Irinotecan or oxaliplatin combined with 5-fluorouracil and leucovorin as first-line therapy for advanced colorectal cancer: a meta-analysis

BACKGROUND

To compare clinical efficacy and toxicity of irinotecan combined with 5-fluorouracil and leucovorin with those of oxaliplatin combined with 5-fluorouracil and leucovorin as first-line therapy for advanced colorectal cancer.

METHODS

Literature search was performed by keywords "irinotecan", "oxaliplatin" and "colorectal cancer" on all randomized controlled trails reported on irinotecan versus oxaliplatin combined with 5-fluorouracil and leucovorin as first-line therapy for advanced colorectal cancer in MEDLINE, OVID, Springer, Cochrane Controlled Trials Register (CCTR) and CBMdisc (Chinese Biology and Medicine disc) before January 2010. Two authors drew the details of trial design, characteristics of patients, outcomes, and toxicity from the studies included. Data analysis was performed by RevMan 4.2.

RESULTS

According to the screening criteria, 7 clinical studies with 2095 participants of advanced colorectal cancer were included in this meta analysis. The baseline characteristics of irinotecan group were similar to those of oxaliplatin group. The response rate of oxaliplatin group was higher than that of irinotecan group (relative risk (RR) = 0.82, 95% confidence interval (95%CI) (0.70, 0.96), P = 0.01), and the median overall survival of oxaliplatin group was longer by 2.04 months than that of irinotecan group (95%CI (-3.54, -0.54), P = 0.008). In the comparison of grade 3 - 4 toxicity between the two groups, the incidences of nausea, emesis, diarrhoea and alopecia in irinotecan group were higher than those in oxaliplatin group (RR = 1.94, 95%CI (1.22, 3.09), P = 0.005; 1.71, 95%CI (1.34, 2.18), P < 0.001; 14.56, 95%CI (4.11, 51.66), P < 0.0001), respectively. However, the incidence of neurotoxicity, neutropenia and thrombocytopenia in irinotecan group were lower than those in oxaliplatin group (RR = 0.06, 95%CI (0.03, 0.14), P < 0.00001; 0.70, 95%CI (0.55, 0.91), P = 0.006; 0.18, 95%CI (0.05, 0.61), P = 0.006), respectively.

CONCLUSIONS

Both irinotecan and oxaliplatin combined with 5-fluorouracil and leucovorin were effective in the first-line therapy of advanced colorectal cancer. However, the combined regimen of oxaliplatin plus 5-fluorouracil and leucovorin is more excellent. Irinotecan tended to result in more gastrointestinal tract reactions than oxaliplatin did, but the myelosuppression and neurotoxicity were more frequent in oxaliplatin regimen than irinotecan regimen.

Numb regulates meiotic spindle organisation in mouse oocytes

Numb is an adaptor protein that controls the fate of cells in different species through asymmetrical inheritance by sibling cells during division. It has been investigated extensively in mitosis, mostly in neural progenitor cells, but its function in meiosis remains unknown. The present study was designed to investigate the expression, subcellular localisation and functional roles of Numb during mouse oocyte meiotic maturation. Using real-time polymerase chain reaction and western blotting, we found that the expression of Numb increased from the germinal vesicle (GV) to MII stages. Immunofluorescent staining revealed that Numb was mainly concentrated in the GV before meiosis resumption, aggregated in the vicinity of the chromosomes after GV breakdown and then localised to the spindle poles from prometaphase I to MII. Nocodazole treatment resulted in spindle destruction and Numb diffusion into the cytoplasm. However, Numb appeared at the spindle poles again once the spindles had formed when nocodazole-treated oocytes were washed and cultured for spindle recovery. Depletion of Numb by RNA interference resulted in chromosome misalignment, spindle deformation and even doubled spindle formation. Our results suggest that Numb is critical for spindle organisation during mouse oocytes meiosis. The present study provides evidence of a new function for Numb in addition to its action as a cell fate-determining factor.

Visualization of the Orai1 homodimer and the functional coupling of Orai1-STIM1 by live-cell fluorescence lifetime imaging

The Orai1-STIM1 constructed store-operated Ca2+ channels (SOCs) have been found to exert several essential Ca2+ entry/signaling cascades, e.g., the generation of immune response in T lymphocytes. Although biochemical and novel imaging evidence appear to indicate that Orai1 and STIM1 interact with each other to achieve store-operated Ca2+ entry (SOCE), the detailed mechanism of functional SOCE in situ has yet to be fully understood. In this study, green fluorescence protein (EGFP as donor) targeted to either the N- or C-terminal of Orai1 (wild type or delta1-90+delta267-301 double deletion type) and mOrange (as acceptor) tagged STIM1 were used to comprise a fluorescence resonance energy transfer (FRET) pair within living PC12 cells. The fluorescence lifetime map and histogram/distribution of each single cell, determined by one-photon excitation fluorescence lifetime imaging microscopy (FLIM), was used to visualize FRET and show the Orai1 homodimer and Orai1-STIM1 binding. Both the color-coded lifetime map and the distribution of EGFP-tagged Orai1 significantly changed after the administration of thapsigargin, the SOCE stimulating agent. The FRET efficiency from each experimental set was also calculated and compared using double exponential analysis. In summary, we show the detailed interactions Orai1-Orai1 and Orai1-STIM1 within intact living cells by using the FLIM-FRET technique.

Meta-analysis: adefovir dipivoxil in combination with lamivudine in patients with lamivudine-resistant hepatitis B virus

Background

Currently, there are no conclusive results on the efficacy of adefovir dipivoxil (ADV) plus lamivudine (LAM) in LAM-resistant patients with chronic hepatitis B (CHB). The aim of study was to evaluate the efficacy of rescue therapy with ADV plus LAM compared to ADV monotherapy in LAM-resistant CHB patients.

Results

We searched PUBMED, EMBASE, Web of Science, CNKI (National Knowledge Infrastructure), VIP database, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Six eligible trials (442 patients in total) were included and evaluated for methodologic quality and heterogeneity. Greater virological response and lower emergence rate of ADV-associated mutants was observed in ADV plus LAM compared to ADV monotherapy (both P < 0.05). On the contrary, the rate of ALT normalization, HBeAg clearance and seroconversion were all similar between ADV plus LAM and ADV (all P > 0.05). Additionally, adding-on or switch-to ADV was both well tolerated.

Conclusion

The combination of ADV with LAM was superior in inhibiting HBV replication and preventing drug resistance as compared to ADV alone for LAM-resistant CHB patients.

Gastrointestinal polyps in children

BACKGROUND

Gastrointestinal polyps are common in children. The purpose of this study was to review the clinical manifestations, diagnostic procedures, endoscopic findings, management, pathology, and recurrence of gastrointestinal polyps in children at Mackay Memorial Hospital.

METHODS

We retrospectively reviewed the charts of 50 children with a diagnosis of gastrointestinal polyps managed at Mackay Memorial Hospital between January 1984 and April 2007. Demographic data; clinical features; polyp size, number and location; endoscopic findings; management; pathology; and information on recurrences were extracted from the clinical records.

RESULTS

The distribution of polyps in the 50 patients included gastric (4 patients), duodenal (2), ileocecal (4) and colorectal polyps (40). All patients with gastric polyps presented with vomiting, and three of the four patients with ileocecal polyps presented with intussusception. The mean age of the 40 patients with colorectal polyps was 6.8 years. The majority of those polyps were in the rectosigmoid colon; 36 patients presented with hematochezia. Solitary polyps were identified in 33 patients and multiple polyps were identified in seven patients. Most of the colorectal polyps were less than 2cm in diameter. Histologically, the most frequent type was juvenile polyp.

CONCLUSION

Gastrointestinal polyps in children are usually benign. Pediatricians treating a child with a gastrointestinal polyp should pay attention to the immediate complications of the polyps, such as intussusception or bleeding, the extraintestinal manifestations and long-term risk for malignancy.

Transcriptional regulation of the Herpes Simplex Virus 1alpha-gene by the viral immediate-early protein ICP22 in association with VP16

Herpes Simplex Virus 1 (HSV1) is capable of inducing two forms of infection in individuals, and the establishment of which type of infection occurs is linked to the transcriptional activation of viral alpha genes. One of the HSV1 alpha genes, ICP22, is known to have multiple functions during virus replication, but its distinct roles are still unclear. This study showed that ICP22 functions as a general repressor for certain viral and cellular promoters, and this transcriptional repression by ICP22 is independent of the specific upstream promoter element, as shown using the CAT enzyme assay system. Further work also found that VP16 interfered with ICP22 mediated transcriptional repression of the viral alpha4 gene, through interactions with specific elements upstream of the alpha4 gene promoter. These findings support the possibility that ICP22 and VP16 control transcription of HSV1alpha genes in a common pathway for the establishment of either viral lytic or latent infections.

Expression of Bim gene in colorectal cancer

AIM: To study the expression of Bim gene in human colorectal cancer and to examine the association between the Bim expression, and the clinicopathological parameters and prognosis.

METHODS: Ninety-eight colorectal cancer cases with complete data were collected at the affiliated tumor hospital of Harbin Medical University from 2001 to 2002. All cases had received radical surgery and were pathologically confirmed. At the same time, cancer tissue and normal tissue 5 cm away were analyzed for Bim protein expression using immunohistochemical SP method.

RESULTS: The positive rate of Bim protein expression was significantly lower in colorectal cancer than in controls (28.57% vs 98.97%, P < 0.05). The expression of Bim protein was correlated to the invasive depth, lymph node metastasis and clinical staging (χ² = 6.959, 35.381, 4.905, all P < 0.05), but not to the age, tumor size, tumor types or tumor differentiation. The survival rate of the patients with positive Bim protein was higher than with negative Bim protein (P < 0.05). Survival time of the patients with positive Bim protein after operation was 1 mo longer than negative Bim protein.

CONCLUSION: Bim may play an important role in the carcinogenesis and progression of colorectal carcinoma. The expression of Bim protein has a definite value in evaluating the prognosis.

Change of liver histology in chronic hepatitis B patients with alanine aminotransferase less than two-time up limits of normal

AIM: To analyze the change of hepatic histology in patients with chronic hepatitis B virus (HBV) infection whose alanine aminotransferase (ALT) level is lower than two-time up limit of normal (ULN) and discuss the factors affecting the change of liver histology.

METHODS: According to ALT ≤ 0.5 × ULN, 0.5 × ULN < ALT ≤ 1 × ULN and 1 × ULN < ALT < 2 × ULN, 170 patients were divided into group Ⅰ (n = 39), group Ⅱ (n = 87) and group Ⅲ (n = 44). We retrospectively analyzed whether the change of liver histology was related to ALT level, HbeAg status, HBV DNA duplication and the age of patients.

RESULTS: The rates of grade 2 or 2+ inflammation in group Ⅰ, Ⅱ and Ⅲ were 43.6%, 56.4% and 65.9%, respectively, and the rates of stage 2 or 2+ fibrosis were 38.4%, 48.3% and 61.3%, respectively. There were 5.1%, 8.1% and 18.2% patients with liver cirrhosis (stage 4) in the three groups. The activity of liver inflammation and degree of fibrosis were related to ALT level (F= 4.162, 3.992; both P < 0.05) and the age of patients (F = 32.831, 20.084; both P < 0.05), while the degree of liver fibrosis was related with HbeAg positive rate (χ² = 7.839, P < 0.05).

CONCLUSION: Of the patients with chronic HBV infection, 55.9% have grade 2 or 2+ inflammation even if ALT level is less than 2 × ULN. Thus for the patient with a long medical history, especially those over 40 years old, conventional liver biopsy should be performed, which may help us decide whether to start antiviral therapy.

[Clinical characteristics and long-term prognosis of patients with ischemic and hemorrhagic stroke]

OBJECTIVE

To investigate the risk factors, pathogenesis, cause of death, and outcome of different stroke subtypes.

METHODS

The relevant data, including demographics, baseline risk factors, cause of death, and 1-year case fatality, were analyzed among 1913 consecutive hospitalized patients with ischemic and hemorrhagic stroke, 599 (31.3%) with intracerebral hemorrhage (ICH) and 1314 with ischemic stroke (68.7%), including 209 cases (15.9%) of total anterior circulation infarction (TACI), 417 cases (31.7%) of partial anterior circulation infarction (PACI), and 186 cases (14.2%) of posterior circulation infarctions (POCI), and 502 cases (38.2%) of lacunar infarctions (LACI), 1098 males and 815 females, aged 64 +/- 13 (14-98).

RESULTS

Multivariate analysis showed that when age and sex were adjusted, atrial fibrillation was the independent predictive factor of TACI [odds ratio (OR) = 1.42, 95% CI = 1.25-2.31), hypertension and alcohol intake were the independent predictive factor LACI (OR = 1.24, 95% CI = 1.02-2.18; 0R = 1.12, 95% CI = 1.03-3.04) and ICH (OR = 1.84, 95% CI = 1.31-3.02; OR = 1.04, 95% CI = 1.01-4.13). A negative association was observed between hypertension and TACI (OR = 0.62, 95% CI = 0.34-0.72), atrial fibrillation and LACI (OR = 0.46, 95% CI = 0.26-0.82), and ICH and diabetes (OR = 0.56, 95% CI = 0.42-0.76). As compared to LACI, TACI and ICH significantly increased the risk of 1-year mortality (OR = 6.21, 95% CI = 2.86-8.42; OR = 5.86; 95% CI = 2.46-8.52).

CONCLUSIONS

Stroke subtypes have different risk factor profile, causes and outcome. Information on determinants of the clinical syndromes may impact on the prevention and acute phase interventions.

Serum lipid levels and 3-month prognosis in Chinese patients with acute stroke

INTRODUCTION

The possible correlation between serum lipid levels and outcome after stroke is still controversial. Therefore we examined whether serum lipid levels at admission had any prognostic value in the 3-month outcome after stroke.

METHODS

We performed a prospective, observational study of 649 patients with acute ischaemic stroke and intracerebral haemorrhagic stroke (ICH). Information on age, sex, history of arterial hypertension, diabetes mellitus, drinking, current smoking status, stroke type, Glasgow Coma Scale and Scandinavian Stroke Scale score, time from stroke onset, and presence of atrial fibrillation was obtained. Serum lipid levels were measured in blood samples taken from fasting patients 12 to 48 hours following ictus. Death and poor neurological outcome (Modified Rankin Scale score of > or =3 points) were defined as outcome events. A logistic regression model was performed to estimate the effect of the above variables on outcome after stroke.

RESULTS

We found that the median levels of serum total cholesterol (TC), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) in good outcome patients with acute stroke were significantly higher (P<0.005) than those of poor outcome patients. The low levels of serum TC, TG and HDL-C (P<0.05) were independently related to increased 3-month poor outcome after acute ischaemic stroke and ICH. However, there was no significant relationship between LDL-C levels and 3-month outcome.

CONCLUSION

The data from this study show that low levels of serum TC, TG and HDL-C are strong independent predictors of 3-month poor outcome in patients with acute ischaemic stroke and ICH.

Immediate-early gene product ICP22 inhibits the trans-transcription activating function of P53-mdm-2

As a product of HSVI immediate-early gene, ICP22 is capable of interacting with various cellular transcriptive and regulatory molecules during viral infection so as to impact the normal cellular molecular mechanism. ICP22 expressed in transfected cells can push the cells' entering into S phase with binding to mdm-1 promoter region and impact its trans-transcription activating effect by P53. Consequently, the MDM-2 binds to P53, and the degradation effects by the ubiquitous pathway are decreased, improving indirectly the P53 levels in cells and making the cells progress into the S phase.

Analysis of HSV-I ICP22 effects on HCMV major immediate-early promoter structure

The human cytomegalovirus (HCMV) major immediate-early (MIE) promoter has strong transcriptional promoting capability. Its cis-acting regulatory elements form a special structure in this region that is repeated multiple times; the biological significance of these elements and their different compositions in the transcriptional promoting process remain unclear. Our results demonstrate that the HSV-I MIE protein ICP22 can generate strong repression of many viral and cellular promoters and enhancers. We further studied the transcriptional effects of ICP22 on structural elements and mutations in various HCMV MIE promoters by using a CAT assay. In spite of different transcriptional effects of all the elements in the presence of ICP22, the transcriptional efficiencies exhibited by mutations generated by different compositions and an entire HCMV promoter, are not the simple sum of the functions of these elements. Furthermore, the transcriptional activities of specific sequences were not affected by the presence of ICP22. Therefore, it is assumed that the HCMV MIE promoter co-regulates expression of downstream genes by using viral and cellular specific factors via a specific pathway.

C-Reactive protein-induced endothelial microparticle generation in HUVECs is related to BH4-dependent NO formation

BACKGROUND

C-reactive protein (CRP) has been proven to facilitate endothelial injury via reduced NO production. Endothelial microparticles (EMPs) have emerged as a novel marker of endothelial injury.

METHODS

In vitro cultured human umbilical vein endothelial cells (HUVECs) were incubated with CRP (20 mg/l) for 24 h. The numbers of EMPs with CD31- and CD51-positive staining were assessed flow-cytometrically, and NO production was measured using the Griess reaction in the presence or absence of tetrahydrobiopterin (BH(4)), respectively.

RESULTS

The number of EMPs was significantly increased in HUVECs stimulated by CRP compared with the control group and, in parallel, NO production was decreased (p < 0.05). In the presence of CRP, pretreatment with BH(4) decreased EMP counts and restored NO production to baseline levels (p < 0.05) while pretreatment with 2,4-diamino-6-hydroxypyrimidine (DAHP), a BH(4) synthesis inhibitor, further prompted EMP formation and decreased NO production (p < 0.05). However, adding exogenous BH(4) after pretreatment with DAHP suppressed EMP formation and restored NO production (p < 0.05).

CONCLUSIONS

This study demonstrates that CRP induces EMP generation in HUVECs and this effect is, at least in part, related to impaired BH(4)-dependent NO production. Augmented EMP generation in HUVECs is suggested as a novel potential mechanism contributing to the pathogenesis of vascular injury related to CRP.

Length-dependent toxicity of untranslated CUG repeats on Caenorhabditis elegans

Expansion of CTG repeat within the 3'-untranslated region of the DMPK gene causes the most common neuromuscular disorder, myotonic dystrophy type 1 (DM1), through a RNA trans-dominant mechanism. Here, we explore Caenorhabditis elegans as a model system to investigate the repeat size-dependent toxic effect by expression of green fluorescent protein (GFP) transcripts with various lengths of untranslatable CUG repeats (CUG5, CUG30, CUG83, CUG125, and CUG213) in body wall muscles. CUG213 animals died during embryogenesis or showed retarded growth at larval stages due to defective muscle development. CUG125 animals, although can produce offspring, exhibited uncoordinated muscle function, deviated electropharyngeogram, and an age-dependent abnormality in muscle structure. Most CUG83 animals had normal muscle structure and function as those expressing 30 and shorter repeats. Our results demonstrate for the first time that the in vivo toxicity of CUG repeats is repeat length- and growth-regulated and suggest that expanded CUG repeats are sufficient to cause congenital-like phenotypes in living organisms.

[Experimental study of liver fibrosis reversal effect of warming-yang compound formula ganzhifu]

OBJECTIVE

To observe the effect of Ganzhifu (GZF), a Chinese compound formula for Warming-yang on experimental hepatic fibrosis, and to explore its mechanism.

METHODS

Fifty-nine Wistar rats were divided into the normal control group and the model group. After the hepatic fibrosis model was established in rats by subcutaneous injection of CCl4 and feeding 10% alcohol in the model group, the rats were randomly sub-divided into the Ganzhifu group, colchicine group and model group, they were treated with Ganzhifu, colchicine and normal saline of same volume once a day respectively for 30 days as one treatment course. The serum liver function and hepatic fibrosis indexes, liver tissue contents of hydroxyproline (Hyp), malondialdehyde (MDA) and superoxide dismutase (SOD) activity were measured at the end of the experiment. Histologic changes of liver tissue were observed and scored by the modified inflammatory activity and fibrosis semiquantative scoring system (SSS), and collagen type I , III and IV in liver tissue were stained and semiquantitive analysis conducted.

RESULTS

In the Ganzhifu group, liver function and inflammatory activity and fibrosis SSS scores were markedly improved, indexes of hepatic fibrosis, liver contents of Hyp, MDA and collagen type I, III and IV were significantly decreased, and the SOD activity was increased, the changes were more significant as compared with those in the model group. The protective effect of Ganzhifu against hepatic fibrosis was the same as that of colchicine.

CONCLUSION

Ganzhifu can alleviate or reverse hepatic fibrosis in experimental hepatic fibrosis, and antioxidation may be its mechanism.

Osteoclastogenic activity during mandibular distraction osteogenesis

Mandibular distraction osteogenesis is a well-developed clinical modality for the treatment of craniofacial deformities and dental arch discrepancies, in combination with orthodontic treatment. However, in our previous study, orthodontic tooth movement into the distraction gap caused severe root resorption. The present study aimed to clarify the osteoclastogenic activity of cells in the distraction gap. We hypothesized that the gene expression of osteoclastogenic- and osteoclast-supporting molecules in osteoblasts and stromal cells would increase at distraction sites during the consolidation period. An animal model experiment involving rabbits was designed for mandibular distraction osteogenesis and subjected to in situ hybridization analysis. The number of osteoclasts was larger in the distraction gap during the early consolidation period than in normal controls, due to an increase of gene expression for osteoclastogenic cytokines in osteoblasts. It was concluded that osteoclastogenic and osteoclastic activities are stimulated at distraction sites during the early consolidation period.

Effect of Chinese drug compound Ganzhifu on liver fibrosis in rats

AIM: To investigate the effect of compound Ganzhifu on experimental hepatic fibrosis and its possible mechanism.

METHODS: Forty-five Wistar rats were randomly divided into four groups: normal (N) group, Ganzhifu (G) group, colchicine (C) group and model (M) group. All the rats, except those in N group, were given CCl₄ by subcutaneous injection and alcohol (10%) by oral administration to establish the model of hepatic fibrosis. At the same time, the rats in G, C or M group were treated through stomach irrigation with Ganzhifu, colchicine or saline, respectively. Blood was collected for the examination of liver function and serum fibrosis markers. Hydroxyproline (Hyp), malondial dehyde (MDA) content, and superoxide disumutase (SOD) activity were determined in liver tissues. HE, Masson and Gorden-Sweet staining were used to examine the pathological changes in liver tissue sections. Inflammation and fibrosis were evaluated by semi-quantitative scoring system (SSS). In addition, The expression of typeI, III, IV collagens was detected by immunohistochemistry.

RESULTS: Compared with that in M group, liver function was improved remarkably in G group, and there were significant decreases in the liver fibrosis markers (Hyp: 1.52±0.35 mg/g vs 1.12±0.29 mg/g, P<0.05; MDA: 16.3±6.0 mmol/g vs

8.8±2.1 mmol/g, P<0.01). However, the SOD activity was notably elevated (86.33±17.74 nkat/g vs 122.01±19.12 nkat/g, P<0.01). Less inflammation, lower degree of fibrosis and reduced content of typeI, III, IV collagens were observed in G group than in M group. No significant difference was found between the effects of Ganzhifu and colchicines against fibrosis.

CONCLUSION: Ganzhifu can protect liver from fibrosis and the mechanism may be related to its anti-oxidative effect.

Abrin-a A chain expressed as soluble form in Escherichia coli from a PCR-synthesized gene is catalytically and functionally active

Abrin-a A chain (ABRaA) is a potent plant toxin, which possesses N-glycosylase activity toward eukaryotic 28S rRNA, and may have potential use in cancer therapy. To improve levels of expression in Escherichia coli, the gene encoding ABRaA was optimized by replacing rare codons with high-frequency ones, and synthesized using two-step PCR. The optimized ABRaA was cloned into the pET-His vector, and highly expressed in cytoplasm of E. coli. The yield of the purified recombinant (r) ABRaA proteins was up to 80 mg/l of induced culture. The rABRaA was one-step purified to homogeneity and its RNA-N-glycosylase ability to inhibit protein biosynthesis in a cell-free system and to depurinate 28S rRNA in rat liver ribosomes was demonstrated in vitro. The MTT assay showed that it also had a killing effect on human hepatoma cell line SMMC-7721 and myeloma cell line Sp2/0. For the first time, ABRaA expressed as soluble form in E. coli from a PCR-synthesized gene is catalytically and functionally active.

Sera from children with active Henoch-Schönlein purpura can enhance the production of interleukin 8 by human umbilical venous endothelial cells

OBJECTIVE

To investigate the ability of sera from children with active Henoch-Schonlein purpura (HSP) to enhance endothelial interleukin (IL) 8 production and intercellular adhesion molecule (ICAM)-1 expression.

METHODS

Nine children with active HSP and nine normal healthy children were enrolled. IL8 serum levels of patients and controls at different stages were analysed. Production of IL8 and expression of ICAM-1 by human umbilical venous endothelial cells were detected (ELISA for IL8, flow cytometry for ICAM-1) and compared under various stimuli, including sera of patients at different stages, sera of controls, and medium alone.

RESULTS

Serum levels of IL8 were increased at the acute stage. Levels of IL8 in supernatants from human umbilical venous endothelial cells (HUVEC) co-cultured with sera from children with active HSP were significantly higher than those from HUVEC without any treatment (p = 0.001), HUVEC treated with inactive sera (p = 0.004), and HUVEC treated with sera from healthy controls (p = 0.004). Sera from patients and from controls did not enhance the expression of ICAM-1 on HUVEC.

CONCLUSIONS

Some factors may be present in sera from children with active HSP that could activate endothelial cells to produce IL8. This process may account, in part, for the mechanisms of perivascular neutrophil infiltration and leucocytosis in HSP.