Functional interaction of HTLV-1 tax protein with the POZ domain of the transcriptional repressor BCL6

The Tax protein encoded by human T-cell leukaemia virus type 1 (HTLV-1) has a pivotal role in T-cell transformation by deregulating cellular signalling pathways. Using the yeast two-hybrid system to screen a human leukocyte cDNA library, we identified BCL6 (B-cell lymphoma 6) as a cellular protein, which interacts with Tax 1. The BCL6 gene encodes a sequence-specific transcriptional repressor that contains a conserved N-terminal poxvirus and zinc finger (POZ) repressor domain and a C-terminal Kruppel-like zinc finger DNA binding domain. Using both in vivo and in vitro methods, we demonstrate that the POZ domain of BCL6 is sufficient for its interaction with Tax 1. Using functional assays, we demonstrate that Tax 1 enhanced the repressive activity of BCL6 and increased the levels of apoptosis induced by BCL6 in osteosarcoma cells indicating that both proteins cooperate in vivo to cause a physiological affect. Furthermore, BCL6 recruited Tax 1 into punctate nuclear structures, which suggests that Tax 1 colocalizes with BCL6 in repressor complexes in vivo. BCL6 expression significantly downregulated both basal and Tax-induced nuclear factor-kappaB and long terminal repeat activation. This suggests that the expression of BCL6 in HTLV infected cells may contribute to the silencing of viral gene expression and to the long clinical latency associated with HTLV infection.

The acceptability of isoflavones as a treatment of menopausal symptoms: a European survey among postmenopausal women

OBJECTIVE

To investigate determinants of the acceptability of isoflavone products among postmenopausal women with regard to social and lifestyle factors, dietary habits, health concerns, food beliefs, menopausal symptoms and therapies, and to elucidate preferences for specific products.

METHODS

A consumer survey was conducted among postmenopausal women in four European countries (Germany, Denmark, Italy and the UK), including a total of 465 respondents.

RESULTS

The declared acceptability of isoflavones was highest in Germany (80%), followed by Italy (75%), the UK (59%) and Denmark (55%; p < 0.001). Among other factors, prior information about isoflavones (odds ratio (OR) 2.64, 95% confidence interval (CI) 1.54-4.51, p < 0.001) and belief that foods can be used to treat medical conditions (OR 2.18, 95% CI 1.17-4.05, p = 0.014) were the strongest predictors of potential acceptability. The preferred forms in which isoflavones might be taken differed markedly between countries.

CONCLUSIONS

Information about the health effects of isoflavones and health-diet links should be considered the most important factors in attempts to influence the potential acceptability of isoflavone products. Foods enriched with isoflavones need to be developed with regard to specific cultural demands in order to assure consumer acceptance on the marketplace.

Route of administration and adverse effects of amphetamine use among young adults in Sydney, Australia

The relationship between route of administration and the adverse effects of amphetamine use (dependence symptoms, treatment-seeking, adverse psychological symptoms and violence) were examined among 231 Australian amphetamine users, half of whom usually injected amphetamine. Although 87% of users were recruited from non-treatment sources, a third had experienced symptoms of dependence on amphetamine, and a third had experienced an amphetamine-related health problem for which one in four had sought medical attention. There was also a high prevalence of psychological symptoms, such as depression, anxiety, paranoia, hallucinations and violence which were related to frequency of amphetamine use, and use by injection. Amphetamine users need to be better informed about the potential adverse effects of amphetamine use, and about ways in which they can reduce their risks of experiencing these harms by avoiding injecting use, and the regular use of high doses of amphetamines.

The effectiveness of methadone maintenance treatment: an overview

This paper reviews the evidence for the effectiveness of methadone maintenance as used in the treatment of opioid dependence. Findings from randomized controlled trials and observational studies suggest that methadone maintenance reduces heroin use, crime, injection-related risk behaviours and premature mortality among people dependent on opioids. The research further suggests that two aspects of treatment are important in ensuring this effectiveness. Methadone treatment is more effective when higher doses (>50 mg) are employed and, overall, the evidence suggests that a treatment goal of successful maintenance on methadone rather than total abstinence is appropriate. The importance of ancillary services in treatment outcome is less clear and is the subject of current research and debate.

A summary of recommendations for the management of opioid dependence: the quality assurance in the treatment of drug dependence project*

This report presents outlines for approaches to intervening with opioid-dependent individuals. These recommendations are based on a review of the extant treatment-outcome literature, a survey of treatment practices used in Australia, and the views of a panel of experts. Recommendations for appropriate treatment goals, assessment, detoxification and intervention are made.

Geographical differences in risk-taking among Sydney methadone maintenance patients: a comparison of inner city and outer south western methadone maintenance patients

The study compared the demographic profiles, treatment factors, current drug use, injecting behaviour and psychological functioning of inner city (ICS) and south-west Sydney (SWS) methadone patients. A total of 104 patients from two clinics in the inner city, and 118 patients from two clinics in the outer south-western suburbs of Sydney were interviewed using a structured interview. SWS patients were more likely to be married or de facto, to have a regular sexual partner who was an injecting drug user, and to have children in their care. While they were no more likely to have recently injected, SWS patients were twice as likely to have recently shared a needle. While SWS patients were more likely to have had sex in the month preceding interview, ICS patients were more likely to have had more than one partner in that period. Patients from the south-western clinics were twice as likely to receive a diagnosis of antisocial personality disorder, and had poorer social functioning. The clinical implications of these differences are discussed.

What have population surveys revealed about substance use disorders and their co-morbidity with other mental disorders?

This paper reviews the epidemiology of alcohol and drug abuse and dependence as revealed in recent US general population surveys of the prevalence and correlates of mental disorders, the Epidemiologic Catchment Area (ECA) studies, and the National Comorbidity Study (NCS). These surveys indicate that mental disorders affect between a third and a half of people at some time in their lives, and around one in four in any year. Among the most common forms of mental disorder are phobias, alcohol use disorders, affective disorders and drug use disorders. There are marked gender differences in the prevalence of these disorders: substance use disorders and anti-social personality disorders predominate in men while affective and anxiety disorders predominate in women. The co-occurrence of substance use and other mental disorders is less common in the community than in the clinic because the presence of other mental disorders increases the chances of people with substance use disorders receiving specialist treatment. Only a minority of those with substance use and other mental disorders in the community are treated, with the more severe cases with multiple co-morbid mental disorders and manifest distress the most likely to be treated.

Alcohol and recreational drug use by HIV-seropositive homosexual men

The objectives of this study were to describe the patterns of alcohol and recreational drug use of HIV-seropositive homosexual men and to determine the effect of alcohol use on HIV risk-taking behaviour. Of particular interest was the effect of knowledge of HIV status on these behaviours. Information on alcohol and drug use was obtained from 485 HIV-seropositive homosexual and bisexual men presenting to a HIV-antibody testing and medical management clinic. Heavy alcohol use was common, with 46.2% reporting consumption of six or more standard drinks on one day recently. Men who knew that they were HIV infected drank significantly more than those men who had yet to learn of their HIV status at the time of interview. There was clear evidence in this study for a role of alcohol use in HIV risk-taking behaviour. Almost one-third (27%) of the HIV-seropositive men reported unprotected anal intercourse during the previous 3 months with approximately one-third of these (27/76, 35.5%) nominating alcohol as contributing to their high HIV-risk behaviour.

Characteristics of admissions to residential drug treatment agencies in New South Wales, 1988-92: I. Illicit drug problems

The Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with illicit drug problems over the years 1988-92. The mean age of admissions rose from 26.8 years to 27.9 years over the study period. There was a small increase in the proportion of male admissions to agencies (66.5% in 1988 to 69.9% in 1992). The proportion of admissions reporting opiates as their primary drug problem declined from 81% to 65%, while the proportion of admissions for stimulant problems doubled in that period (8% to 16%), as did those for cannabis (3.6% to 8.7%). There was a significant increase in the proportions of admissions who had drug problems of 10 or more years' standing (34.9-41.3%). The proportion of admissions that had never been in treatment decreased from 51% to 15% over the study period. Admissions with prior methadone experience rose from 37% to 69% between 1988 and 1992.

Benzodiazepine use among heroin users in Sydney: patterns of use, availability and procurement

A sample of 210 heroin users who had used benzodiazepines during the preceding 6 months were interviewed about their benzodiazepine use. Forty-one percent of the sample reported having used benzodiazepines more than once a week during the 6 months preceding interview. Forty-eight percent had injected benzodiazepines, with 17% having done so during the preceding 6 months. Eleven percent of the sample reported having experienced convulsions when attempting detoxification from benzodiazepines. The majority of subjects (86%) indicated that benzodiazepines are easy or very easy to obtain. Only a third of the sample reported obtaining benzodiazepines exclusively through a doctor in the last 6 months. Over a half of the sample indicated that they had given or sold benzodiazepines to someone during that time. Diazepam was considered by subjects to be the easiest benzodiazepine to procure. Doctors should avoid the prescription of benzodiazepines to injecting drug users, particularly the more readily injectable drug temazepam. Given the widespread use of benzodiazepines by injection, research needs to examine the harm associated with the parenteral use of these drugs.

Correlates of the perceived health risks of marijuana use among Australian adults

A quota sample of 3272 people from the Australian population was surveyed by telephone about the health risks of marijuana use. Three-fifths of the sample (62%) believed that there were health problems caused by marijuana use and one in four (27%) were uncertain. The most commonly cited health effects were: lung cancer, mental problems, memory loss and respiratory disease. The health risks of marijuana use were perceived to increase with increasing frequency of use, and to be greater when the user was a teenager rather than an adult. The perceived health risks of marijuana increased with age, were higher among women than men, decreased with increasing education and frequency and quantity of alcohol and were substantially lower among those who had used marijuana, and those who knew someone who had used marijuana.

Changes in the characteristics of clients admitted to an Australian therapeutic community, “The Buttery”, 1980-92

Data are presented on the characteristics of clients admitted to an Australian therapeutic community, The Buttery, between 1980 and 1992. The typical client was a 28-year-old male with a primary opioid drug problem complicated by polydrug use, particularly of alcohol and stimulants. Prior treatment experience was common, with one in three having been enrolled in methadone maintenance treatment. The average age of clients increased by about 7 months per year, and there was an increase in the prevalence of alcohol, stimulant and polydrug problems over the period of study. There was also an increase in the exposure of clients to methadone maintenance treatment prior to admission to the Buttery. Overall, the characteristics of patients in this drug-free treatment programme were strikingly similar to those observed among patients in methadone maintenance treatment over the same period.

Proinsulin peptide immunotherapy in type 1 diabetes: report of a first-in-man Phase I safety study

Immunotherapeutic strategies under consideration for type 1 diabetes include modification of the autoimmune response through antigen-specific routes. Administration of short peptides representing T cell epitopes targeted by patients with the disease represents one approach. This study evaluated safety and mechanistic outcomes during first-in-man intradermal administration of a human leucocyte antigen-DR4 (HLA-DR4)-restricted peptide epitope of proinsulin (C19-A3). This randomized, open-label study assessed two major theoretical risks of peptide immunotherapy, namely induction of allergic hypersensitivity and exacerbation of the proinflammatory autoimmune response, using clinical assessment and mechanistic assays in vitro. Patients with long-standing type 1 diabetes and HLA-DRB1*0401 genotype received 30 microg (n = 18) or 300 microg (n = 18) of peptide in three equal doses at 0, 1 and 2 months or no intervention (n = 12). Proinsulin peptide immunotherapy in the dosing regimen used is well tolerated and free from risk of systemic hypersensitivity and induction/reactivation of proinsulin-specific, proinflammatory T cells. Peptide-specific T cells secreting the immune suppressive cytokine interleukin (IL)-10 were observed at month 3 in four of 18 patients in the low-dose group (versus one of 12 in the control group; P = not significant). Mean IL-10 response to peptide in the low-dose group increased between 0 and 3 months (P = 0.05 after stimulation with 5 microM peptide in vitro) and then declined to baseline levels between 3 and 6 months (P = 0.01 at 10 microM peptide in vitro). These studies pave the way for future investigations in new-onset patients designed to examine whether proinsulin peptide immunotherapy has beneficial effects on markers of T cell autoimmunity and preservation of beta cell mass.

A qualitative study of parents' perceptions of a behavioural sleep intervention

BACKGROUND

A study, entitled Evaluation of an Intervention Aimed at Resolving Behavioural Sleep Problems in 6- to 12-month-old Infants: A Pilot Study, was undertaken to evaluate the efficacy of a behavioural sleep intervention. This descriptive qualitative study aimed to describe parents' perceptions of the sleep intervention and any burden associated with participating in the study.

METHODS

Fourteen of the 35 families who had participated in the quantitative study were interviewed. Respondents comprised well-educated, middle-class and mixed-ethnicity families. Data were collected through semi-structured interviews, with open-ended trigger questions, and were analysed using inductive content analysis.

RESULT

Nine themes, which subsumed a number of categories, were constructed. Parents changed their perspectives about sleep and parenting styles; they experienced many challenges and inadvertent benefits; and they welcomed a structured framework for assisting with sleep problems. The parents fitted intervention strategies into their realities; many factors interfered with their success; and their support systems and their expectations of the study varied.

CONCLUSION

These parents' previous education about normal infant sleep cycles and behavioural sleep problems was inadequate. The parents who were able to use the structured framework, flexible strategies and access to healthcare professionals for problem solving not only excelled in resolving their infants' sleep problems, but also gained confidence about their parenting skills and success.