PHEX may have interdependent effects to regulate FGF23 and bone mineralization. To determine the relative importance of DMP1 and PHEX in regulating FGF23 and mineralization, we tested whether the transgenic expression of full-length [Dmp1(Tg(full-length))] or C-terminal Dmp1 [Dmp1(Tg(57kDa))] could rescue the phenotype of Hyp mice. We found that Dmp1(ko) and Hyp mice have similar phenotypes characterized by decreased cortical bone mineral density (-35% vs. wild type, P < 0.05) and increased serum FGF23 levels (~12-fold vs. wild type, P < 0.05). This was significantly corrected by the overexpression of either the full-length or the C-terminal transgene in Dmp1(ko) mice. However, neither of the transgenes rescued the Hyp mice phenotype. Hyp/Dmp1(Tg(full-length)) and Hyp mice were similar, but Hyp/Dmp1(Tg(57 kDa)) mice exhibited worsening of osteomalacia (-20% cortical bone mineral density) in association with increased serum FGF23 levels (+2-fold) compared with Hyp mice. Bone FGF23 mRNA expression was decreased and a 2-fold increase in the ratio of the full-length/degraded circulating FGF23 was observed, indicating that degradation of FGF23 was impaired in Hyp/Dmp1(Tg(57 kDa)) mice. The paradoxical effects of the C-terminal Dmp1 transgene were observed in Hyp/Dmp1(Tg(57 kDa)) but not in Dmp1(Tg(57 kDa)) mice expressing a functional PHEX. These findings indicate a functional interaction between PHEX and DMP1 to regulate bone mineralization and circulating FGF23 levels and for the first time demonstrate effects of the C-terminal DMP1 to regulate FGF23 degradation.

Conditional survival in patients treated with vascular endothelial growth factor-targeted therapy for advanced renal cell carcinoma

PURPOSE

Conditional survival (CS) offers more relevant prognostic information for patients once they have survived for some time. The objective of this study was to determine the CS for advanced renal cell carcinoma (RCC) patients treated with vascular endothelial growth factor-targeted therapy.

METHODS

A total of 345 patients treated between 2006 and 2011 fulfilled the inclusion criteria and were reviewed for analyses. The 1-year conditional and actual survival rates were calculated for survivors from treatment to month 24. Subgroup-specific CS rates were generated after adjustment of the covariate influence. The Cox proportional hazard models were used to assess the prognostic factors at baseline and 1-year landmark.

RESULTS

The probabilities of surviving an additional year given survival to 6, 12, 18, and 24 months were 72.2, 76.3, 78.2, and 78.6 %, respectively. Remarkable increase in CS was observed in patients initially classified as intermediate or poor risk according to Heng risk groups. For patients survived 24 months after treatment, the adjusted CS for the following year was over 80 % regardless of initial risk attribution. Compared to baseline analysis, Heng risk groups were less predictive of survivorship after surviving 1 year. The addition of disease control status to multifactorial model significantly improved survival estimation for 1-year survivors (p < 0.01).

CONCLUSIONS

CS provides useful information regarding life expectancy for survivors of advanced RCC treated with targeted therapy. Furthermore, disease control status within a specific period of time is critical to the prediction of subsequent survival.

Age-dependent alterations of HLA-DR expression and effect of lipopolysaccharide on cytokine secretion of peripheral blood mononuclear cells in the elderly population

HLA-DR, a major histocompatibility complex, MHC class II, is involved in several autoimmune conditions, disease susceptibility and disease resistance. Here, we investigate the impact of different age individuals on HLA-DR expression on peripheral blood mononuclear cells (PBMCs) induced by lipopolysaccharide (LPS). The results indicate that HLA-DR expression on PBMCs in the population aged above 70 years significantly increased as compared with that in the lower-age groups by flow cytometry analysis (B-D; r = 0.690, P = 0.000265). In addition, followed by LPS stimulation, the levels of cytokine TNF-α, IL-6 and IL-10 secretion by allogeneic T lymphocytes from different age groups (A-D) were significantly increased (P < 0.05). Notably, levels of TNF-α and IL-6 were significantly reduced in groups B, C and D as compared with group A (P < 0.05), whereas levels of IL-10 increased (P = 0.012). However, no significant difference in PBMC-secreted TNF-α, IL-6 and IL-10 levels was observed among groups A, B, C and D (P > 0.05) before LPS stimulation. We firstly present data showing an age-dependent increase in HLA-DR expression in the population aged above 70 years and the individual with aged above 70 years has reduced the secretion of inflammatory mediators (TNF-α and IL-6) by PBMCs and increased the secretion of anti-inflammatory cytokine (IL-10) after LPS stimulation in vitro. The better understanding of HLR-DR expression on human PBMCs in aged individuals and its relation to the host cellular immunity would provide important insights into the immunity of aged individuals and particularly, in elderly patients with sepsis.

Loss of macrophage migration inhibitory factor impairs the growth properties of human HeLa cervical cancer cells

OBJECTIVES

  This study aims to determine the role of macrophage migration inhibitory factor (MIF), a proinflammatory cytokine associated with cell proliferation and tumour growth in vivo.

MATERIALS AND METHODS

  Our team used RNA interference technology to knock down MIF expression in human HeLa cervical cancer cells and to establish a stable cell line lacking MIF function.

RESULTS

  Our results showed that long-term loss of MIF had little effect on cell morphology, but significantly inhibited their population growth and proliferation. The HeLa MIF-knockdown cells retained normal apoptotic signalling pathways in response to TNF-alpha treatment; however, they exhibited unique DNA profiles following doxorubicin treatment, suggesting that MIF may regulate a cell cycle checkpoint upon DNA damage. Our data also showed that knockdown of MIF expression in HeLa cells led to increased cell adhesion and therefore impaired their migratory capacity. More importantly, cells lacking MIF failed to either proliferate in soft agar or form tumours in vivo, when administered to nude mice.

CONCLUSION

  MIF plays a pivotal role in proliferation and tumourigenesis of human HeLa cervical carcinoma cells, and may represent a promising therapeutic target for cancer intervention.

Aberrant FoxM1B expression increases matrix metalloproteinase-2 transcription and enhances the invasion of glioma cells

We recently showed that FoxM1 is overexpressed in human glioblastomas and that forced FoxM1B expression in anaplastic astrocytoma cells leads to the formation of highly invasive glioblastoma multiforme (GBM) in nude mice. However, the molecular mechanisms by which FoxM1 enhances glioma invasion are unknown. In this study, we found that FoxM1 overexpression increased matrix metalloproteinase (MMP)-2 expression in glioma cells, whereas blockade of FoxM1 expression suppressed MMP-2 expression. Transfection of FoxM1 into glioma cells directly activated the MMP-2 promoter, whereas inhibition of FoxM1 expression by FoxM1-siRNA suppressed its activation. We identified a FoxM1-binding site in the MMP-2 promoter and demonstrated that FoxM1 protein bound directly to it. Mutation of this FoxM1-binding site significantly attenuated MMP-2 promoter activity. Furthermore, FoxM1 overexpression increased the invasiveness of glioma cells, whereas inhibition of FoxM1 expression suppressed the invasiveness of GBM cells. Inhibition of MMP-2 by a specific MMP-2 inhibitor reversed the invasive phenotype of glioma cells overexpressing FoxM1. Finally, immunohistochemical analysis of 45 human GBM specimens showed a significant correlation between FoxM1 overexpression and elevated MMP-2 expression. Collectively, these findings provide evidence that FoxM1 contributes to glioma progression by enhancing MMP-2 gene transcription and thus tumor-cell invasion.

The 44 kDa Pim-1 kinase directly interacts with tyrosine kinase Etk/BMX and protects human prostate cancer cells from apoptosis induced by chemotherapeutic drugs

Protein kinase Pim-1 has been implicated in the development of hematopoietic and prostatic malignancies. Here, we present the evidence that two isoforms, the 44 and 33 kDa Pim-1, are expressed in all human prostate cancer cell lines examined. The subcellular localization of human 44 kDa Pim-1 is primarily on the plasma membrane, while the 33 kDa isoform is present in both the cytosol and nucleus in PCA cells. The 44 kDa Pim-1 contains the proline-rich motif at the N-terminus and directly binds to the SH3 domain of tyrosine kinase Etk. Such interaction leads to the activation of Etk kinase activity possibly by competing with the tumor suppressor p53. This is corroborated by the fact that overexpression of the 44 kDa Pim-1 in prostate cancer cells confers the resistance to chemotherapeutic drugs. Our results suggest that these two isoforms of Pim-1 kinase may regulate distinct substrates and the 44 kDa Pim-1 may play a more prominent role in drug resistance in prostate cancer cells.

[Analysis of molecular karyotype of Leishmania isolates from hilly foci and plain foci of China]

AIM

To analyse the molecular karyotypes of Leishmania isolates from hilly and plain foci of China.

METHODS

Pulsed field gel electrophoresis(PFGE) was performed in 1% agarose at 6 V/cm in 0.5 x TBE at 14 degrees C with a pulse time of 60 s for 15 h and a pulse time 90 s for 9 h.

RESULTS

Each isolate was resolved into 15 different EtBr-staining bands ranging in size from 200 to 2,200 kb, in which the karyotypes of 6 isolates from hilly foci were similar (including karyotypes of canine isolates similar with those of human isolates), and they were partly similar with those of L. infantum. The karyotypes of the two isolates from plain foci were similar, but the isolates from the two topographically different foci were different from each other.

CONCLUSION

Homology exists between L. d. isolates from hilly foci and plain foci respectively, and exists in part between L. d. isolates from hilly foci and L. infantum; while heterogeneity exists between L. d. isolates from hilly foci and plain foci. The reservoir host, domestic dog, plays an important role as the infection source of leishmaniasis in the hilly foci of China.

[Tumor targeted expression of adenovirus mediated CDglyTK gene regulated by irradiation via Egr-1 promoter]

OBJECTIVE

To construct adenoviral vecter of AdEgr-CD/TK in which CDglyTK gene was driven by Egr-1 promoter, and control the tumor targeted expression of CDglyTK gene by gamma irradiation so as to observe the effects of gene-radiotherapy of liver cancer.

METHODS

Adenoviral vector of AdEgr-CD/TK was generated through homologous recombination in bacteria. The expression of CDglyTK gene in MM45T. Li cells infected with AdEgr-CD/TK and exposed to different doses of gamma irradiation were analyzed, and the relative survival rate of the cells in presence of prodrugs 5-FC and GCV was tested. In addition, the tumor suppression effects of different treatments were investigated in 64 mice bearing liver cancer by observing the size of tumor at interval of four days.

RESULTS

In vitro experiment showed that gamma irradiation markedly and dose-dependently induced CDglyTK expression in MM45T. Li tumor cells, and significantly enhanced the sensitivity of MM45T. Li cells infected with AdEgr-CD/TK to prodrugs 5-FC or GCV resulting in cell being killed (P < 0.01). A synergetic cytotoxic effect was found when both 5-FC and GCV were added. In vivo experiment revealed that, compared with other control treatments, intratumoral injection of AdEgr-CD/TK combined with intraperitoneal injection of GCV + 5-FC and TLI obviously suppressed tumor growth (P < 0.01), with 30% of the tumor eradicated completely while without causing the increase of whole body cytotoxic effect.

CONCLUSION

Tumor targeted expression of CDglyTK gene under the control of irradiation represents a novel strategy for safe and effective gene therapy of cancer and might have wide application in the future.

[Changes in cyclin expression during proliferation and differentiation of CD34(+) cells derived from fetal liver induced by thrombopoietin]

In order to elucidate the intrinsic mechanism underlying proliferation and differentiation of megakaryocytes during ontogenesis, CD34(+) cells were isolated from human fetal liver (FL) with a high-gradient magnetic sorting system (MACS) and were incubated in liquid suspension with 50 and 100 ng/ml of thrombopoietin (TPO) and in MegaCult(Tm) -C semi-solid culture system with 0, 12.5, 25, 50, 100, and 200 ng/ml of TPO. The cell number, colony number of CFU-Mk, platelet-associated antigen phenotype, and DNA ploidy of CD41(+) cells were examined from d 0 to d 12 in culture. The expression patterns of cyclins B1, D1, and D3 were also analyzed by using immunoblot and flow cytometry. TPO stimulated proliferation of CD34(+) cells of FL from 1 x 10(5)/ml to 13.12 +/-4.06 10(5)/ml with 95% of CD41a(+) cells and 3% of CD34(+) cells after 12 d of culture. Most of the megakaryocytes (MKs) derived from FL were in 2 N ploidy class, and few in 4 N ploidy class, but no megakaryocytes ploidy class was higher than 4 N. The effect of TPO on the formation of CFU-Mk colonies from FL derived CD34(+) cells is shown in a dose-response curve. The expression of cyclin B1 increased progressively and the high level of cyclin B1 was maintained in FL CD34(+) cells induced by TPO during 12 d of culture. A high level of cyclin B1 appeared on FL derived MKs of G1 phase at d 12. The expression of cy-of cyclins D1 and D3 gradually increased in FL CD34(+) cells, which was induced by TPO during the initial 6-day incubation. Afterwards, the level of cyclins D1 and D3 decreased progressively, particularly in MKs which were in G2+M phases. These data suggest that (1) TPO induced proliferation and differentiation of FL derived CD34(+) cells through upregulation of cyclin B1 in G2+M phases and cyclins D1 and D3 in all phases of cell cycle, and (2) Continuing high level of cyclin B1 and decreases of cyclins D1 and cyclin D3 on MKs in G2+M phases may contribute to a retardation of MK endoreduplication.

[One stage otoplasty treatment for congenital malformations of the auricle and middle ear]

OBJECTIVE

To investigate the application of one stage otoplasty for congenital atresia of the external acoustic canal and malformations of the middle ear and the auricle.

METHOD

Patients with the ear malformations were given surgical reconstruction of one stage otoplasty. The auricle was reconstructed with the rib which was encapsulated with the superthin temporal flap. According to the malformations of the middle ear in patients, I style tympanoplasty and III style tympanoplasty were carried out respectively. All patients were performed myringoplasty with temporal fascia and reconstructed the external acoustic canal with full thickness skin-grafting.

RESULT

A long term follow-up (4-6 years) demonstrated that 11 ears were survival of which 8 ears figuration were ideal. The hearing improvement was observed in all patients.

CONCLUSION

One stage otoplasty is effective for treatment of the congenital malformations of the external and middle ear.

Identification of a novel cis element required for cell density-dependent down-regulation of insulin-like growth factor-2 P3 promoter activity in Caco2 cells

The activity of the exogenous, full-length insulin-like growth factor-2 (IGF-2) P3 promoter is significantly up-regulated during the logarithmic growth phase but rapidly declines in confluent CaCo2 cells undergoing differentiation. Nuclear run-on assays confirmed cell density-dependent regulation of endogenous P3 promoter. To identify regulatory elements in the P3 promoter that may be required for regulating cell density-dependent transcriptional activity, we used the methods of promoter truncation, electrophoretic mobility shift assay, DNase footprinting, and mutation analysis. The relative activity of the full-length (-1229/+140) and truncated (-1090/+140) promoter was identical, being approximately 19, 27, 7, and 3% of pSV-luc activity on days 3, 5, 7, and 9 of cell culture, respectively. However, truncation to -1048 resulted in complete loss of cell density-dependent down-regulation of P3 promoter activity on days 7 and 9, suggesting the presence of regulatory elements between -1091 and -1048 sequence. Further stepwise truncation to -515 did not change promoter activity. Truncation to -138/+140 resulted in complete loss of promoter activity, suggesting that the core promoter was within the -515/-138 segment. A 14-base pair footprint (-1084/-1070) was identified by DNase footprinting within the distal -1091/-1048 segment. Electrophoretic mobility shift assay with wild type and mutant probes confirmed the presence of a novel 7-base pair (CGAGGGC) (-1084/-1078) cis element (P3-D); its mutation abolished binding. Functionality of P3-D cis element was confirmed by measuring the activity of core P3 promoter ligated to distal P3 segment containing either the mutant or wild type P3-D element. We have, therefore, identified a novel cis element, P3-D, that appears to play a critical role in regulating IGF-2 P3 promoter activity in a cell density/differentiation-dependent manner.

Recording of spared motor evoked potentials and its augmentation by 4-aminopyridine in chronic spinal cord-injured rats

OBJECTIVE

To research the direct electrophysiological evidence of discomplete spinal cord injury (SCI) and the effect of 4-aminopyridine on it.

METHODS

Motor evoked potentials (MEPs), both spinal cord recorded MEPs (scMEPs) and extracellularly recorded MEPs (exMEPs) were recorded and characterized on a T13 epidural electrode (scMEPs) and an extracellular microelectrode (exMEPs) for 10 normal rats and 40 rats with lesions of various severity (sham, 35 g.cm force (gcf), 70 gcf, 100 gcf impact injury) at the T8-T9 cord using the Allen's drop model. The incline plane and Tarlov techniques were used to assess clinical neurological function.

RESULTS

MEPs in the normal rats were elicited by applying transcortical suprathreshold stimulation consisting of 3-4 early negative peaks (N1, N2, N3 and N4) followed by several late waves. The N1 and N2 peaks were largest in the anterior and ventrolateral funiculus, respectively, which was indicative of extrapyramidal pathways. The 100 gcf impact injuries and the cord transection abolished the MEP distal to the lesion, whereas the 35 gcf injuries resulted in a latency shift and amplitude decrement of the MEP peaks. Eighteen of the 20 rats with 70 gcf-injuries showed clinical paraplegia. Among them, 7 rats had neurophysiological evidence of residual conduction pathways through the lesioned cord segment, such as the presence of N1 and N2 peaks in the scMEPs or exMEPs. After 4-aminopyridine (4-AP) administrations (1 mg/kg), the amplitude of the spared exMEP increased significantly and spread more widely.

CONCLUSIONS

MEPs evoked by transcortical stimulation travel mostly in the extrapyramidal tract. MEP monitoring could provide an excellent method of detecting the functional integrity of the motor tracts after SCI, and could even detect spared motor fibers after discomplete SCI. Furthermore, the use of 4-AP or other K+ channel blocking agents may be a potential treatment for patients with chronic moderate to severe SCI.

Autocrine gastrins in colon cancer cells Up-regulate cytochrome c oxidase Vb and down-regulate efflux of cytochrome c and activation of caspase-3

Suppression of the gastrin gene in human colon cancer cells by stably expressing antisense (AS) gastrin RNA results in significant growth suppression of AS cells. To understand mechanisms mediating the growth effects of autocrine gastrins, differential expression of transcripts by AS and control (C) clones of a representative cell line (HCT-116) was analyzed to identify target genes of autocrine gastrins. Six differentially expressed transcripts were confirmed and sequenced. Of these, the RNA and protein levels of cytochrome c oxidase (COX) Vb were significantly higher in C versus AS cells. The expression of COX Vb by colon cancer cells was proportional to the expression of gastrin. Higher levels of COX Vb coprecipitated with cytochrome c in the mitochondria of C versus AS cells. Treatment of mitochondria with digitonin resulted in a 2-fold higher release of cytochrome c from AS versus C mitochondria. As a corollary, the cytosolic levels of cytochrome c were significantly higher in AS versus C cells, which correlated with approximately 2- and approximately 3-fold higher activation of caspase-9 and -3, respectively, in AS versus C cells in response to camptothecin. Thus, autocrine gastrins may support growth/survival of cells by up-regulating COX Vb, which may decrease the sensitivity of the cancer cells to apoptotic stimuli by increasing retention of cytochrome c in mitochondria.