Urinary BLCA-4 is highly specific for detection of bladder cancer in Chinese Han population and is related to tumour invasiveness

BLCA-4 is currently the most sensitive and specific urinary marker for bladder cancer. As the incidence of bladder cancer varies by ethnic and territory, we tended to evaluate the feasibility of bladder cancer detection using urinary BLCA-4 in Chinese Han nationality. Urines from 79 bladder cancer patients, 31 urinary tract infection patients and 29 normal controls were included. Tissue specimens of 53 bladder cancers, 24 pathologically normal tumour- adjacent urothelium and 15 healthy controls were involved. BLCA-4 antibody was produced and applied in an indirect ELISA assay for urine samples and immunohistochemistry study in tissue samples. Urinary BLCA-4 was significantly higher in the bladder cancer group (P=0.0001). The level was in no relation to age, gender, growth pattern, grade or stage. Discrepant to reported data, a cut-off value of 1.7×10⁻⁴ A was acquired here, which yields a sensitivity of 97.37% and specificity of 100%. Muscle invasiveness was related to a higher BLCA-4 level (P=0.0175). Tumour tissues were also scored higher in staining (P=0.0001), yet this was not related to invasiveness. In 41.67% of adjacent normal tissue we found positive BLCA-4 expression. Urinary BLCA-4 was also highly specific in bladder cancer detection in the Chinese, with additional indicative value in muscle invasiveness detection. A cut-off value of 1.7×10⁻⁴ A may be more adaptive to Chinese Han population.

PCATMIP: enhancing signal intensity in diffusion-weighted magnetic resonance imaging

Diffusion-weighted MRI studies generally lose signal intensity to physiological motion, which can adversely affect quantification/diagnosis. Averaging over multiple repetitions, often used to improve image quality, does not eliminate the signal loss. In this article, PCATMIP, a combined principal component analysis and temporal maximum intensity projection approach, is developed to address this problem. Data are first acquired for a fixed number of repetitions. Assuming that physiological fluctuations of image intensities locally are likely temporally correlated unlike random noise, a local moving boxcar in the spatial domain is used to reconstruct low-noise images by considering the most relevant principal components in the temporal domain. Subsequently, a temporal maximum intensity projection yields a high signal-intensity image. Numerical and experimental studies were performed for validation and to determine optimal parameters for increasing signal intensity and minimizing noise. Subsequently, a combined principal component analysis and temporal maximum intensity projection approach was used to analyze diffusion-weighted porcine liver MRI scans. In these scans, the variability of apparent diffusion coefficient values among repeated measurements was reduced by 59% relative to averaging, and there was an increase in the signal intensity with higher intensity differences observed at higher b-values. In summary, a combined principal component analysis and temporal maximum intensity projection approach is a postprocessing approach that corrects for bulk motion-induced signal loss and improves apparent diffusion coefficient measurement reproducibility.

Toll-like receptor (TLR)-4 mediates anti-β2GPI/β2GPI-induced tissue factor expression in THP-1 cells

Our previous study demonstrated that annexin A2 (ANX2) on cell surface could function as a mediator and stimulate tissue factor (TF) expression of monocytes by anti-β₂-glycoprotein I/β₂-glycoprotein I complex (anti-β₂GPI/β₂GPI). However, ANX2 is not a transmembrane protein and lacks the intracellular signal transduction pathway. Growing evidence suggests that Toll-like receptor 4 (TLR-4) might act as an 'adaptor' for intracellular signal transduction in anti-β₂GPI/β₂GPI-induced TF expressing cells. In the current study, we investigated the roles of TLR-4 and its related molecules, myeloid differentiation protein 2 (MD-2) and myeloid differentiation factor 88 (MyD88), in anti-β₂GPI/β₂GPI-induced TF expressing human monocytic-derived THP-1 (human acute monocytic leukaemia) cells. The relationship of TLR-4 and ANX2 in this process was also explored. Along with TF, expression of TLR-4, MD-2 and MyD88 in THP-1 cells increased significantly when treated by anti-β₂GPI (10 µg/ml)/β₂GPI (100 µg/ml) complex. The addition of paclitaxel, which competes with the MD-2 ligand, could inhibit the effects of anti-β₂GPI/β₂GPI on TLR-4, MD-2, MyD88 and TF expression. Both ANX2 and TLR-4 in THP-1 cell lysates could bind to β₂GPI that had been conjugated to a column (β₂GPI-Affi-Gel). Furthermore, TLR-4, MD-2, MyD88 and TF expression was remarkably diminished in THP-1 cells infected with ANX2-specific RNA interference (RNAi) lentivirus (LV-RNAi-ANX2), in spite of treatment with a similar concentration of anti-β₂GPI/β₂GPI complex. These results indicate that TLR-4 and its signal transduction pathway contribute to anti-β₂GPI/β₂GPI-induced TF expression in THP-1 cells, and the effects of TLR-4 with ANX2 are tightly co-operative.

miR-29b expression is associated with disease-free survival in patients with ovarian serous carcinoma

Micro-RNAs are a group of small noncoding RNAs approximately 22 nucleotides in length. Recent work has shown differential expression of mature micro-RNAs in human cancers. We characterized the alteration in expression of miR-29b in ovarian serous carcinoma. miR-29b expression was analyzed using quantitative stem-loop reverse transcriptase polymerase chain reaction on a set of 50 formalin-fixed, paraffin-embedded ovarian serous carcinoma samples. Protein expression of p53, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, and insulinlike growth factor 1 was quantified in the corresponding tissue microarray. The expression profile of miR-29b was correlated with clinicopathological and patient survival data. We provide definitive evidence that miR-29b is down-regulated in a significant proportion of ovarian serous carcinomas and is associated with specific clinicopathological features, most notably high miR-29b expression being associated with reduced disease-free survival.

[Effect of liposomal albendazole on the ultrastructure of Echinococcus granulosus cysts in mice]

AIM

To observe the histopathological changes of Echinococcus granulosus cysts in mice treated with liposomal albendazole and co-administration with cimetidine by light microscopy and electron microscopy.

METHODS

An oral dose of liposomal ABZ with different formulations was given at 200 mg/kg.d. Cimetidine was administered daily at an oral dose of 100 mg/kg.d. Sixty-seven mice were orally given different drugs six days per week for a total of twelve weeks.

RESULTS

The histopathological changes indicated that there were significant differences (P < 0.01) between treated groups and control group. The degeneration and necrosis of E. granulosus cysts were marked in liposomal albendazole combined with cimetidin group.

CONCLUSION

Liposomal albendazole was more effective against E. granulosus cyst than albendazole. Cimetidine had an apparent synergistic effect when given in combination with liposomal albendazle.

Bone hydatid disease

Bone hydatid disease lacks a typical clinical appearance and image characteristics on x ray or CT are similar to those of tuberculosis, metastases and giant cell tumour or bone cysts. However, MRI does show distinctive diagnostic features of bone hydatid disease, especially in the spine. Until recently, treatment of osseous hydatid disease has been entirely surgical. Effective chemotherapy using benzimidazoles, particularly mebendazole, albendazole and combination treatments, has now been achieved in experimental studies and clinical practice. However, most of these drugs are still in the experimental stage or are in the early stages of clinical use.

A correlative study of ultrasound with serology in an area in China co-endemic for human alveolar and cystic echinococcosis

We correlated ultrasound (US) imaging classifications for human alveolar echinococcosis (AE) and cystic echinococcosis (CE) with serology (ELISA and immunoblotting (IB) incorporating native and recombinant/purified echinococcal antigens) in community surveys (2001-2003) and follow-up (2002 and 2003) of US-confirmed cases in Ningxia, China. One hundred and seventy-one cases (96 with AE, 75 with CE) were identified; of these, US classification and serological data were obtained for 142 and 112 cases, respectively. Seropositive-rates increased in CE patients with highly viable unilocular cyst lesions (Types CL, CE 1 or CE 2) to degenerating primary lesions (CE 3), but then decreased in subjects with inactive (CE 4) or dead (CE 5) cysts. In contrast, there was a constant increase in seropositivity from the early (P1, P2) to the advanced stages (P3, P4) with AE cases. For US-confirmed cases, follow-up by US combined with serology is invaluable for studying the clinical progression of echinococcosis and for detecting recurrent cysts or reinfection post-treatment.

Epigenetics, disease, and therapeutic interventions

Heritable changes in gene expression that do not involve coding sequence modifications are referred to as "epigenetic". Epigenetic mechanisms principally include DNA methylation and a variety of histone modifications, of which the best characterized is acetylation. DNA hypermethylation and histone hypoacetylation are hallmarks of gene silencing, while DNA hypomethylation and acetylated histones promote active transcription. Aberrant DNA methylation and histone acetylation have been linked to a number of age related disorders including cancer, autoimmune disorders and others. Since epigenetic alterations are reversible, modifying epigenetic marks contributing to disease development may provide an approach to designing new therapies. Herein we review the role of epigenetic changes in disease development, and recent advances in the therapeutic modification of epigenetic marks.

v-Myb represses the transcription of Ets-2

The v-Myb oncogene causes monoblastic leukemia and transforms only myelomonocytic cells in culture. The v-Myb protein is nuclear and binds to specific DNA sequences. To identify genes regulated by v-Myb, we utilized primary cells transformed by a retrovirus encoding a v-Myb-estrogen receptor (ER) fusion protein. The Ets-2 gene was not expressed in v-Myb-ER transformed cells in the presence of estradiol, but was expressed within 4 h after estradiol withdrawal. The expression of Ets-2 also increased dramatically following phorbol ester-induced differentiation of the v-Myb-transformed BM2 cell line. Conversely, CRYP-alpha, encoding a transmembrane tyrosine phosphatase, was expressed in the presence but not the absence of estradiol in v-Myb-ER transformed cells. CRYP-alpha was downregulated during the phorbol ester-induced differentiation of BM2 cells. Although LIM-3 expression was estradiol-inducible in v-Myb-ER transformed monoblasts, LIM-3 was expressed neither in primary yolk sac cells transformed by unfused v-Myb nor in BM2 cells. We conclude that although v-Myb has been intensively studied as a transcriptional activator, v-Myb can repress biologically relevant genes such as Ets-2, which promotes macrophage differentiation. In addition, we have shown that some genes that are regulated by a v-Myb-ER fusion protein may not be relevant to the biological function of the unfused v-Myb protein.

Genotyping of human cystic echinococcosis in Xinjiang, PR China

The Xinjiang Uygur Autonomous Region, multi-ethnic province in northwestern China, is one of the most important foci of human cystic echinococcosis (CE) in the world. Two Echinococcus granulosus genotypes (G1 and G6) are known to infect the intermediate hosts in this area but, to date, the source of the human infection remains unclear. The current study aimed to genetically analyse 67 hydatid cysts removed from 47 CE patients for which epidemiological, clinical and serological data were also recorded. Mitochondrial cox 1 gene sequencing suggested that the E. granulosus G1 genotype is the major source of infection (45/47 CE patients). Nevertheless, for the first time in China, 2 patients were found with hydatid cysts of the G6 genotype. In addition, 45 E. granulosus gravid tapeworms, isolated from 13 dogs, were genotyped. The majority of adult worms (42/45) exhibited the G1 genotype, whereas 3 adult tapeworms with the G6 genotype were found in one dog, that also harboured E. granulosus tapeworms of the G1 genotype. This sympatric occurrence of G1 and G6 genotypes of E. granulosus, not only in the same area but also in the same definitive host, raises the interesting question of putative genetic recombination between these E. granulosus genotypes.

Human cystic echinococcosis in two Mongolian communities in Hobukesar (China) and Bulgan (Mongolia)

In order to investigate the prevalence of human cystic echinococcosis (CE) in traditional Mongolian communities in western Mongolia and Xinjiang (northwest China), studies were carried out between 1995 and 2000, on two ethnically identical populations in Hobukesar (China) and Bulgan (Mongolia). The prevalence of human hepatic CE in the two communities was significantly different. In Hobukesar, human CE prevalence by ultrasound was 2.7% (49/1844), while in Bulgan it was 0.2% (4/1609) (P<0.001). Dog surveys showed that coproantigen-positive rates or dog necropsy positives were similar in both communities (35.0% in Hobukesar and 35.7% in Bulgan). Comparing possible risk factors, there appeared to be some significant differences between the two communities, which might contribute to the observed difference in CE prevalence. These included: the proportion of herdsman or farmers recorded; the proportions of dog ownership and livestock ownership; and the proportion of families practising home slaughter. The presence of a Russian dog-dosing programme up to the mid-1980s may explain the lower prevalence of human CE in the Bulgan population; no similar programme operated in the China-administered Hobukesar community.

Anaphylaxis after hamster bites--identification of a novel allergen

BACKGROUND

Hamsters are popular household pets and anaphylaxis after their bites have described. However, the putative allergen has not been identified.

OBJECTIVE

This study was conducted to identify the allergen causing dwarf hamster (Phodopus sungoris) bite-induced anaphylaxis.

METHODS

Two children with hamster bite-induced anaphylaxis were enrolled. They both had negative results to skin testing and specific IgE to hamster epithelium. However, they were both allergic to Dermatophagoides pteronyssinus (Der p). Identification of the putative IgE-binding allergens from the hamster saliva was performed using immunoblot analysis.

RESULTS

A specific IgE-binding component at 21 kD in the hamster saliva was identified. ELISA inhibition tests showed partial inhibition with Der p.

CONCLUSIONS

The putative allergen from the hamster saliva causing dwarf hamster-induced anaphylaxis was identified. Possible cross-reactivity with Der p was demonstrated. Further studies will be needed to identify the exact nature and function of this allergen.

GNB3 gene C825T and ACE gene I/D polymorphisms in essential hypertension in a Kazakh genetic isolate

The Kazakh inhabitants living in Barkol pasture of northeast China belong to a genetic isolate characterized by ethnically homogeneous and a communal pastoral lifestyle. To investigate whether the polymorphisms in the G-protein beta-3 subunit (GNB3) gene and angiotensin-converting enzyme (ACE) gene are associated with essential hypertension (EH), we carried out a case-control study of 290 hypertensive subjects and 244 normotensive (NT) controls randomly selected from Kazakh populations of Barkol. A previous medical history of diabetes and hypertension, and body mass index (BMI) was recorded. Plasma glucose, triglyceride, and cholesterol were measured. The insertion/deletion (I/D) polymorphism of the ACE gene and the C825T polymorphism of the GNB3 gene were determined by the polymerase chain reaction (PCR) technique. The distributions of genotypes and alleles for the two polymorphisms did not differ significantly between the case and control populations, and odds ratio of EH related to the ACE gene D allele and GNB3 gene T allele was not significantly different from 1.0. Logistic regression analysis shows the variation at the GNB3 and ACE did not have any statistically significant synergistic effect on blood pressure (BP). Stratification of NT and untreated hypertensives according to I/D polymorphism of ACE gene and C825T polymorphism of GNB3 gene disclosed no significant difference across genotypes with respect to BMI, glucose, triglyceride, cholesterol, systolic and diastolic BP. In conclusion, the polymorphisms in the GNB3 gene and ACE gene, solely or combined, did not confer a significantly increased risk for the development of EH in the Kazakh isolate of northeast China.

[Experimental observation on anaphylaxis induced by Echinococcus infection in Meriones unguiculatus]

OBJECTIVE

To observe the anaphylaxis induced by Echinococcus granulosus or E. multilocularis (E. g. and E. m.) infection in Meriones unguiculatus.

METHODS

56 and 48 gerbils were intraperitoneally inoculated with E. g. protoscoleces and E. m. tissue homogenate. After three months, the anaphylactic responses initiated by intraperitoneal challenge injection with E. g. cystic fluids or partially purified antigen or E. m. metacestode homogenate antigen were observed. IgE antibody and direct eosinophilic leukocyte count (DELC) were detected at pre-postchallenge.

RESULTS

The infection rates for E. g and E. m. in 56 and 48 gerbils were 89.3% and 97.9%, respectively. Among these groups, the lowest rate of anaphylaxis was 62.5%, the highest was 100%. The lowest rate of anaphylactic shock was 12.5%, and the highest 16.7%. After the gerbis were infected with E. g. and E. m., both IgE antibody and DELC increased gradually. At 60 min post challenge, IgE antibody level were significantly decreased, while DELC showed a sharp increase.

CONCLUSION

Anaphylaxis could be induced in gerbils by Echinococcus infection followed by a challenge injection. Different antigens lead to different and degrees among the anaphylactic responses in the gerbils, however, there were no significant differences between E. g. and E. m. infections in gerbils.

[Evaluation of diagnostic value of 18 kDa antigen in alveolar echinococcosis]

AIM

To evaluate the 18 kDa antigen in diagnosis of human alveolar echinococcosis.

METHODS

A total of 214 sera from patients with alveolar echinococcosis (AE, 33), cystic echinococcosis (CE, 69), cysticercosis (30) and healthy controls (82) were examined by Western blotting to detect the antibodies against 18 kDa antigen using both antigens from protoscoleces of E. granulosus (Eg) and E. multilocularis (Em). All the sera were tested simultaneously by ELISA to detect the antibodies against hydatid cystic fluid antigens of sheep as a comparison.

RESULTS

The positive rate by ELISA was 93.9% in AE, 85.5% in CE, 50% in cysticercosis and 6.1% in healthy controls, respectively, suggesting a critical cross-reaction and a certain degree of nonspecific reaction. The serum positive rates by Western blotting with the 18 kDa antigen of Eg and Em were 90.9% and 90.9% in AE, 10.1% and 13% in CE, 13.3% and 16.7% in cysticercosis, respectively. No positive was found in the sera from healthy controls.

CONCLUSION

The 18 kDa antigen may be used in the differential diagnosis of AE from CE.

Classification, follow-up and recurrence of hepatic cystic echinococcosis using ultrasound images

Ultrasound image and morphological structure of hepatic cystic echinococcosis (CE) were analysed in 277 human cases (385 hepatic hydatid cysts). These included 65 CE cases from community surveys carried out between 1995 and 2000 in 3 countries (China, Mongolia and Jordan) and 212 cases from a clinical hospital survey from Xinjiang, China. A new simplified WHO ultrasound classification for human CE was assessed, and considered useful. It is proposed that type, size and number in particular need to be included in the ultrasound classification of hepatic CE. For comparative purposes 6 categories of type were classified in the study as Type 0 to Type 5 (T0-T5): T0, univesicular without pathognomonic signs; T1, univesicular with pathognomonic signs; T2, cysts with sagging or floating laminated membrane; T3, cysts containing daughter cysts; T4, solid mass or mixed cysts; and T5, cysts with partial or full calcifications. This differs from the WHO classification wherein Type T3 cysts (daughter cysts present) are considered a pathological stage to occur in general prior to the sagging or floating membrane (T2) stage. Recurrent hydatid cysts in the liver were also studied based on morphological structures observed directly from surgical intervention. Case follow-up over 1-5 years since endocystectomy in the community surveys indicated 10% (2/10) recurrence of cysts in the residual surgical cavity. Recurrent CE included 2 (2/4) cases after percutaneous treatment.