CYP2C9 Ile359Leu polymorphism, plasma irbesartan concentration and acute blood pressure reductions in response to irbesartan treatment in Chinese hypertensive patients

Our previous study demonstrated that the CYP2C9*3 gene variant was significantly associated with elevated plasma irbesartan concentration and blood pressure decline, assessed by a 4-week follow-up and revisit following daily administration of irbesartan. We conducted a further analysis to examine the acute effects of the CYP2C9 polymorphism on plasma concentration and blood pressure through remeasurement 6 h after administration of irbesartan. We used an extreme-sampling approach by selecting individuals from the top and bottom deciles of blood pressure response residuals to irbesartan from the previous study population in Anhui, Taihu, and Dongzhi Counties, in China. A total of 196 subjects were available for the analysis. Pre- and posttreatment systolic and diastolic blood pressures (SBP and DBP), and venous blood samples (0.5, 2, and 6 h following the first treatment) were collected from each individual. Plasma irbesartan concentrations were determined by a standard HPLC/fluorescence method. The observed frequencies were 97.7% for CYP2C9*1 (Ile359) and 2.3% for CYP2C9*3 (Leu359). Subjects with the CYP2C9*1/CYP2C9*3 genotype had significantly higher plasma irbesartan concentrations when compared with those with the CYP2C9*1/CYP2C9*1 genotype (beta +/- SE = 81 +/- 36) and greater DBP response (beta +/- SE = 5.6 +/- 2.5 mmHg) at the 6-h time point after adjusting for important confounders. Our finding suggests that the CYP2C9*3 gene variant significantly alters the plasma concentration and acute DBP response at the 6-h point following irbesartan treatment in Chinese hypertensive patients.

Polymorphisms in the HBB gene relate to individual cardiorespiratory adaptation in response to endurance training

OBJECTIVE

The crucial role of haemoglobin in endurance performance has been well documented. We examined whether polymorphisms in the HBB gene modified aerobic capacity.

METHODS

102 recruits were trained by running 5000 m three times per week for 18 weeks. Exercise intensity progressively increased from an initial heart rate corresponding to 95% of the individual baseline ventilatory threshold during the first 10 weeks to 105% during the last 8 weeks. The phenotypes measured were running economy and VO(2)max. Running economy was determined by measuring submaximal VO(2) for 5 min at a constant running speed of 12 km.h(-1) and VO(2)max was obtained during an incremental test to exhaustion. Genomic DNA was extracted from white cells of peripheral blood and the -551C/T, intron2,+16C/G and +340 A/T genotypes were examined relative to the TAA site variants by PCR-RFLP.

RESULTS

Genotype distributions were in Hardy-Weinberg equilibrium at three loci. None of the running economy and VO(2)max-related traits were associated with the three polymorphisms or haplotypes at baseline, while the training response of running economy was associated with -551C/T and intron2,+16C/G polymorphisms. Subjects homozygous for intron2,+16C/C or -551C/C had decreased oxygen cost of running compared to the other individuals.

DISCUSSION

It was concluded that the -551C/C or intron2,+16C/C genotype might explain part of the individual variation in the cardiorespiratory adaptation to endurance training.

Expression of PPARdelta in multistage carcinogenesis of the colorectum: implications of malignant cancer morphology

Whether peroxisome proliferator-activated receptor (PPAR) delta is a good target for the chemoprevention and/or treatment of colorectal cancer (CRC) remains controversial. Our goal was to examine PPARdelta expression in multistage carcinogenesis of the colorectum and to assess the relevance of PPARdelta in CRC. Immunohistochemical analysis indicated that PPARdelta expression increased from normal mucosa to adenomatous polyps to CRC. In cancer tissues, the PPARdelta protein was accumulated only in those cancer cells with highly malignant morphology, as represented by a large-sized nucleus, round-shaped nucleus, and presence of clear nucleoli. Interestingly, the cancer tissue often contained both PPARdelta-positive and -negative areas, each retaining their respective specific morphological features. Moreover, this pattern persisted even when PPARdelta-positive and -negative cells were aligned next to each other within a single cancer nest or gland and was present in the majority of CRC cases. Immunohistochemistry for Ki-67 proliferation marker showed no significant correlation between Ki-67 and PPARdelta in CRC samples. Based on Western blot analysis and quantitative RT-PCR, high PPARdelta protein expression correlated with high PPARdelta mRNA levels. Peroxisome proliferator-activated receptor delta may have a supporting role in tumorigenesis, and the close association between PPARdelta expression and malignant morphology of CRC cells suggests a pivotal role in cancer tissue.

NMDA receptor activation induces mitochondrial dysfunction, oxidative stress and apoptosis in cultured neonatal rat cardiomyocytes

Glutamate is a well-characterized excitatory neurotransmitter in the central nervous system (CNS). Recently, glutamate receptors (GluRs) were also found in peripheral tissues, including the heart. However, the function of GluRs in peripheral organs remains poorly understood. In the present study, we found that N-methyl-D-aspartate (NMDA) could increase intracellular calcium ([Ca(2+)]i) level in a dose-dependent manner in cultured neonatal rat cardiomyocytes. NMDA at 10(-4) M increased the levels of reactive oxygen species (ROS), cytosolic cytochrome c (cyto c), and 17-kDa caspase-3, but depolarized mitochondrial membrane potential, leading to cardiomyocyte apoptosis. In addition, NMDA treatment induced an increase in bax mRNA but a decrease in bcl-2 mRNA expression in the cardiomyocytes. The above effects of NMDA were blocked by the NMDA receptor antagonist (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine hydrogen maleate (MK-801), and by ROS scavengers glutathione (GSH) and N-acetylcystein (NAC). These results suggest that stimulation of NMDA receptor in the cardiomyocyte may lead to apoptosis via a Ca(2+), ROS, and caspase-3 mediated pathway. These findings suggest that NMDA receptor may play an important role in myocardial pathogenesis.

Short-term administration of ACTH improves plasma lipid profile and renal function in kidney transplant patients

The present study investigated effects of short-term administration of adrenocorticotrophic hormone (ACTH) on blood lipid profile and renal function in kidney transplant patients. Six patients who had kidney transplantations 2 to 10 years earlier received ACTH intramuscularly (1 mg/d) for 4 days. We analyzed serum levels of lipids, lipoproteins, apolipoproteins, blood creatinine, and other parameters. Short-term ACTH treatment significantly decreased serum apolipoprotein B and apolipoprotein AI, whereas it significantly increased plasma high-density lipoproteins (HDL). Interestingly, creatinine level moderately decreased and creatinine clearances moderately increased among five of six patients. Hepatic function and serum concentration of cyclosporine did not change. There were no serious side effects during ACTH treatment. It was concluded that ACTH treatment had beneficial effects on serum lipoprotein profile, potentially improving renal function in kidney transplant patients. Further observations are needed to confirm these effects.

BRCA1 germline mutations in Chinese patients with hereditary breast and ovarian cancer

The role of germline BRCA1 mutations in hereditary breast and ovarian cancer (HBOC) has been well established in women in Western countries. However, relatively few studies have been carried out in Chinese population. In the present study, we investigated the frequency and spectrum of germline BRCA1 mutations in Chinese HBOC patients, all of whom were from northern part of China. A total of 25 women with HBOC and ten relatives were analyzed. Mutation screening was performed by a combination of denaturing high-performance liquid chromatography and sequencing. Seven protein-truncating mutations were identified. They were 667delG, 3347A --> T, 3478del5, 4255delCT, 1235A --> G, 2064G --> T, and 5589del8. The first four of the mutations were putative ones never reported before. The prevalence of the protein-truncating mutations in this HBOC series was 40.0%, which is similar to that observed in Western hereditary ovarian cancer patients but higher than that reported in Chinese women with sporadic breast and ovarian cancer. Among the ten relatives we analyzed, six shared the same mutations with their affected relatives. No ovarian cancer was detected after 19 months of follow-up. This study showed that BRCA1 mutations play an important role in Northern Chinese HBOC.

Paths swept out by initially slack flexible wires when cutting soft solids; when passing through a very viscous medium; and during regelation

Flow and fracture of some soft solids may be described by the ‘solid’ mechanical properties of elastic modulus, yield stress and fracture toughness, all being dependent on rate, temperature and environment. Other soft solids behave more like very viscous materials. When cutting soft solids, friction is often high between the blade and the material, and cutting is made easier when performed with a thin wire. The wire may be held taut in a frame like a fretsaw, but cutting is often done using an initially slack wire pulled into the solid by hand or machine. For both types of material behaviours, we investigate the curved shape taken by a loaded wire, elements along which cut into the material both radially and tangentially.

For soft materials displaying solid properties, the treatment is based on the analysis of bi-directional cutting by Atkins et al . (Atkins et al . 2004 J. Mater. Sci. 39 , 2761–2766), in which it was shown that the ratio ξ of tangential to radial displacements strongly influences the cutting forces. The shapes of wires of various lengths arranged as bowstrings, and the loads in the wires, are assessed against experiments on cheddar cheese. The resultant force takes a minimum value for a particular length of the wire, owing to the competition between lower cutting forces, but higher friction at large ξ and vice versa.

Passage of a wire through very viscous materials is flow at very low Reynolds number. To determine the path swept out, we make use of the property of all slender bodies of revolution in highly viscous flow, namely, that the drag exerted across the body is approximately twice as large as along. Comparison is made with the experiments on weighted threads falling under gravity in glycerine.

Regelation is another example of passage of a wire through a solid. The mechanism is completely different but, in the context of the present paper, we provide in appendix A the solution for the typical hours-long school demonstration where, unlike most reported studies, non-uniform temperature fields develop in the block of ice. Comparison is made with experiment.

LMO4 can interact with Smad proteins and modulate transforming growth factor-beta signaling in epithelial cells

LIM-only protein 4 (LMO4) plays critical roles in mammalian development, and has been proposed to play roles in epithelial oncogenesis, including breast cancer. As LMO4 is highly expressed in the epithelial compartments at locations of active mesenchymal-epithelial interactions, we reasoned that LMO4 might act by modulating signaling pathways involved in mesenchymal-epithelial signaling. One such candidate signal is the transforming growth factor-beta (TGFbeta) cytokine pathway, which plays important roles both in development and cancer. We show here that the transcriptional response to TGFbeta in epithelial cells is sensitive to LMO4 levels; both up- and downregulation of LMO4 can enhance TGFbeta signaling as assessed by a TGFbeta-responsive reporter gene. Furthermore, LMO4 can interact with the MH1 and linker domains of receptor-mediated Smad proteins, and associate with the endogenous TGFbeta-responsive Plasminogen Activator Inhibitor-1 gene promoter in a TGFbeta-dependent manner, suggesting that such interactions may mediate the effects of LMO4 on TGFbeta signaling. When introduced into mammary epithelial cells, LMO4 potentiated the growth-inhibitory effects of TGFbeta in those cells. These results define a new function for LMO4 as a coactivator in TGFbeta signaling, and provide a potential novel mechanism for LMO4-mediated regulation in development and oncogenesis.

Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS

AIMS

To investigate the relationships between a known history of diabetes and ambient fasting plasma glucose (FPG) levels with death and morbidity rates in patients with severe acute respiratory syndrome (SARS).

METHODS

In this retrospective analysis, the clinical and biochemical characteristics of 135 patients who had died from SARS, 385 survivors of SARS and 19 patients with non-SARS pneumonia were compared.

RESULTS

All patients were treated according to a predefined protocol. Before steroid treatment, the mean FPG level was significantly higher in the SARS group (deceased vs. survivors vs. non-SARS pneumonia group: 9.7 +/- 5.2 vs. 6.5 +/- 3.0 vs. 5.1 +/- 1.0 mmol/l, P < 0.01). In the SARS group, the percentage of patients with a known history of diabetes was significantly higher in the deceased patients than in the survivors (21.5% vs. 3.9%, P < 0.01). Among patients with no known history of diabetes and before commencement of steroid therapy, those who had hypoxaemia (SaO(2) < 93%) had higher FPG levels than those who did not have hypoxia in both the survivor (8.7 +/- 4.9 vs. 6.3 +/- 2.1 mmol/l, P < 0.001) and deceased (9.8 +/- 4.8 vs. 7.2 +/- 1.5 mmol/l, P < 0.001) groups. A known history of diabetes [odds ratio (OR) 3.0, 95% confidence interval (CI) 1.4, 6.3; P = 0.005] and FPG > or = 7.0 mmol/l before steroid treatment (OR 3.3, 95% CI 1.4, 7.7, P = 0.006) were independent predictors of death. During the course of the illness, FPG levels were negatively associated with SaO(2) (beta =-0.682 +/- 0.305, P = 0.025, general estimation equation model) in SARS patients. Survival analysis showed that FPG was independently associated with an increased hazard ratio (HR) of mortality (HR = 1.1, 95% CI 1.0, 1.1, P = 0.001) and hypoxia (HR = 1.1, 95% CI 1.0, 1.1, P = 0.002) after controlling for age and gender.

CONCLUSIONS

A known history of diabetes and ambient hyperglycaemia were independent predictors for death and morbidity in SARS patients. Metabolic control may improve the prognosis of SARS patients.

Transcriptional profile of shrimp white spot syndrome virus (WSSV) genes with DNA microarray

In an attempt to obtain the transcriptional profile of shrimp white spot syndrome virus (WSSV) genes, DNA microarray analysis was performed using amplified DNA fragments of the WSSV genome that covered most of the presumptive open reading frames (ORFs). Total RNAs were extracted from WSSV-infected crayfish (Cambarus clarkii) and reverse transcribed into cDNA and labeled with 32P-dATP. The DNA microarray detected 81.1% of the ORFs, and 47 of these were transcribed at 6 h post infection, suggesting they may be early genes. Some early genes were further confirmed by temporal analyses of gene transcription. Results in this study indicated the effectiveness of DNA microarray for discovering early viral genes.

The differential effects of low dose and high dose concanavalin A on cytokine profile and their importance in liver injury

OBJECTIVE

Intravenous injection of concanavalin A (Con A) can cause mice to suffer from acute liver failure in a dose dependent manner and little is known about the difference between the high dose and the low dose of Con A regarding the immune response they initiate. The aim of this study was to analyze whether differential effects exist between the low dose and high dose of concanavalin A on the intrahepatic immune system and their importance in the development of liver injury.

MATERIALS AND METHODS

A high dose of Con A (15 microg/g) was injected intravenously to induce murine hepatitis. A low dose of Con A (3 microg/g) was injected intravenously 12 h before the injection of the high dose of Con A (15 microg/g). Liver injury was evaluated by serum transaminase assay and H&E staining. Serum cytokine concentrations were determined by enzyme-linked immunosorbent assay (ELISA), intrahepatic cytokine and Fas mRNA levels by reverse transcriptase polymerase chain reaction. Intracellular cytokine expression and FasL expression were analyzed by flow cytometry and Fas protein expression in hepatocytes by Western-blotting. Intrahepatic apoptosis was evaluated by terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL).

RESULTS

Low dose Con A injection induced a distinct cytokine expression profile, characterized by a preferentially elevated serum IL-6 at the early stage of stimulation, whereas high dose Con A injection provoked significant elevation of various cytokines involved in Con A-induced hepatitis. Pretreatment with a low, nonhepatoxic dose of Con A (3 microg/g) significantly decreased production of proinflammatory cytokines induced by the high dose Con A (15 microg/g). Furthermore, low dose Con A pretreatment could significantly decrease the serum levels of transaminases and liver necrosis induced by high dose of Con A. The intrahepatic Fas expression was also apparently reduced, accompanied by a decrease in hepatocyte apoptosis.

CONCLUSION

Low dose Con A stimulation induced a different cytokine profile from high dose Con A stimulation resulting in differential importance in the development of liver injury.

The relationship between patient knowledge of hemoglobin levels and health-related quality of life

BACKGROUND

An anti-anemia drug may improve self-reported quality of life (QOL) partly because patients know their hemoglobin level is rising. In the absence of any published studies on this topic, the authors investigated the association between knowledge of hemoglobin levels and self-reported QOL.

METHODS

The study analyzed health-related QOL (HRQOL) data from five randomized clinical trials of erythropoietic therapy in patients with cancer-related anemia. Patients were asked whether they knew their hemoglobin level and, if so, to report its value. Patients (n=1007) were grouped into three categories depending on the extent and accuracy of hemoglobin level knowledge. HRQOL scale scores were compared between categories.

RESULTS

Only 23.2% of patients reported knowing their hemoglobin level at the end of the study; however, the value was accurate (within 1 g/dl) in 88.0% of these patients. On five of the 11 HRQOL scales studied, there was a significant association between knowledge of hemoglobin level and HRQOL score. However, the magnitude of the mean difference between those who knew vs. those who did not know their hemoglobin was generally below scale thresholds for minimally important differences.

CONCLUSIONS

Patient knowledge of hemoglobin level has a modest association with some aspects of self-reported HRQOL. The magnitude of this association, where it exists, would be unlikely to explain large group differences in HRQOL reports over time, even for patients who know their hemoglobin level.

Investigation of MR image distortion for radiotherapy treatment planning of prostate cancer

MR imaging based treatment planning for radiotherapy of prostate cancer is limited due to MR imaging system related geometrical distortions, especially for patients with large body sizes. On our 0.23 T open scanner equipped with the gradient distortion correction (GDC) software, the residual image distortions after the GDC were <5 mm within the central 36 cm x 36 cm area for a standard 48 cm field of view (FOV). In order to use MR imaging alone for treatment planning the effect of residual MR distortions on external patient contour determination, especially for the peripheral regions outside the 36 cm x 36 cm area, must be investigated and corrected. In this work, we performed phantom measurements to quantify MR system related residual geometric distortions after the GDC and the effective FOV. Our results show that for patients with larger lateral dimensions (>36 cm), the differences in patient external contours between distortion-free CT images and GDC-corrected MR images were 1-2 cm because of the combination of greater gradient distortion and loss of field homogeneity away from the isocentre and the uncertainties in patient setup during CT and MRI scans. The measured distortion maps were used to perform point-by-point corrections for patients with large dimensions inside the effective FOV. Using the point-by-point method, the geometrical distortion after the GDC were reduced to <3 mm for external contour determination and the effective FOV was expanded from 36 cm to 42 cm.