Prediction of response to entecavir therapy in patients with HBeAg-positive chronic hepatitis B based on on-treatment HBsAg, HBeAg and HBV DNA levels

Quantitative hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) assays are emerging as effective tools of on-treatment predictors of response to antiviral agents, in addition to monitoring serum HBV DNA levels. However, the dynamic relationship between quantitative HBsAg, as well as HBeAg and HBV DNA, and the predictability of subsequent clinical outcomes during entecavir (ETV) therapy remain unclear. Eighty-two patients with HBeAg-positive chronic hepatitis B (CHB) received ETV therapy for ≥3 years. Virologic response (VR) after 3 years of ETV therapy was achieved in 73 (89.0%) patients. Among baseline and on-treatment factors, on-treatment HBV DNA levels performed better with respect to the prediction of response than HBsAg and HBeAg levels. Especially, the performance of absolute values of HBV DNA with respect to response was superior to HBV DNA decline from the baseline. The best predictive value was an absolute HBV DNA level of 2.3 log(10) IU/mL at month 6 (areas under the curve [AUROC], 0.977; 95% CI, 0.940-1.000; P < 0.001). HBeAg seroconversion after 3 years of therapy was achieved in 26 (31.7%) patients. On-treatment HBeAg levels performed better with respect to the prediction of seroconversion than HBsAg and HBV DNA levels. The best cut-off value for the HBeAg level at month 12 for the prediction of seroconversion was 0.62 log(10) PEIU/mL. Although the HBsAg level at baseline is often used to predict the antiviral potency of entecavir, on-treatment HBV DNA and HBeAg levels are more helpful for prediction of subsequent clinical outcomes in HBeAg-positive CHB patients with entecavir treatment.

Prediction of response to entecavir therapy in patients with HBeAg-positive chronic hepatitis B based on on-treatment HBsAg, HBeAg and HBV DNA levels

Quantitative hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) assays are emerging as effective tools of on-treatment predictors of response to antiviral agents, in addition to monitoring serum HBV DNA levels. However, the dynamic relationship between quantitative HBsAg, as well as HBeAg and HBV DNA, and the predictability of subsequent clinical outcomes during entecavir (ETV) therapy remain unclear. Eighty-two patients with HBeAg-positive chronic hepatitis B (CHB) received ETV therapy for ≥3 years. Virologic response (VR) after 3 years of ETV therapy was achieved in 73 (89.0%) patients. Among baseline and on-treatment factors, on-treatment HBV DNA levels performed better with respect to the prediction of response than HBsAg and HBeAg levels. Especially, the performance of absolute values of HBV DNA with respect to response was superior to HBV DNA decline from the baseline. The best predictive value was an absolute HBV DNA level of 2.3 log(10) IU/mL at month 6 (areas under the curve [AUROC], 0.977; 95% CI, 0.940-1.000; P < 0.001). HBeAg seroconversion after 3 years of therapy was achieved in 26 (31.7%) patients. On-treatment HBeAg levels performed better with respect to the prediction of seroconversion than HBsAg and HBV DNA levels. The best cut-off value for the HBeAg level at month 12 for the prediction of seroconversion was 0.62 log(10) PEIU/mL. Although the HBsAg level at baseline is often used to predict the antiviral potency of entecavir, on-treatment HBV DNA and HBeAg levels are more helpful for prediction of subsequent clinical outcomes in HBeAg-positive CHB patients with entecavir treatment.

Concentrations of analyzed or reactive lysine, but not crude protein, may predict the concentration of digestible lysine in distillers dried grains with solubles fed to pigs

The objectives of this experiment were to evaluate procedures that may be used to predict the concentration of standardized ileal digestible (SID) Lys in distillers dried grains with solubles (DDGS) fed to pigs and to evaluate the accuracy of a published equation to predict SID Lys in DDGS. Twenty-one sources of DDGS were analyzed (as-fed basis) for CP (23.8% to 33.6%; CV = 8.3%), Lys (0.69% to 1.17%; CV = 12.4%), and furosine (0.02% to 0.22%; CV = 91.4%). The concentration of reactive Lys (%, as-fed basis) was calculated as analyzed Lys (%) - furosine (%) ÷ 0.32 × 0.40 and ranged from 0.47% to 1.15% (CV = 20.7%) in the 21 sources of DDGS. Twenty-one diets that each contained 60.0% of 1 source of DDGS as the sole source of CP and AA were formulated. An N-free diet was also formulated and was used to determine basal endogenous losses of CP and AA. Twenty-two barrows with an initial BW of 45.2 kg (SD = 3.1 kg) were fitted with a T-cannula in the distal ileum and allotted to a 22 × 10 Youden square design with the 22 diets and 10 periods. The SID of CP and AA were calculated for each source of DDGS. The SID of CP ranged from 69.8% to 79.6%, and the SID of Lys ranged from 45.3% to 74.1%. The concentration of SID Lys in the 21 samples of DDGS was highly related to the concentration of analyzed Lys (P < 0.001; r(2) = 0.849) and with the concentration of reactive Lys in the samples (P < 0.001; r(2) = 0.898). In contrast, the concentration of SID Lys in the 21 sources of DDGS was not related to the concentration of CP in the samples (P = 0.558; r(2) = 0.021). However, values for SID Lys were in good agreement with values predicted using a published prediction equation. In conclusion, analyzed Lys in DDGS, but not CP, may be used to predict the concentration of SID Lys in DDGS fed to pigs. However, analysis of furosine in addition to Lys and subsequent calculation of reactive Lys improve the prediction accuracy of digestible Lys concentration in DDGS.

Loss of p27 enhances gastrointestinal eptithelial malignancy in mice with Smad4 deficiency in T cells. (120.17)

We previously reported that selective loss of Smad4 signaling in T cells (Smad4KO) leads to spontaneous gastrointestinal inflammation and cancer. The expression of p27Kip1 is significantly decreased in the colon of Smad4KO mice, thus we investigated the role of p27Kip1 in the maintenance of intestinal mucosal immune and epithelial homeostasis. Smad4KO and p27Kip1 germ line mutation (Smad4/p27DKO) mice develop spontaneous gastrointestinal inflammation and carcinoma at 1-2 months of age and 3 months of age, respectively. Smad4/p27DKO had little in vitro TGF-β-induced Foxp3+CD4+ T cells (iTregs) and decreased natural Foxp3+CD4+ T cells (nTregs) in vivo, whereas Smad4KO had little iTregs and p27KO had decreased nTregs. Furthermore, Smad4/p27DKO have an increased number of mucosal CD4+ T cells and an increased percentage of memory T cells. The production of pro-inflammatory cytokines including IL-6, IFN-γ and TNF-α was greatly increased in the colon mucosa of Smad4/p27DKO mice. The colon epithelium of Smad4/p27DKO mice exhibit an oncogenic signature with a significant elevation in expression of iNOS, p-stat1 and p-stat3 and a repression of the tumor suppressor gene, 15-PGDH when compared with WT, p27KO and Smad4KO mice. Thus, our data indicate that p27Kip1 deficiency promotes gastrointestinal epithelial malignancy through both enhancement of the activation of pathogenic T cells and through promotion of the expression of pro-inflammatory mediators by mucosal epithelial cells.

Sulfur concentration in diets containing corn, soybean meal, and distillers dried grains with solubles does not affect feed preference or growth performance of weanling or growing-finishing pigs

Four experiments were conducted to investigate the effects of distillers dried grains with solubles (DDGS) and dietary S on feed preference and performance of pigs. In a 10-d feed preference experiment (Exp. 1), 48 barrows (20.1 ± 2.2 kg of BW) were randomly allotted to 3 treatment groups, with 8 replicate pens per treatment and 2 pigs per pen. A control diet based on corn and soybean meal, a DDGS diet containing 20% DDGS, and a DDGS-sulfur (DDGS-S) diet were prepared. The DDGS-S diet was similar to the DDGS diet with the exception that 0.74% CaSO(4) was added to the diet. Two diets were provided in separate feeders in each pen: 1) the control diet and the DDGS diet, 2) the control diet and the DDGS-S diet, or 3) the DDGS diet and the DDGS-S diet. Preference for the DDGS diet and the DDGS-S diet vs. the control diet was 35.2 and 32.6%, respectively (P < 0.05), but there was no difference between the DDGS diet and the DDGS-S diet. In Exp. 2, a total of 90 barrows (10.3 ± 1.4 kg of BW) were allotted to 3 treatments, with 10 replicate pens and 3 pigs per pen, and were fed the diets used in Exp. 1 for 28 d, but only 1 diet was provided per pen. Pigs fed the control diet gained more BW (497 vs. 423 and 416 g/d; P < 0.05) and had greater G:F (0.540 vs. 0.471 and 0.455; P < 0.05) than pigs fed the DDGS or the DDGS-S diet, but no differences between the DDGS and the DDGS-S diets were observed. In a 10-d feed preference experiment (Exp. 3), 30 barrows (49.6 ± 2.3 kg of BW) were allotted to 3 treatment groups, with 10 replicates per group. The experimental procedures were the same as in Exp. 1, except that 30% DDGS was included in the DDGS and DDGS-S diets and 1.10% CaSO(4) was added to the DDGS-S diet. Feed preference for the DDGS and the DDGS-S diets, compared with the control diet, was 29.8 and 32.9%, respectively (P < 0.01), but there was no difference between the DDGS and the DDGS-S diets. In Exp. 4, a total of 120 barrows (34.2 ± 2.3 kg of BW) were fed grower diets for 42 d and finisher diets for 42 d. Diets were formulated as in Exp. 3. Pigs on the control diets gained more BW (1,021 vs. 912 and 907 g/d; P < 0.05) and had greater G:F (0.335 vs. 0.316 and 0.307; P < 0.05) than pigs fed the DDGS or DDGS-S diet, respectively, but no differences between pigs fed the DDGS and the DDGS-S diets were observed. In conclusion, dietary S concentration does not negatively affect feed preference, feed intake, or growth performance of weanling or growing-finishing pigs fed diets based on corn, soybean meal, and DDGS.

Energy concentration and phosphorus digestibility in whey powder, whey permeate, and low-ash whey permeate fed to weanling pigs

Two experiments were conducted to determine DE and ME, the apparent total tract digestibility (ATTD) of P, and the standardized total tract digestibility (STTD) of P in whey powder (3,646 kcal/kg), whey permeate (3,426 kcal/kg), and low-ash whey permeate (3,657 kcal/kg) fed to weanling pigs. The DE and ME in the 3 whey products were determined using 32 barrows (9.2 ± 0.4 kg of BW). A basal diet based on corn, soybean meal, and fish meal and 3 diets containing 70% of the basal diet and 30% of each whey product were prepared. Each diet was fed to 8 pigs that were housed individually in metabolism cages. The total collection method was used for fecal and urine collections with 5-d adaptation and 5-d collection periods, and the difference procedure was used to calculate DE and ME in the 3 whey products. The concentrations of DE in whey powder and low-ash whey permeate were greater (P < 0.001) than in whey permeate (3,646 and 3,683 vs. 3,253 kcal/kg of DM). The concentrations of ME in whey powder and low-ash whey permeate were also greater (P < 0.001) than in whey permeate (3,462 and 3,593 vs. 3,081 kcal/kg of DM). The ATTD and STTD of P in the 3 whey products were determined using 32 barrows (11.0 ± 0.81 kg of BW). Three cornstarch-sucrose-based diets containing 30% of each whey product as the sole source of P were prepared. A P-free diet that was used to estimate the basal endogenous losses of P was also formulated. The ATTD of P in whey powder and in whey permeate was greater (P < 0.001) than in low-ash whey permeate (84.3 and 86.1 vs. 55.9%), but the STTD values for P were not different among the 3 ingredients (91.2, 93.1, and 91.8% in whey powder, whey permeate, and low-ash whey permeate, respectively). In conclusion, whey permeate contains less GE, DE, and ME than whey powder and low-ash whey permeate, but all 3 ingredients have an excellent digestibility of P.

Amino acid digestibility in heated soybean meal fed to growing pigs

Heat treatment of soybean meal (SBM) is necessary to reduce the concentration of trypsin inhibitors, but excessive heat treatment may reduce AA concentration and digestibility because AA can be destroyed by the Maillard reaction. The objective of this experiment was to determine the effects of heat treatment of SBM on apparent ileal digestibility and standardized ileal digestibility (SID) of AA by growing pigs. A source of conventional dehulled SBM (48.5% CP) was divided into 4 batches. One batch was not additionally heated, 1 batch was autoclaved at 125°C for 15 min, 1 batch was autoclaved at 125°C for 30 min, and 1 batch was oven-dried at 125°C for 30 min. Four SBM-cornstarch diets were formulated, and each of the 4 batches of SBM was used as the sole source of dietary AA in 1 diet. A N-free diet was used to estimate basal endogenous losses of AA. Ten growing barrows with an initial BW of 25.3 ± 2.0 kg were individually fitted with a T-cannula in the distal ileum. Pigs were allotted to treatments in a replicated 5 × 5 balanced Latin square design with 5 diets and 5 periods. Each period lasted 7 d, and ileal digesta were collected on d 6 and 7 of each period. Results of the experiment indicated that the apparent ileal digestibility and SID of CP and all AA decreased linearly (P < 0.01) as the time of autoclaving increased from 0 to 30 min. The concentration of furosine and the color of samples of SBM indicated that autoclaving resulted in a Maillard reaction in the SBM. However, oven drying at 125°C for 30 min did not change (P > 0.10) the SID of CP and AA in the SBM or the furosine concentration, and the color in the oven-dried sample indicated that this sample was not heat damaged. In conclusion, the digestibility of all AA in autoclaved SBM is linearly reduced as the autoclaving time increases from 0 to 30 min. The reason for these changes is most likely that autoclaving at 125°C results in Maillard reactions in SBM.

Phospho-Smad1 modulation by nedd4 E3 ligase in BMP/TGF-β signaling

A considerable number of studies have focused on the regulation of mothers against decapentaplegic homologue (Smad)-dependent or -independent pathways in the signaling by each transforming growth factor β (TGF-β) superfamily member in diverse biologic contexts. The sophisticated regulation of the actions of these molecules and the underlying molecular mechanisms still remain elusive. Here we show new mechanisms of ambilateral R (receptor-regulated)-Smad regulation of bone morphogenetic protein 2 (BMP-2)/TGF-β1 signals. In a specific context, both signals regulate the nonclassic Smads pathway reciprocally, BMP-2 to Smad2/3 and TGF-β1 to Smad1/5/8, as well as their own classic linear Smad pathway. Interestingly, in this study, we found that C-terminal phosphorylated forms of each pathway Smad degraded rapidly 3 hours after stimulation of nonclassic signals but are dramatically restored by treatment with via proteasomal inhibition. Furthermore, an E3 ligase, neural precursor cell expressed, developmentally down-regulated 4 (Nedd4), also was found as one of the important modulators of the p-Smad1 in both BMP-2 and TGF-β1 action. Overexpressed Nedd4 suppressed the BMP-induced osteoblast transdifferentiation process of premyoblast C2C12 cells or alkaline phosphatase (ALP) level of human osteosarcoma cells and promoted TGF-β1-induced degradation of p-Smad1 via physical interaction and polyubiquitination. Conversely, siNedd4 potentiated BMP signals through upregulation of p-Smad1 and ALP activity, the effect of which led to an increased the rate of P(i) -induced calcification of human vascular smooth muscle cells. These new insights about proteasomal degradation-mediated phosphorylated nonclassic Smad regulation of BMP-2/TGF-β1 could, in part, help to unravel the complex mechanisms of abnormal nonosseous calcification by the aberrant activity of BMP/TGF-β/Smads.

Abstract 827: The protective effects of the synthetic triterpenoid CDDO-methyl ester on colitis associated colon cancer

Colitis-associated colon cancer (CAC) is the principal colorectal cancer associated with inflammatory bowel disease, and is associated with a high mortality rate. The synthetic oleanane triterpenoid 2-cyano-3,12-dioxooleana-1,9(11)-dien-C28-methyl ester (CDDO-me) has been shown to exert potent anti-inflammatory effects, and to suppress the growth and inhibit viability of colon cancer cells. However, the utility of triterpenoids in the chemoprevention of CAC has not been investigated. Therefore, we have interrogated the ability of CDDO-me to suppress inflammation and epithelial transformation in a unique mouse model of colon cancer developed in our laboratory, in which a T cell-restricted disruption of the Smad4 gene leads to progressive inflammation and epithelial neoplasia. Smad4 is a common intermediate in the signaling pathways for transforming growth factor-beta (TGF-β), bone morphogenetic protein (BMP), Activin and other members of the TGF-β superfamily. Naïve Smad4−/− T cells are develop a pro-inflammatory phenotype characterized by the production of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β, IFN-γ) and are unable to differentiate to a suppressor T cell phenotype in response to TGF-beta. Mice lacking T cell expression of Smad4 (Smad4co/coTcellCre+) exhibit progressive mucosal inflammation and thickening, including increased expression of inflammatory mediators (iNOS, COX-2), and a concomitant loss of expression of important tumor suppressors, including 15-hydroxyprostaglandin dehydrogenase (15-PGDH), compared to wild type littermates. Treatment of Smad4co/coTcellCre+ mice with CDDO-me for 1 month significantly reduces the inflammation, weight loss, and epithelial neoplasia. These effects were also associated with an overall increase in survival in CDDO-me treated Smad4co/coTcellCre+ mice compared with those receiving vehicle alone. CDDO-me treatment down regulated the production of pro-inflammatory cytokines and the expression of iNOS and COX-2 in the colon epithelium and restored the expression of 15-PGDH. We investigated the direct effects of CDDO-me on colon epithelial cells using FET cells and found that CDDO-me induced 15-PGDH transcripts and protein expression in a dose dependent manner. Finally, CDDO-me activated TGF-β signaling and potentiated TGF-β induced 15-PGDH expression in a manner that could be blocked by TGF-β signaling inhibitors. This in vivo induction of 15-PGDH expression was not observed in mice with a germ-line deletion of the gene encoding the TGF-β intermediate, Smad3. These data suggest that CDDO-me increases the expression of 15-PGDH by potentiating TGF-β signaling in colon epithelial cells. Therefore, CDDO-me may be a potent agent for the chemoprevention of colitis induced colon cancer due to its ability to increase the expression of 15-PGDH and down-regulate the expression of pro-inflammatory mediators.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 827. doi:10.1158/1538-7445.AM2011-827

Role of Smad4-deficient T cells in Gastrointestinal Inflammatory Disease (59.7)

Selective loss of Smad4 signaling in T cells leads to spontaneous gastrointestinal inflammation and cancer. However, the mechanism underlying the pathogenesis of these diseases is not completely understood. Here, we report that Smad4 is essential for TGF-β conversion of naïve T cells into Foxp3+ regulatory T (Treg) cells and for TGF-β suppression of effector T cells activity. We show that Smad4 deficient (Smad4KO) T cells do not generate Foxp3-expressing cells in inducible Treg (iTreg) differentiation condition. In suppression assays, iTreg cells from naïve WT T cells suppress T cell proliferation but Smad4KO T cells lack suppressive activity. In Smad4KO mice at 6 months of age, FoxP3+ Treg cells among CD4+ T cells are significantly reduced in the colon, but not in the thymus or spleen compared to those of WT. Moreover, TGF-β suppresses the proliferation of WT CD4+ T cells via cell cycle arrest and reduces the production of pro-inflammatory cytokines including INF-γ and IL-6, but TGF-β fails to suppress T cell proliferation and pro-cytokine production of Smad4 KO T cell. As expected, CD4+ and CD8+ T cells in the colon of Smad4KO mice are highly activated and produce pro-inflammatory cytokines, such as INF-γ and IL-6 greater compared with those of WT. Taken together, our results suggest the important role of Smad4 dependent TGF-β signaling in T cells in the maintenance of mucosal immune homeostasis and the pathogenic mechanism underlying gastrointestinal disease.

The synthetic triterpenoid, CDDO-Me, modulates the proinflammatory response to in vivo lipopolysaccharide challenge

The synthetic triterpenoid, CDDO-Me, has potent antiproliferative and antioxidant properties. However, its immunomodulatory effects in the context of LPS challenge are incompletely defined. Pretreatment with oral CDDO-Me significantly improved survival following lethal-dose LPS challenge in mice. To define this protection further, we measured effects of CDDO-Me pretreatment on splenocyte populations and cytokine production following LPS challenge, using low-level LPS pretreatment as an in vivo control for reducing cytokine production. Despite similar decreases in levels of LPS-inducible, circulating proinflammatory cytokines (IL-12p70, IFN-gamma, IL-6, IL-17, and IL-23) and increases in heme oxygenase 1 (HO-1) protein expression, low-dose LPS and CDDO-Me pretreatments markedly differed in their overall response profiles. Splenocytes from LPS-pretreated mice contained reduced numbers of dendritic cells, increased percentages of Th17 and T-regulatory cells, lower levels of TLR-inducible IL-6, and higher levels of TLR-inducible IL-10. In contrast, CDDO-Me protection against LPS challenge had no impact on absolute numbers or distribution of splenocyte subsets, despite attenuating in vivo induction of proinflammatory cytokines in an IL-10-independent manner. Together, these results suggest that CDDO-Me pretreatment uniquely confers protection against LPS challenge by modulating the in vivo immune response to LPS. Thus, CDDO-Me potentially represents a novel oral agent for use in LPS-mediated inflammatory diseases.

Prognostic significance of MRI-detected bladder muscle and/or serosal invasion in patients with cervical cancer treated with radiotherapy

In cervical cancer, the prognostic significance of bladder wall invasion on MRI without pathological evidence of mucosal invasion is not known. From 454 consecutive patients with cervical cancer who were treated with radiation, we reviewed images and analysed the outcome of 92 patients with the Federation of International Gynecology and Obstetrics (FIGO) stage IIIB-IVA. We analysed the patients in three groups, normal, wall (muscle and/or serosal) invasion and mucosal invasion, according to the findings on the MRI. Kaplan-Meier life table analysis and the log-rank test were used to assess the survival rates and differences according to prognostic factors. MRI detected abnormalities in the bladder wall in 42 patients (45.6%): wall invasion in 24 and mucosal invasion in 18. 5 of 18 patients, suspected on MRI to have mucosal invasion, showed no pathological evidence of mucosal invasion. Median follow-up period was 34 months. 3-year cause-specific survival (CSS) in the normal group compared with the wall invasion group was 76.2% vs 71.4% (p = 0.48). 3-year CSS for the wall invasion group compared with the mucosal invasion group was 71.4% vs 54.3% (p = 0.04). Mucosal invasion on MRI (p = 0.03) and concurrent chemoradiotherapy (p = 0.01) was significant for CSS. The prognosis for patients with cervical cancer with evidence of muscle and/or serosal invasion of the bladder on MRI may not differ from that for patients without abnormality on MRI. In patients with the MRI finding of bladder mucosal invasion, further studies should be conducted regarding the role of cystoscopy to determine the need for pathological confirmation.

Clinical features of acute renal failure associated with hepatitis A virus infection

Acute hepatitis A (AHA) is one of the most common infectious diseases; it is usually a self-limiting disease affecting the liver. Although extrahepatic manifestations are not common, some cases have been reported associated with acute renal failure. We reviewed the clinical features of patients with AHA complicated by acute renal failure (ARF group) and compared them with patients with noncomplicated AHA (non-ARF group). The medical records of 208 consecutive patients with AHA who were diagnosed between January 2003 and October 2008 were reviewed. We identified 15 patients (7.2%) with ARF associated with AHA. There were no differences between the ARF and non-ARF group with regard to gender and age. The peak value of alanine aminotransferase (ALT) (median: 6060 IU/L vs 1792 IU/L, P < 0.001), prothrombin time (PT) (International normalized ratio, median 1.72 vs 1.10, P < 0.001), and total bilirubin level (median: 9.6 mg/dL vs 6.3 mg/dL, P = 0.04) were significantly higher in the ARF than in the non-ARF group. Twelve patients (80%) recovered completely with haemodialysis (seven patients, 46.7%) or only conservative management (five patients, 33.3%), while one patient underwent liver transplantation because of fulminant hepatic failure, and two patients died because of fulminant hepatic failure. There were no deaths among patients with noncomplicated AHA in the non-ARF group. Five patients underwent kidney biopsy; two patients were diagnosed with acute tubular necrosis, two patients with acute interstitial nephritis with IgA nephropathy and one patient with acute tubulointerstitial nephritis. All patients in the ARF group had microscopic haematuria and proteinuria (100%vs 31.1%, P < 0.001). Urine sodium levels were more than 10 mEq/L in 10 patients. The findings of high urinary sodium concentrations, microscopic haematuria and proteinuria did not support the diagnosis of hepatorenal syndrome (HRS). Patients with AHA with ARF had higher ALT levels, more prolonged PTs, and higher total bilirubin levels. The prognosis for these patients was poorer than for those without ARF. However, the patients with ARF and nonfulminant AHA had recovered with proper treatment and should not be confused with patients that have HRS.

High viremia, prolonged Lamivudine therapy and recurrent hepatocellular carcinoma predict posttransplant hepatitis B recurrence

Hepatitis B virus (HBV) recurrence following orthotopic liver transplantation (OLT) is generally preventable by prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine (LAM). However, HBV recurrence sometimes develops despite prophylaxis. This study assessed posttransplant outcomes and identified predictors of HBV recurrence. We analyzed the outcomes of 209 consecutive patients positive for hepatitis B surface antigen who underwent OLT, who received either combination prophylaxis with HBIG and LAM (89.0%) or HBIG monoprophylaxis (11.0%). The median follow-up was 36.8 months (range, 1.0-84.4). Posttransplant HBV recurrence occurred in 22 patients (10.5%), including 13 patients with drug-resistant mutations. HBV recurrence was observed in six patients after hepatocellular carcinoma (HCC) recurrence. Independent predictors of HBV recurrence were recurrent HCC (p < 0.001), LAM therapy >1.5 years (p = 0.001) and high HBV DNA titers (> or =10(5) copies/mL) at OLT (p = 0.036). In conclusion, high viremia at OLT and prolonged exposure to LAM should be further stressed as main predictors of HBV recurrence.

A structured, segregated model for genetically modified Escherichia coli cells and its use for prediction of plasmid stability

A structured, segregated model is presented for an asynchronously growing population of genetically modified Escherichia coli cells. A finite representation method was modified so that 272 cells could be used to represent a microbial population. The concept of a "limbo" compartment was introduced to allow random plasmid distribution to daughter cells upon cell division while restricting the number of computer cells included in the calculation. This scheme enabled us to predict plasmid instability and distribution of plasmid-originated properties in a population without a priori determination of growth rates or probability of forming plasmid-free cells from plasmid-containing cells. Predictions of population behavior using a single-cell model requires no adjustable parameters. The results comparing different induction strategies suggest that in continuous culture, there exists an optimum efficiency of partial induction that maximizes the long-term productivity of the gene product due to plasmid stability. With the optimum efficiency of partial induction, constant induction appears to prove more stable than cycling induction.

Role of PI3K on the regulation of BMP2-induced beta-Catenin activation in human bone marrow stem cells

Bone morphogenetic protein 2 (BMP2), a very potent bone-inducing agent, promotes the differentiation of bone marrow stem cells (BMSCs) to osteoblasts. However, the potency of BMP2 action is variable and its perturbed dynamic signaling pathways in human BMSCs has not been fully elucidated. In this study, we used a combination of stable isotope labeling by amino acids during cell culture (SILAC) and liquid-chromatography electrospray ionization mass spectrometry (LC-ESI-MS/MS) technology to reveal the BMP2 action in BMSC. In this quantitative proteomic analysis, 414 of 449 proteins were successfully quantified with 79.2% peptide quantification efficiency. Interestingly, beta-Catenin was identified in BMP2-stimulated heavy isotope-labeled cells, and further analysis confirmed that BMP2 increased beta-Catenin mRNA and protein levels. The increment effects of BMP2 on the beta-Catenin expression levels and its translocation to nucleus were diminished by blocking the PI3K signal pathway. In addition, BMP2-induced beta-Catenin activity and ALP activity were blocked by PI3K inhibition. Thus, our quantitative proteomics analysis and further biochemical investigations showed that BMP2 modulates beta-Catenin signaling via PI3K pathway and that this pathway plays roles in BMP2-induced osteoblast differentiation of hBMSCs.

Kinetic resolution of alpha-methylbenzylamine with omicron-transaminase screened from soil microorganisms: application of a biphasic system to overcome product inhibition

Two microorganisms showing high omicron-transaminase activity (Klebsiella pneumoniae JS2F and Bacillus thuringiensis JS64) were screened by the enrichment method using (S)-alpha-methylbenzylamine (alpha-MBA) as a sole nitrogen source. Optimal carbon and nitrogen sources for enzyme induction and the properties of omicron-transaminases were investigated. omicron-Transaminase from B. thuringiensis JS64 was highly enantioselective (E = 75.3) for (S)-enantiomer of alpha-MBA and showed remarkable stability. However, omicron-transaminase showed severe product inhibition by acetophenone. An aqueous/organic two-phase system was introduced to overcome this problem. Through solvent screening, cyclohexanone and ethyl acetate were selected as the best organic phases. The acetophenone-extracting capacity of the solvent and the biocompatibility of the solvent to the cell were important determinants in the reaction rate at high concentrations of alpha-MBA. The reaction rate of omicron-transamination was strongly influenced by the volume ratio of organic phase to aqueous phase as well as agitation speed in the biphasic mixture. Using the optimal volume ratio (Vorg:Vaq = 1:4) in the biphasic system with cyclohexanone, the reaction rate of omicron-transaminase under vigorous mixing conditions increased ninefold compared with that in the monophasic aqueous system. At the same optimal conditions, using whole cells, 500 mM alpha-MBA could be resolved successfully to above 95% enantiomeric excess of (R)-alpha-MBA with ca. 51% conversion. (c) 1997 John Wiley & Sons, Inc. Biotechnol Bioeng 55: 348-358, 1997.

Identification of diabetic nephropathy-selective proteins in human plasma by multi-lectin affinity chromatography and LC-MS/MS

PURPOSE

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus. Microalbuminuria has been established as a risk factor for the development of diabetic renal disease. Recently, microalbuminuria has been reported to have limitations in determining disease risk and predicting DN. Therefore, identification of more specific biomarkers for prediction of DN is needed.

EXPERIMENTAL DESIGN

When kidney damage is initiated, glycoprotein leakage into the blood may occur, thus altering the glycoproteome profile of the blood. Here, we have used a combined approach of glycoprotein enrichment of plasma with a proteomic analysis to discover potential DN biomarkers. We isolated glycoproteins from plasma provided by six type 2 diabetes control (DC) and six type 2 DN patients using multi-lectin affinity chromatography. Captured glycoproteins were resolved by 1-D PAGE and tryptic digests of isolated proteins were analyzed by LC-MS/MS.

RESULTS

From the comparative and semi-quantitative proteome analysis, we identified 13 up- and 14 down-regulated glycoproteins in DN plasma. Among the up-regulated glycoproteins, the levels of lumican, vasorin and retinol binding protein-4 were verified by Western blot analysis of individual plasma samples.

CONCLUSION AND CLINICAL RELEVANCE

Collectively, our findings show that biomarker discovery has considerable potential for predicting diabetic nephropathy in diabetic patients.

Dominant mobility modulation by the electric field effect at the LaAlO3/SrTiO3 interface

Caviglia et al. [Nature (London) 456, 624 (2008)] have found that the superconducting LaAlO3/SrTiO3 interface can be gate modulated. A central issue is to determine the principal effect of the applied electric field. Using magnetotransport studies of a gated structure, we find that the mobility variation is almost 5 times that of the sheet carrier density. Furthermore, superconductivity can be suppressed at both positive and negative gate bias. These results indicate that the relative disorder strength strongly increases across the superconductor-insulator transition.

Retinoic acid can enhance conversion of naive into regulatory T cells independently of secreted cytokines

It has been reported that retinoic acid (RA) enhances regulatory T (T reg) cell conversion by inhibiting the secretion of cytokines that interfere with conversion. This report shows that these conclusions provide a partial explanation at best. First, RA not only interfered with cytokine secretion but also with the ability of these cytokines to inhibit T reg cell conversion of naive T cells. Furthermore, RA enhanced conversion even in the absence of inhibitory cytokines. The latter effect depended on the RA receptor α (RARα) but did not require Smad3, despite the fact that RA enhanced Smad3 expression. The RARα1 isoform was not essential for RA-dependent enhancement of transforming growth factor β–driven conversion, suggesting that conversion can also be mediated by RARα2. Interleukin (IL)-6 strongly reduced RARα expression levels such that a deficiency of the predominant RARα1 isoform leaves too little RARα2 for RA to inhibit the generation of Th17 cells in the presence of IL-6.

Collection of biological and non-biological particles by new and used filters made from glass and electrostatically charged synthetic fibers

Synthetic filters made from fibers carrying electrostatic charges and fiberglass filters that do not carry electrostatic charges are both utilized commonly in heating, ventilating, and air-conditioning (HVAC) systems. The pressure drop and efficiency of a bank of fiberglass filters and a bank of electrostatically charged synthetic filters were measured repeatedly for 13 weeks in operating HVAC systems at a hospital. Additionally, the efficiency with which new and used fiberglass and synthetic filters collected culturable biological particles was measured in a test apparatus. Pressure drop measurements adjusted to equivalent flows indicated that the synthetic filters operated with a pressure drop less than half that of the fiberglass filters throughout the test. When measured using total ambient particles, synthetic filter efficiency decreased during the test period for all particle diameters. For particles 0.7-1.0 mum in diameter, efficiency decreased from 92% to 44%. It is hypothesized that this reduction in collection efficiency may be due to charge shielding. Efficiency did not change significantly for the fiberglass filters during the test period. However, when measured using culturable biological particles in the ambient air, efficiency was essentially the same for new filters and filters used for 13 weeks in the hospital for both the synthetic and fiberglass filters. It is hypothesized that the lack of efficiency reduction for culturable particles may be due to their having higher charge than non-biological particles, allowing them to overcome the effects of charge shielding. The type of particles requiring capture may be an important consideration when comparing the relative performance of electrostatically charged synthetic and fiberglass filters.

PRACTICAL IMPLICATIONS

Electrostatically charged synthetic filters with high initial efficiency can frequently replace traditional fiberglass filters with lower efficiency in HVAC systems because properly designed synthetic filters offer less resistance to air flow. Although the efficiency of charged synthetic filters at collecting non-biological particles declined substantially with use, the efficiency of these filters at collecting biological particles remained steady. These findings suggest that the merits of electrostatically charged synthetic HVAC filters relative to fiberglass filters may be more pronounced if collection of biological particles is of primary concern.