Lithium chloride preconditioning optimizes skeletal myoblast functions for cellular cardiomyoplasty in vitro via glycogen synthase kinase-3beta/beta-catenin signaling

The benefits of skeletal myoblast (SkM) transplantation for cardiomyoplasty are limited due to their decreased functional integration with host cardiomyocytes and the poor survival of implanted cells in ischemic hearts. However, little success has been achieved with respect to the strategies aiming to improve the efficiency of SkM transplantation. In this study, we demonstrated that LiCl-preconditioned SkMs resulted in significantly increased connexin 43 (Cx43) expression and gap-junctional communication with cardiomyocytes. Vascular endothelial growth factor (VEGF) expression of SkMs was significantly upregulated in response to LiCl. Furthermore, hydrogen peroxide induced SkM apoptosis and increased caspase-3 expression, whereas LiCl inhibited SkM apoptosis, resulted in the decrease of caspase-3 expression and promoted SkM proliferation. These effects of LiCl were mediated by inactivating glycogen synthase kinase-3beta (GSK-3beta), stabilizing the effector protein beta-catenin and translocating it into the nucleus of SkMs, confirming that LiCl mimics canonical Wnt signaling. These findings suggest that LiCl preconditioning may be a novel strategy to optimize SkM function for cellular cardiomyoplasty in vitro.

[Multivariate analysis of impacting perinatal outcomes in preeclampsia]

OBJECTIVE

To discuss the influencing factors of perinatal outcomes in preeclampsia.

METHODS

Statistically the single factor analysis and multivariate logistic regression analysis were performed for 448 preeclamptic women.

RESULTS

There were 94 cases (21.0%) with had perinatal outcomes in 448 preeclamptic women, among which there were 41 perinatal death cases (9.2%). Single analyses showed that Onset gestation weeks, labor gestation weeks, subjective symptoms, convulsion, proteinuria degrees, edema, systolic pressure, diastolic pressure, white blood count, granulocyte count, urine protein quantity, plasma-albumin, lactate dehydrogenase, creatinine, antenatal care frequencies, hypertension (gestation weeks) and edema (gestation weeks) were correlated to bad perinatal Outcomes (P < 0.05). The logistic regression screened out such factors as labor gestation weeks (OR 0.583, 95% CI: 0.367-0.926), subjective symptoms (OR 9.315, 95% CI: 1.500-57.833) and proteinuria degrees (OR 3.394, 95% CI: 1.226-9.397), which would influence perinatal outcome in preeclampais.

CONCLUSION

Regular antenatal cares and extending gestation weeks may improve the perinatal Outcome in preeclampais.

[Expression and action of keratinocyte growth factor, keratinocyte growth factor receptor on CaSki cell]

OBJECTIVE

To investigate the expressions of keratinocyte growth factor (KGF), keratinocyte growth factor receptor (KGFR) in CaSki cell and action of keratinocyte growth factor on proliferation, migration of the CaSki cell.

METHODS

ELISA and Western blot methods were used to determine the protein expressions of the KGF and KGFR in CaSki cell respectively: 3H-Thymidine incorporation method was used to determine the effect of recombinant human KGF and anti-KGF on CaSki cell proliferation; Millicell-PCF was used to determine the effect of recombinant human KGF, anti-KGF on CaSki cell migration.

RESULTS

Both KGF and KGFR were expressing in the CaSki cell; Recombinant human KGF resulted in a increase in the proliferation and migration of CaSki cells; The proliferation and migration of CaSki cell became weak due to autocrine KGF neutralized by KGF antibodies (P < 0.05).

CONCLUSION

Current results demonstrate that KGF and KGFR express in CaSki cell; Both autocrine and recombinant human KGF have the effect on CaSki cell proliferation and migration.

Changes of CSF and spinal pathomorphology after high-concentration ozone injection into the subarachnoid space: an experimental study in pigs

BACKGROUND AND PURPOSE

Our aim was to explore the changes of CSF and spinal pathomorphology after high-concentration ozone injection into a pig's subarachnoid space.

MATERIALS AND METHODS

Eight experimental pigs were randomly divided into 4 groups (n=2 in each group). In groups A, B, C, and D, animals were sacrificed for pathology 1 day, 1 week, 1 month, and 3 months after the injection, respectively. Ozone (10 mL, 90 microg/mL) was injected along the lumbar 4-5 interspace into the subarachnoid space with a 21-ga Chiba needle under fluoroscopy. CSF collection and CT and MR imaging were performed before injection and 30 minutes, 1 week, 1 month, and 3 months after injection, respectively. The spinal cords were observed macroscopically and microscopically.

RESULTS

No serious behavior abnormalities were observed in any animals. There were no abnormalities in CSF and spinal cords pathologically and radiologically after injection.

CONCLUSION

Our initial study suggests that high-concentration ozone injection into a pig's subarachnoid space will not cause serious sequelae such as chemical arachnoiditis and necrosis of the spinal cord, and this finding provides evidence of the safety of ozone inadvertently injected into subarachnoid space in the clinical treatment of disk herniation.

[Expression of keratinocyte growth factor and keratinocyte growth factor receptor and its impact on Hela cells]

OBJECTIVE

To identify the expression of keratinocyte growth factor (KGF) and keratinocyte growth factor receptor (KGFR) in Hela cells and the impact of keratinocyte growth factor on Hela cells.

METHODS

Reverse transcriptase polymerase chainreaction (RT-PCR) method was employed to determine the gene expression of KGF and KGFR in Hela cells. The ELISA and Western blot methods were employed to determine the protein expression of the KGF and KGFR. The 3H-Thymidine incorporation method was employed to determine the impact of the KGF on the proliferation of Hela cells.

RESULTS

The KGF and KGFR genes were expressed in the Hela cells. The KGF and KGFR proteins were expressed in the Hela cells. The Hela cells were stimulated to proliferate by the recombinant human KGF. The proliferation of the autocrine KGF in the Hela cells was neutralized by the KGF antibodies significantly (Dunnett's test, P<O. 05).

CONCLUSION

KGF and KGFR are expressed in Hela cells. Both autocrine and recombinant human KGF has an impact on the proliferation of Hela cells.

[Homocysteine decreases the invasion in cultured human trophoblasts: relationship between homocysteine and matrix metalloproteinase-2, -9 expression]

OBJECTIVE

To test the hypothesis that homocysteine can decrease MMP-2 and MMP-9 expression in cultured trophoblasts of early pregnancy and that homocysteine can prevent trophoblasts invasion in the early stage of preeclampsia.

METHODS

Cytotrophoblasts from early pregnancy were isolated and cultured. Trophoblasts were treated with or without Hcy (1 mmol/L) for 48 hour, and real time RT-PCR and gelatin zymography were used to quantify the mRNA and protease activity of MMP-2, -9.

RESULTS

Treatment with Hcy (1 mmol/L) induced a decrease in MMP-2 mRNA by 21% and MMP-9 mRNA by 11%. At protein level MMP-2 expression decreased 14% and MMP-9 expression decreased 52% compared with control.

CONCLUSIONS

Homocysteine can decrease MMP-2, -9 expression in trophoblasts of early pregnancy and influence its invasion process.

Cytokine release from osteoblasts in response to ultrasound stimulation

Bone is a dynamic tissue with a well-balanced homeostasis preserved by both formation and resorption of bone. Normal turnover of bone, however, can be upset by either increased osteoclast activity or decreased osteoblast function; either mechanism alone or both may result in a net loss of bone. Both osteoclasts and osteoblasts could be stimulated by mechanical stimulation in vitro, and it is assumed that this process may occur in vivo as well. In this experiment, we investigated this hypothesis by examining the effects of ultrasound stimulation on osteoblast growth and cytokine release. With this model, we explored the mechanism of low-intensity pulsed ultrasound on osteoblasts growth and upregulation of osteoclasts formation and function by cytokine release. The results showed that specific pulsed ultrasound exposure could enhance osteoblasts population together with increase in TGFbeta1 secretion and decrease in concentration of IL-6 and TNFalpha in the culture medium. Although, animal studies and clinical trial are needed to understand the real process in the whole body, ultrasound stimulation might be a good method for prevention of bone loss due to osteoporosis.

Purification and characterization of White Spot syndrome virus (WSSV) produced in an alternate host: crayfish, Cambarus clarkii

Penaeid shrimp is the natural host of White Spot Syndrome Virus (WSSV) that can cause high mortality in the infected hosts. Attempts to obtain sufficient amounts of purified intact WSSV for characterization have been unsuccessful. Using crayfish, Cambarus clarkii as a proliferation system, a large amount of infectious WSSV was reproduced and intact WSSV viral particles were purified with a new isolation medium by ultra-centrifugation. Purified WSSV particles were very sensitive to organic solvents and the detergent, Triton X-100. The size of the rod-shape, somewhat elliptical, intact WSSV was 110-130x260-350 nm with a long, tail-like envelope extension. The naked viral nucleocapsid was about 80x350 nm, and it possessed 15 spiral and cylindrical helices composed of 14 globular capsomers along its long axis, and a 'ring' structure at one terminus. Distinct WSSV genome DNA patterns were obtained when the purified genomic dsDNA of WSSV was digested with five different restriction enzymes (HindIII, XhoI, BamHI, SalI, and SacI). In addition, at least 13 major and distinct protein bands could be observed when purified intact WSSV viruses were separated by SDS-PAGE followed by Coomassie Brilliant R-250 staining. The estimated molecular weights of these proteins were 190, 84, 75, 69, 68, 58, 52, 44, 28, 27.5, 23, 19, and 16 kD, respectively. Both the 44 and 190 kD proteins were easily removed if the hemolymph from the WSSV infected crayfish was transiently treated with 1% Triton X-100 before it was subjected to gradient centrifugation, indicating that both of them are located on the surface of the viral envelope. These characteristics are consistent with WSSV isolated from the penaeid shrimp.

Factors predicting the age when type 2 diabetes is diagnosed in Hong Kong Chinese subjects

OBJECTIVE

To examine the factors predicting age at diagnosis of type 2 diabetes in Hong Kong Chinese.

RESEARCH DESIGN AND METHODS

The relationships between age at diagnosis and parental history of diabetes as well as an array of clinical and metabolic factors were examined using a hospital clinic-based diabetes registry involving 3,414 index patients with type 2 diabetes Patterns of age at diagnosis in successive generations were also examined using 21 affected child-parent pairs and 7 affected child-parent-grandparent trios.

RESULTS

Approximately 29% of the index patients were diagnosed with type 2 diabetes at < or = 35 years of age (hereby defined as early-onset). Compared with the patients diagnosed at >35 years of age (hereby defined as late-onset) the early-onset patients had higher rates of positive paternal (16 vs. 5%) and maternal (22 vs. 12%) history of diabetes (both at P < 0.01) and had poorer metabolic profiles. In the overall index patients, male sex, higher HbA1c waist-to-hip ratio (WHR), and systolic blood pressure (sBP); lower HDL cholesterol level; and a positive paternal was well as maternal history of diabetes predicted younger age at diagnosis. More senior age and higher BMI and diastolic blood pressure predicted olderq age at diagnosis. Predictors for younger age at diagnosis in the male patients were higher HbA1c and sBP and a positive paternal history of diabetes Predictors for younger age at diagnosis in the female patients were higher HbA1c WHR, and sBP and a paternal as well as maternal history of diabetes. In the affected child parent pairs and clild-parent-grandparent trios there was a decrease in age at diagnosis in successive generations.

CONCLUSIONS

Our data indicate that both familial (possibly genetic) and metabolic factors affect the age of onset of type 2 diabetes in the Chinese population. The results also suggest an onset and progression pattern of the disease that is compatible with the phenomenon of anticipation.

The islet amyloid polypeptide (amylin) gene S20G mutation in Chinese subjects: evidence for associations with type 2 diabetes and cholesterol levels

BACKGROUND AND OBJECTIVES

There has been evidence that the S20G mutation in the islet amyloid polypeptide (amylin) gene may be associated with type 2 diabetes. In the present study, we investigated the distribution of the mutation in Hong Kong Chinese, and examined whether there was evidence for associations between the mutation and type 2 diabetes and/or metabolic profiles.

SUBJECTS AND METHODS

This study involved 227 early and 235 late-onset (defined as onset age < or = 40 and > 40 years, respectively) type 2 diabetic patients, as well as 126 nondiabetic subjects. The mutation was detected using a PCR-RFLP method.

RESULTS

We identified six (2.6%) and one (0.4%) patients heterozygous for the mutation from the early and late-onset groups, respectively (P = 0.05). None of the nondiabetic subjects had the mutation. Insulin deficiency and poor glycaemic control were not common findings amongst carriers of the mutation. In the early onset group, the patients with the mutation had lower plasma levels of total (4.3 +/- 0.9 mmol/l vs. 5.3 +/- 1.1 mmol/l, P = 0.02) and low density lipoprotein (LDL)-cholesterol (2.3 +/- 0.7 mmol/l vs. 3.2 +/- 0.9 mmol/l, P = 0.01) than those without the mutation.

CONCLUSIONS

Our data suggest that the islet amyloid polypeptide gene mutation might be associated with early occurrence of type 2 diabetes and lower plasma levels of total and low density lipoprotein-cholesterol in the Chinese population.

Familial early-onset type 2 diabetes in Chinese patients: obesity and genetics have more significant roles than autoimmunity

OBJECTIVE

We examined the prevalence of different forms of diabetes in Hong Kong Chinese patients with familial early-onset type 2 diabetes and compared their clinical features with patients with familial late-onset type 2 diabetes.

RESEARCH DESIGN AND METHODS

A total of 145 young patients with early-onset diabetes (age and age at diagnosis < or = 40 years) and a family history of diabetes were studied. They were screened for mutations in the genes encoding glucokinase, hepatocyte nuclear factor (HNF)-4alpha, and HNF-1alpha. The mitochondrial DNA A-->G at nucleotide 3243 (mt3243) and amyLin S20G mutations were studied, and antibodies to GAD (anti-GADs) were also examined.

RESULTS

The prevalence of putative diabetogenic gene mutations and autoimmune markers were 4% for glucokinase, 0% for HNF-4alpha, 5% for HNF-1alpha, 3% for mt3243, 2% for amylin 520G, and 4% for anti-GAD. Compared with late-onset patients, the patients with early-onset diabetes had a higher prevalence of a parental history of diabetes and were generally more obese. When classified by obesity indexes (BMI and waist circumference), the obese patients, especially those with early-onset diabetes, had a clustering of cardiovascular risk factors and increased rates of retinopathy and albuminuria. CONCLUSIONS; Genetic factors (up to 14%) and obesity (55%) play more significant roles than autoimmunity (4%) in familial type 2 diabetes in young Chinese patients. The significance of obesity-related genes and other gene-gene and gene-environment interactions in these young patients remains to be determined.

Diabetes in Hong Kong Chinese: evidence for familial clustering and parental effects

OBJECTIVE

To investigate transmission patterns of diabetes and their relationships with clinical characteristics in Hong Kong Chinese patients with late-onset (age > or =35 years) type 2 diabetes.

RESEARCH DESIGN AND METHODS

This study involved 2,310 patients consecutively selected from a hospital clinic-based diabetes registry. These patients all reported the diabetes status of their parents as well as siblings.

RESULTS

Approximately 36% of the 2,310 patients reported at least 1 affected parent or sibling (25 and 21% reported at least 1 diabetic parent and sibling, respectively). These patients, irrespective of their sex, were more likely to have a diabetic mother than a diabetic father (17 vs. 13% of the male patients and 18 vs. 9% of the female patients, P<0.01). The male patients were more likely than the female patients to have a diabetic father (13 vs. 9%, P<0.01). The female patients with a diabetic mother were found to have higher levels of plasma total cholesterol compared with the female patients with a diabetic father in multiple comparisons with adjustment for significance (5.56+/-1.30 vs. 5.09+/-0.95 mmol/l, P<0.05). In 2-group comparisons, there was also evidence that the male patients with a diabetic father had higher BMI values than the male patients with a diabetic mother (25.9+/-3.5 vs. 25.0+/-3.5 kg/m2, P<0.05).

CONCLUSIONS

We found familial clustering of diabetes in the Hong Kong Chinese population as well as a significant maternal influence and a male sex-specific paternal effect. We suggest that both maternal and paternal factors may be implicated in the development of type 2 diabetes in the Chinese population.

Treatment of Chinese acromegaly with a combination of bromocriptine and octreotide

BACKGROUND

Good results have been reported with combined use of octreotide and bromocriptine in acromegalic Caucasians. Data concerning the efficacy and tolerability of this combination treatment in Chinese acromegalic patients are scanty.

AIM

The aim of this study was to assess the efficacy and tolerability of combined therapy using bromocriptine and octreotide in the treatment of acromegaly in Chinese patients and to compare the cost-effectiveness of various regimes.

METHODS

Sixteen Chinese acromegalic patients with growth hormone (GH) concentration not suppressible to below 5 mU/L (2 microg/L) during an extended OGTT were recruited to undergo four phases of the study. During the study period, the patients were given bromocriptine alone, bromocriptine and low dose octreotide, bromocriptine and medium dose octreotide, and medium dose octreotide alone. Plasma concentrations of GH and insulin-like growth factor-1 (IGF-1) were measured before and after the completion of each phase.

RESULTS

The number of patients reaching target GH concentrations was significantly higher when treated with octreotide compared to baseline (p<0.05). Bromocriptine alone had a significant effect but not to the extent of octreotide alone. A combination of low dose octreotide and bromocriptine is as efficacious in the treatment of acromegaly as high dose octreotide. None of the patients suffered from serious adverse effects.

CONCLUSION

The results confirmed the usefulness and tolerability of bromocriptine and octreotide in Chinese acromegalics. The most cost-effective regime in this study was a combination of low dose octreotide and bromocriptine.

Mitochondrial DNA A3243G mutation in patients with early- or late-onset type 2 diabetes mellitus in Hong Kong Chinese

BACKGROUND AND OBJECTIVES

The mitochondrial DNA A to G mutation at nucleotide 3243 (mt3243) is associated with a subtype of diabetes characterized by maternal transmission and deafness. We have previously reported a 2.7% prevalence of this mutation in a cohort of young patients with either type 1 or type 2 diabetes. In this study, we aimed to confirm this finding by examining for the prevalence of this mutation in a large-scale study.

SUBJECTS AND METHODS

Nine hundred and six unrelated Chinese patients with type 2 diabetes and 213 nondiabetic controls were studied. The presence of mt3243 mutation was determined by polymerase chain reaction amplification and ApaI digestion.

RESULTS

This mutation was found in four of 133 (3.0%) patients with early onset (</= 40 years) diabetes who also had a positive maternal family history, and in one of 348 (0.3%) patients with late-onset (> 40 years) diabetes and no family history. Basal pancreatic beta-cell function, as assessed by fasting plasma C-peptide, was variable amongst mutation carriers, and did not correlate with the level of heteroplasmy of mutation.

CONCLUSIONS

In agreement with most studies, our results suggest that despite the high prevalence of positive maternal family history of diabetes amongst our type 2 diabetic patients, mt3243 mutation was not a major cause of diabetes in either early- or late-onset diabetic patients in Hong Kong. The role of other genetic, environmental and intrauterine factors needs further investigation.

Young Chinese adults with new onset of diabetic ketoacidosis--clinical course, autoimmune status and progression of pancreatic beta-cell function

AIMS

To examine the clinical course, autoimmune status and pancreatic beta cell function, over a 2-year period, in young Chinese subjects newly presenting with diabetic ketoacidosis (DKA).

METHODS

A prospective study involving 562 out of 27,893 patients who were admitted to the medical ward with a principal diagnosis of diabetes mellitus during the recruitment period of 1 year.

RESULTS

Of these 562 patients, 27 were aged less than 35 years and admitted with a diagnosis of DKA and 11 (six males and five females) of these were newly diagnosed. Antibodies to glutamic acid decarboxylase (GAD) were present in five patients. Anti-ICA 512 was not detected in any of the patients. Basal and post-glucagon stimulated plasma C-peptide remained in the insulin-deficient range although showing improvement at 2 years.

CONCLUSIONS

These findings confirm the relative rarity of autoimmune Type 1 diabetes in young Chinese. Even when the clinical presentation takes the extreme form of acute DKA, less than 50% have positive autoimmune markers.

Glycaemic control in type 2 diabetes: the impact of body weight, beta-cell function and patient education

We examined the determinants of glycaemic control in a consecutive cohort of 562 newly-referred Chinese type 2 diabetic patients (57% women) during a 12-month period. All patients underwent a structured assessment with documentation of clinical and biochemical characteristics. Pancreatic beta-cell function was assessed by fasting plasma C-peptide concentration. Insulin deficiency was defined as fasting plasma C-peptide <0.2 pmol/ml. Insulin resistance (IR) was calculated using the homeostasis model assessment (HOMA) based on a product of fasting plasma glucose and insulin concentrations. Treatment was considered appropriate when insulin-deficient patients were treated with insulin and non-insulin-deficient patients were treated with oral agents or diet. Mean (+/-SD) age was 54.3+/-13.8 years (range 17-87 years) and disease duration was 5.0+/-5.9 years. At the time of referral, 70.5% (n=396) were on drug therapy (9% on insulin and 62.8% on oral agents), 20.6% (n=116) were on diet and 9% (n=50) had not received any form of treatment. The mean HbA(lc) was 8.4+/-2.3%. The geometric mean (x// antilog SD) of IR was 4.62x//2.51 (range 0. 63-162.7) and correlated only with waist : hip ratio (WHR, p=0.008). The geometric mean of plasma C peptide was 0.47x//2.89 nmol/l and correlated with BMI (p<0.001). Glycated haemoglobin was correlated positively with age (p=0.013), disease duration (p<0.001), IR (p<0. 001) and negatively with BMI (p<0.001). Glycated haemoglobin was lower in patients who had seen a dietitian (7.9% vs. 8.7%, p<0.001) or diabetes nurse (7.8% vs. 8.7%, p<0.001) or who performed self blood glucose monitoring (7.9% vs. 8.6%, p=0.001) and higher among smokers (8.9% vs. 8.2%, p=0.003). Compared to insulin-deficient patients (n=118), non-insulin-deficient patients (n=413) had features resembling that of the Metabolic Syndrome with increased WHR (p=0.005), blood pressure (p<0.001), BMI (p=0.001) and were older (p=0.04). Amongst the insulin-deficient patients, 27% were treated with oral agents or diet. Patients receiving appropriate therapy (n=362) had a lower HbA(lc) than those treated inappropriately (n=173) (8.2% vs. 8.7%, p=0.02). On multivariate analysis, short disease duration (p<0.001), low IR (p<0.001), high BMI (p=0.001), diabetes education (p<0.001), lack of smoking (p=0. 014) and choice of appropriate treatment (p=0.009) were the independent determinants of good glycaemic control.

Spontaneous necrosis of parathyroid adenoma: biochemical and imaging follow-up for two years

We report a patient with a biochemically and radiologically confirmed parathyroid adenoma, which underwent spontaneous resolution by necrosis. The patient was followed-up over the subsequent two years during which time the tumour and hypercalcaemia recurred. Sequential radiological and biochemical changes at the time of diagnosis, spontaneous necrosis and recurrence are documented fully.

Molecular genetics of diabetes mellitus in Chinese subjects: identification of mutations in glucokinase and hepatocyte nuclear factor-1alpha genes in patients with early-onset type 2 diabetes mellitus/MODY

AIMS

To examine the prevalence of identified MODY-related genes in Chinese subjects with early onset Type 2 diabetes mellitus and a positive family history of diabetes and to look for possible associations between the gene mutations and the development of diabetes.

METHODS

Ninety-two unrelated Chinese subjects with diabetes diagnosed before the age of 40 years who had a positive family history of diabetes were screened for mutations in hepatocyte nuclear factors (HNF-1alpha and HNF-4alpha) and glucokinase genes by direct sequencing. The family members of patients with mutations and 100 healthy controls were also examined.

RESULTS

Mutations in the HNF-1alpha and the glucokinase genes were found in 5% and 3% of the diabetic subjects, respectively but no mutations were found in the coding region of the HNF-4alpha gene. Three mutations found in the glucokinase gene were novel missense mutations (I110T, A119D and G385V). The mutations in the HNF-1alpha gene were also new and included four missense mutations (G20R, R203H, S432C, I618M) and one splice acceptor site mutation (IVS2nt-1G-->A). Patients with mutations in these genes were clinically heterogeneous with respect to phenotype and basal pancreatic beta cell function.

CONCLUSIONS

Genetic factors such as mutations in the HNF-1alpha and glucokinase genes may be important in the development of diabetes in Chinese people, especially when the disease is of early onset.

Plasma insulin, growth hormone, cortisol, and central obesity among young Chinese type 2 diabetic patients

OBJECTIVE

To examine the relationships between central obesity, insulin resistance index, plasma insulin, growth hormone (GH), and cortisol concentrations in 90 young Chinese type 2 diabetic patients (aged 33+/-5 years) and 104 age- and sex-matched control subjects (aged 32+/-9 years).

RESEARCH DESIGN AND METHODS

Young Chinese diabetic patients (aged <40 years) were recruited from the Prince of Wales Hospital. Blood pressure, height, weight, and waist and hip circumferences were determined. Venous blood was sampled for measurements of fasting plasma glucose, HbA1c, lipids, creatinine, insulin, GH, and cortisol. A 24-h urine was assayed for urinary albumin excretion (UAE). General and central obesity was represented by BMI and waist circumference, respectively. Insulin resistance index was estimated as a product of fasting plasma insulin and glucose concentrations.

RESULTS

Compared with control subjects, diabetic patients were more obese, hyperglycemic, and had worse lipid profile, higher blood pressures, UAE, insulin resistance index, plasma insulin, and cortisol concentrations (all P < 0.001) but lower GH concentrations (P < 0.05). When analyzed as a whole group (n = 194), increasing quartiles of waist circumference were associated with increasing trends of insulin resistance index, plasma insulin, and cortisol concentrations (all P < 0.01) but a decreasing trend of plasma GH concentration (P < 0.05). Using stepwise multiple regression analysis, waist circumference was only associated with sex variable (being higher in men) in the control subjects. In the diabetic group, 51% of waist circumference was independently related to male sex and increased plasma insulin and cortisol concentrations as well as reduced plasma GH levels.

CONCLUSIONS

In young Chinese type 2 diabetic patients, hyperinsulinemia, hypercortisolemia, and reduced plasma GH levels were closely associated with central obesity. Based on these findings, we postulate that maladaptive hormonal responses to rapid changes in lifestyle may have led to obesity and type 2 diabetes in these young patients. Alternatively, lifestyle-related obesity may have given rise to these hormonal changes. More studies are required to delineate the nature of these relationships.

A heterogeneously structured composite based on poly(lactic-co-glycolic acid) microspheres and poly(vinyl alcohol) hydrogel nanoparticles for long-term protein drug delivery

PURPOSE

To prepare a heterogeneously structured composite based on poly (lactic-co-glycolic acid) (PLGA) microspheres and poly(vinyl alcohol) (PVA) hydrogel nanoparticles for long-term protein drug delivery.

METHODS

A heterogeneously structured composite in the form of PLGA microspheres containing PVA nanoparticles was prepared and named as PLGA-PVA composite microspheres. A model protein drug, bovine serum albumin (BSA), was encapsulated in the PVA nanoparticles first. The BSA-containing PVA nanoparticles was then loaded in the PLGA microspheres by using a phase separation method. The protein-containing PLGA-PVA composite microspheres were characterized with regard to morphology, size and size distribution, BSA loading efficiency, in vitro BSA release, and BSA stability.

RESULTS

The protein-containing PLGA-PVA composite microspheres possessed spherical shape and nonporous surface. The PLGA-PVA composite microspheres had normal or Gaussian size distribution. The particle size ranged from 71.5 microm to 282.7 microm. The average diameter of the composite microspheres was 180 microm. The PLGA-PVA composite microspheres could release the protein (BSA) for two months. The protein stability study showed that BSA was protected during the composite microsphere preparation and stabilized inside the PLGA-PVA composite microspheres.

CONCLUSIONS

The protein-containing PLGA-PVA composite may be suitable for long-term protein drug delivery.

Comparative DNA cross-linking by activated pyrrolizidine alkaloids

The toxicity and bioactivity of pyrrolizidine alkaloids (PAs), common constituents of hundreds of plant species, and in herbal remedies and folk medicines prepared thereof, are probably due to their ability to form DNA cross-linking. We investigated DNA cross-linking activity by chemically-activated PAs from four different structural classes in Madin-Darby bovine kidney (MDBK) cells and in pBR322 DNA. In cell culture, alpha,beta-unsaturated macrocyclic diester pyrroles dehydrosenecionine (DHSN), dehydroriddelliine (DHRD) and the saturated macrocyclic diester pyrrole dehydromonocrotaline (DHMO) were significantly more potent cross-linkers than the simple necine base (retronecine) and an N-oxide (indicine N-oxide; INO) as determined by alkaline elution. The proportion of total DNA cross-links that were proteinase K-resistant (DNA-DNA cross-links) induced by the various pyrroles ranged from 0.08 (DHRN) to 0.67 (DHSN). Those pyrroles that were potent cross-linkers of cellular DNA also cross-linked, in a dose-dependent manner, Bam HI-digested pBR322 DNA as assessed by a gel retardation assay. The possible functional relevance of pyrrole-DNA cross-links was determined by their ability to interrupt PCR amplification of a 1.129 kb segment of pBR322. Dehydrosenecionine completely inhibited amplification, while DHMO was of intermediate potency, while DHRN and INO had no effect. Taken together, these studies suggest that structural features, most notably the presence of a macrocyclic diester, confer potent cross-link activity to PAs. In any event, DNA-DNA cross-linking is probably biologically relevant as indicated by their interference with DNA replication.

Poly(vinyl alcohol) nanoparticles prepared by freezing-thawing process for protein/peptide drug delivery

Poly(vinyl alcohol) (PVA) hydrogel nanoparticles have been prepared by using a water-in-oil emulsion technology plus cyclic freezing-thawing process. The PVA hydrogel nanoparticles prepared by this method are suitable for protein/peptide drug delivery since formation of the hydrogel does not require crosslinking agents or other adjuvants and does not involve any residual monomer. Particularly, there is no emulsifier involved in this new method. Bovine serum albumin (BSA), as a model protein drug, is incorporated into the PVA hydrogel nanoparticles. The PVA hydrogel nanoparticles possess a skewed or log-normal size distribution. The average diameter of the PVA hydrogel nanoparticles is 675.5+/-42.7 nm. Protein drug loading efficiency in the PVA hydrogel nanoparticles is 96.2+/-3.8%. The PVA hydrogel nanoparticles swell in an aqueous solution and the swelling degree increases with the increase of temperature. In vitro release studies show that the BSA release from the nanoparticles can be prolonged to 30 h. The BSA release follows a diffusion-controlled mechanism. The number of freezing-thawing cycle and release temperature both influence BSA release rate considerably. Less freezing-thawing cycle or higher release temperature leads to faster drug release. The BSA is stable during preparation of the PVA hydrogel nanoparticles.