Morphine synergizes with lipopolysaccharide in a chronic endotoxemia model

Emergent or elective surgical procedures may be complicated by sepsis, resulting in critical illness that can lead to organ failure and death. The opioid drug, morphine is widely used to alleviate pain in post-surgical patients; however, it is well documented that chronic treatment of mice with morphine affects the proliferation, differentiation and function of immune cells. Thus, morphine might be expected to exacerbate the effects of sepsis, which also compromises the immune system. To test this notion, we investigated the effect on several immune functions of a clinical dose of morphine (4 mg/kg) superimposed upon a lipopolysaccharide (LPS)-induced infection model. Our results show that this relatively low dose of morphine, though generally having no effects on immune parameters by itself, significantly augmented LPS responses. A clinical dose of morphine (4 mg/kg body weight) superimposed upon an animal model of sepsis resulted in a significant increase in mortality at 48 h. In the absence of the drug, most septic animals died after 96 h. Phenotypic responses such as, decreased thymic cellularity, compromised mitogenic response and inhibition of IL-2 synthesis that are evident at 48-72 h after LPS injection appear as early as 24 h in animals that receive morphine in addition to LPS. In addition, our results show that in T cells there is a shift from TH1 type cytokine elaboration to a TH2 type cytokine elaboration in animals that receive both LPS and morphine.

Automatic detection of left ventricular contours from cardiac cine magnetic resonance imaging using fuzzy logic

RATIONALE AND OBJECTIVES

Gated cardiac cine magnetic resonance imaging provides accurate dynamic data of the left ventricular function. However, the manual extraction of important physiologic parameters such as myocardium wall thickness and left ventricular volumes is invariably time consuming and subjective. To reduce the variability and time constraints inherent in observer contour tracing, the authors developed an automatic left ventricle contour-detection method.

METHODS

The purpose was to apply fuzzy logic-based automatic contour detection to identification of endocardial and epicardial borders in short-axis magnetic resonance images. The automatic contouring was compared with manual tracing using the calculated ejection fraction as the comparison criterion.

RESULTS

A good correlation was found between the two approaches (r2 = 0.98).

CONCLUSIONS

The ejection fraction can be obtained using this automatic contouring method.

Stereoselective synthesis of novel cyclopropyl analogues of known cysteine protease inhibitors

Efficient synthesis of two novel analogues of some known protease inhibitors, via the isosteric replacement of oxirane/aziridine moiety of the parent compounds by cyclopropane ring, is described.

A phosphorylation-induced major structural change in the N-terminal domain of the P protein of Chandipura virus

It has previously been shown that phosphorylation of P protein of vesicular stomatitis virus as well as Chandipura (CHP) virus is required for transcription activation and replication switch. The structural nature of this crucial conformational change, however, is largely unknown. We have studied the phosphorylation-associated conformational change in the P protein of Chandipura (CHP) virus using chemical modification, fluorescence, and circular dichroism spectroscopy. Sulfhydryl groups of unphosphorylated CHP-P protein are unreactive to DTNB under nondenaturing conditions. Upon phosphorylation, one sulfhydryl group becomes reactive. We have identified this sulfhydryl group as cysteine 57. The two tryptophan residues (105 and 135) become significantly more buried in the phosphorylated protein. Circular dichroism spectra show significant enhancement in the far-UV region upon phosphorylation. Anisotropy decay of AEDANS-labeled C57 CHP-P protein shows rapid rotation of the probe, suggesting significant mobility of the N-terminal domain in the phosphorylated P protein. The results suggest a global conformational change in the N-terminal domain of the P protein is induced by phosphorylation and yet the phosphorylated N-terminal domain shows significant flexibility.

The effects of cadmium on the hepatic and renal levels of reduced glutathione, the activity of glutathione S-transferase and gamma glutamyl transpeptidase

Cadmium chloride, injected subcutaneously in mice at doses of 1.0, 1.5, and 2.0 mg/Kg body weight, resulted in the alteration of body weight and relative liver and kidney weights, the hepatic and renal reduced glutathione levels, and the activity of the enzymes glutathione S-transferase and gamma-glutamyl transpeptidase in a dose-dependent manner. Body weight increased insignificantly with dosage, but significant elevations in relative liver weight (29% of control) and particularly in kidney weight (93% of control) were documented in the cases that received the highest dose of cadmium chloride (2.0 mg/Kg body weight). The treatment significantly lowered hepatic and renal reduced glutathione levels and glutathione S-transferase activity. On the other hand, the gamma-glutamyl transpeptidase activity was found to increase significantly after treatment, with the highest values in the liver (137% of control) and in the kidneys (204% of control). We found that cadmium chloride at 2.0 mg/Km body weight produced the greatest changes in the abovementioned parameters. A significant correlation (r) was observed in some cases among the abovementioned biomolecules between, as well as within, the organs. The present study showed that the effects of cadmium could be correlated with a decreased level of reduced glutathione and glutathione S-transferase activity and an increased activity of gamma-glutamyl transpeptidase in liver and kidney.

Infectivity and attenuation of Leishmania donovani promastigotes: association of galactosyl transferase with loss of parasite virulence

During the course of long-term in vitro cultivation of Leishmania donovani parasites, the promastigotes were found to lose their infectivity. Lectin agglutination studies revealed that there is an up-regulation of terminally exposed galactose residues on the noninfective promastigotes. The enzyme galactosyl transferase was absent in the infective form but present in the non-infective form of the parasites. An association between galactosylation and loss of infectivity was also observed. We propose that the enzyme galactosyl transferase is developmentally regulated and induces galactosylation of surface carbohydrates.

Flow cytometric determination of cellular thiols

Several biochemical techniques are based on chromatography or electrophoresis for the determination of thiols from biological samples. These techniques are indispensable for the accurate and sensitive detection of specific thiols. Flow cytometric determination of cellular thiols is a powerful technique that is perhaps best suited for clinical application, particularly for cells in blood or other body fluids. Information can be obtained from a small sample amount with a relatively little and quick sample treatment. This technique offers an unique advantage to study the thiol status of a subset of cells because data are collected from individual cells. Multiparameter flow cytometry allows the study of different subsets of immunotyped cells. A major drawback of the flow cytometric method is the lack of specificity for the determination of distinct thiols. The reaction between MBB and thiols is not specific for any particular intracellular thiol, although almost all of the entire thiol-reacted bimane emission is specific for thiols in general. This limitation can be partly overcome by the treatment of cells with known thiol regulatory agents as described in the section on the differential assessment of cellular thiols.

Immunoprophylaxis and immunotherapy against experimental visceral leishmaniasis

The ability of the Leishmanial parasite, UR6 (MHOM/IN/1978/UR6) to act as a immunoprophylactic and immunotherapeutic agent against experimental visceral leishmaniasis in a hamster model was tested. The Leishmanial parasite, UR6, lacked LPG but possessed abundant message for kinetoplastid membrane protein-11 (KMP-11), and failed to induce visceral infection when given through the intracardiac route, unlike the virulent Leishmania donovani, AG83 (MHOM/IN/1983/AG83), the causative agent of Kala-azar. Priming of macrophage with UR6 in vitro, induced superoxide (O2-) generation whereas a similar experiment with virulent AG83 inhibited O2- generation. This observation prompted us to test the efficacy of UR6 as a immunoprophylactic and immunotherapeutic agent. It was observed that priming of hamsters with either live or sonicated UR6 in the absence of any adjuvant provided strong protection against subsequent virulent challenge. The UR6 mediated protection was also observed in hamsters having established infection. Furthermore, UR6 primed infected hamsters displayed a greatly extended life span as compared to infected hamsters. To our knowledge, this is the first report concerning the use of an atypical Leishmanial parasite, UR6 in immunoprophylaxis and immunotherapy in the absence of any adjuvant.

mu-Opioid receptor-knockout mice: the role of mu-opioid receptor in gastrointestinal transit

The role of mu-opioid receptor in gastrointestinal transit was investigated using mu-opioid receptor knockout mice (MOR-KO). Our result establishes unequivocally that inhibition of GI transit by morphine is a mu-opioid receptor mediated function. In addition, we show that neither delta nor kappa receptor agonist given supraspinally or peripherally are able to inhibit GI transit in MOR-KO animals. It was interesting to observe that basal GI motility was lower in MOR-KO (-/-) compared to heterozygous (+/-) and wild type (+/+) animals.

even-skipped determines the dorsal growth of motor axons in Drosophila

Axon pathfinding and target choice are governed by cell type-specific responses to external cues. Here, we show that in the Drosophila embryo, motorneurons with targets in the dorsal muscle field express the homeobox gene even-skipped and that this expression is necessary and sufficient to direct motor axons into the dorsal muscle field. Previously, it was shown that motorneurons projecting to ventral targets express the LIM homeobox gene islet, which is sufficient to direct axons to the ventral muscle field. Thus, even-skipped complements the function of islet, and together these two genes constitute a bimodal switch regulating axonal growth and directing motor axons to ventral or to dorsal regions of the muscle field.

Mass spectral study of substituted allyl aryl and allyl alkyl selenides and some analogous sulfides

The electron impact (EI) mass spectra of allyl aryl selenides showed abundant molecular ions and many fragment ions containing the selenium atom. alpha-Cleavage is the dominant process in the fragmentation of selenides, and cleavage product ions are characteristic of the substituents. In the case of 3-methyl allyl and related aryl selenides, characteristic delta-hydrogen migration to the selenium atom is observed. A McLafferty-type rearrangement is found in benzyl allyl selenides and substituted alkyl allyl selenides. The charge on the rearrangement products preferably remains on the fragments containing the phenyl group. The [M - SeH](+), [M - CH(3)](+) and [M - C(2)H(4)](+) ions are found only in the EI mass spectrum of allyl phenyl selenide, and are attributed to a Claisen rearrangement in the source of the mass spectrometer. All structurally informative fragmentation processes are supported by collision induced dissociation spectra of molecular ions. The fragmentation patterns found in methane chemical ionization (CI) spectra of the selenides were significantly different from those observed in EI. The EI and CI mass spectra of analogous sulfides showed similar behaviour to that observed in the corresponding selenides. Copyright 1999 John Wiley & Sons, Ltd.

High expression of human 15-lipoxygenase induces NF-kappaB-mediated expression of vascular cell adhesion molecule 1, intercellular adhesion molecule 1, and T-cell adhesion on human endothelial cells

Expression of 15-lipoxygenase (15-LO) is induced over 100-fold in early fatty streak lesions. 15-LO activity leads to the production of specific lipid hydroperoxides, which can have major effects on the expression of proinflammatory genes involved in atherogenesis. We have used retrovirus-mediated gene transfer to achieve stable high expression of 15-LO in human endothelial ECV304 cells. These cells were used to study the effects of 15-LO on the expression of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1), activation of nuclear factor kappa B (NF-kappaB), and T-cell adhesion on endothelial cells. NF-kappaB activation was greatly potentiated by increased 15-LO activity in the stably transduced cells, and both VCAM-1 and ICAM-1 were significantly induced in these cells in response to tumor necrosis factor-alpha (TNF-alpha) and phorbol 12-myristate 13-acetate (PMA) stimulation, as studied by flow cytometry. The induction of ICAM-1 was sensitive to antioxidants in a dose-dependent manner. The adherence of Jurkat T cells on the 15-LO-expressing endothelial cells was markedly induced after PMA stimulation. These results indicate that 15-LO activity may be involved in the early pathogenesis of atherosclerosis by inducing VCAM-1 and ICAM-1 expression and by increasing T-cell adhesion on the endothelium.

Association of vitamin D receptor genotype with leprosy type

Host genetic factors including major histocompatibility complex (MHC) polymorphisms influence both susceptibility to leprosy per se and also to leprosy type. Non-MHC genes may play an important role, but such genes remain undefined. The influence of two non-MHC candidate genes was assessed in a case-control study of Bengali leprosy patients from Calcutta. Recent studies have implicated variation in the vitamin D receptor (VDR) gene in susceptibility to several diseases, including osteoporosis and pulmonary tuberculosis. In this population, homozygotes for the alternate alleles of the VDR polymorphism are associated, respectively, with lepromatous and tuberculoid leprosy. The NRAMP1 (natural resistance associated macrophage protein 1) gene may influence human mycobacterial disease susceptibility based on studies with the murine homologue Nramp1. However, no significant association was found between NRAMP1 and leprosy susceptibility. This study suggests that the VDR polymorphism may influence susceptibility to some diseases by affecting the type and the strength of the host immune response.

An apyrase from Mimosa pudica contains N5,N10-methenyl tetrahydrofolate and is stimulated by light

An apyrase (NTP/NDPase) implicated in the response of Mimosa pudica to stimuli, such as touch, has been cloned, sequenced and expressed in Escherichia coli. While purifying and characterizing this enzyme, it was observed that a chromophore is associated with it, having absorption in the ultraviolet-A/blue region of the spectrum. The absorbance maximum of the chromophore, purified from the enzyme complex by gel filtration and HPLC, is around 350 nm. The chromophore has been identified as N5,N10-methenyl tetrahydrofolate (MTHF) by comparing the excitation and emission spectra of synthetic MTHF and the isolated cofactor, and by reconstitution of the enzyme complex with synthetic MTHF. Upon excitation with light (350 nm), an increase of apyrase activity was observed in the purified or reconstituted holoenzyme but not in the apoenzyme. The wavelength dependence of the light stimulation matched well with the fluorescence excitation spectra of the cofactor, MTHF. Possible implications of the results for signal transduction in M. pudica have been discussed.

E1A-induced processing of procaspase-8 can occur independently of FADD and is inhibited by Bcl-2

Expression of the 243-residue form of the adenovirus E1A protein in the absence of other viral proteins triggers apoptosis by a pathway that requires p53. This pathway includes processing and activation of initiator procaspase-8, redistribution of cytochrome c, and activation of procaspase-3. Bcl-2 functions at or upstream of procaspase-8 processing to inhibit all of these events and prevent cell death. This contrasts with the anti-apoptotic influence of Bcl-2 family proteins in the cell death pathway induced by Fas ligand or tumor necrosis factor (TNF), in which Bcl-2 typically acts downstream of Fas/TNFR1-mediated activation of caspase-8. Moreover, E1A induces procaspase-8 processing and cell death in cells deleted of FADD, an adaptor protein critical for Fas/TNFR1 activation of caspase-8. The results indicate that E1A is capable of activating caspase-8 by a Bcl-2-inhibitable pathway that does not involve autocrine stimulation of FADD-dependent death receptor pathways.

Treatment of acute gynecologic infections with trovafloxacin. Trovafloxacin Surgical Group

BACKGROUND

Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovafloxacin with that of cefoxitin, an approved drug for treatment of acute gynecologic infections, together with amoxicillin/clavulanic acid as oral follow-on treatment.

METHODS

Patients with a clinical diagnosis of acute pelvic infection received either intravenous alatrofloxacin with oral trovafloxacin follow-on (trovafloxacin) or a combined regimen of cefoxitin followed by amoxicillin/clavulanic acid for a maximum of 14 days. The primary endpoint was clinical response to therapy on follow-up at day 30.

RESULTS

Clinical success rates were comparable between the trovafloxacin (n = 107) and comparative (n = 119) groups at study end (90% vs. 86%, respectively; 95% confidence interval, -4.5, 12.5). Among clinically evaluable patients, clinical success rates for infections involving Enterococcus species were higher with trovafloxacin than with the comparative regimen at the end of treatment (96% and 85%) and at study end (96% and 86%).

CONCLUSION

Intravenous alatrofloxacin followed by oral trovafloxacin for a maximum of 14 days of total therapy was efficacious in the treatment of acute pelvic infections.

Oral trovafloxacin compared with intravenous cefoxitin in the prevention of bacterial infection after elective vaginal or abdominal hysterectomy for nonmalignant disease. Trovafloxacin Surgical Group

BACKGROUND

Trovafloxacin is a new fourth-generation fluoroquinolone whose pharmacokinetics and in vitro activity suggest that it is well suited for antibiotic prophylaxis in elective hysterectomy.

METHODS

In a randomized, double-blind, multicenter study, parallel groups of women 18 years of age or older received either 200 mg trovafloxacin by mouth and intravenous (i.v.) placebo or 2 g cefoxitin by i.v. infusion and placebo by mouth before elective vaginal or abdominal hysterectomy for nonmalignant disease.

RESULTS

In the 103 and 97 patients in the trovafloxacin and cefoxitin groups, respectively, who were evaluable for efficacy, the prophylactic success rates at hospital discharge (96% in both groups) and 30 +/- 6 days after hysterectomy (88% and 91% in the trovafloxacin and cefoxitin groups, respectively) were statistically equivalent. Both antibiotics were well tolerated.

CONCLUSION

A single oral 200 mg dose of trovafloxacin is as effective and safe as a standard cefoxitin parenteral regimen in the prevention of primary bacterial infection after elective vaginal or abdominal hysterectomy for nonmalignant disease.

Outpatient anesthesia in oral and maxillofacial surgery

An integral part of the specialty of oral and maxillofacial surgery is intra-operative anxiety and pain control with the use of inhalation and intravenous agents. The safety of these agents when used by trained practitioners and staff in properly equipped facilities is well-documented. The purpose of this article is to review the most common sedative agents currently used in the oral and maxillofacial surgery outpatient setting.

X-ray analysis of a complex of Escherichia coli uracil DNA glycosylase (EcUDG) with a proteinaceous inhibitor. The structure elucidation of a prokaryotic UDG

Uracil-DNA glycosylase (UDG), a key highly conserved DNA repair enzyme involved in uracil excision repair, was discovered in Escherichia coli . The Bacillus subtilis bacteriophage, PBS-1 and PBS-2, which contain dUMP residues in their DNA, express a UDG inhibitor protein, Ugi which binds to UDG very tightly to form a physiologically irreversible complex. The X-ray analysis of the E. coli UDG ( Ec UDG)-Ugi complex at 3.2 A resolution, leads to the first structure elucidation of a bacterial UDG molecule. This structure is similar to the enzymes from human and viral sources. A comparison of the available structures involving UDG permits the delineation of the constant and the variable regions of the molecule. Structural comparison and mutational analysis also indicate that the mode of action of the enzyme from these sources are the same. The crystal structure shows a remarkable spatial conservation of the active site residues involved in DNA binding in spite of significant differences in the structure of the enzyme-inhibitor complex, in comparison with those from the mammalian and viral sources. Ec UDG could serve as a prototype for UDGs from pathogenic prokaryotes, and provide a framework for possible drug development against such pathogens with emphasis on features of the molecule that differ from those in the human enzyme.

Binding of peptides in solution by the Escherichia coli chaperone PapD as revealed using an inhibition ELISA and NMR spectroscopy

PapD is the prototype member of a family of periplasmic chaperones which are required for assembly of virulence associated pili in pathogenic, gram-negative bacteria. In the present investigation, an ELISA has been developed for evaluation of compounds as inhibitors of PapD. Synthetic peptides, including an octamer, derived from the C-terminus of the pilus adhesin PapG were able to inhibit PapD in the ELISA. Evaluation of a panel of octapeptides in the ELISA, in combination with NMR studies, showed that the peptides were bound as extended beta-strands by PapD in aqueous solution. The PapD-peptide complex was stabilized by backbone to backbone hydrogen bonds and interactions involving three hydrophobic peptide side chains. This structural information, together with previous crystal structure data, provides a starting point in efforts to design and synthesize compounds which bind to chaperones and interfere with pilus assembly in pathogenic bacteria.