Age-related expression of PEDF/EPC-1 in human endometrial stromal fibroblasts: implications for interactive senescence

Aging is the major risk factor for many cancers, and age-related changes in the tissue microenvironment can facilitate tumor growth. This study uses human endometrial cells to begin to test the hypothesis that age-related changes in pigment epithelium-derived factor/early population doubling cDNA-1 (PEDF/EPC-1) levels create an environment that is more permissive to tumor growth. Endometrial stromal fibroblasts (ESF) are the predominant cell type in the human endometrium and exert regulatory control over the glandular epithelial cells, which are the source of most tumors. As ESF age in vitro, their ability to regulate appropriate growth and differentiation of epithelial cells declines. Endometrial epithelial cells in primary culture expressed relatively low levels of PEDF/EPC-1 mRNA. In contrast, early passage quiescent ESF from adult donors produce higher levels of the 1.5-kb PEDF/EPC-1 mRNA and 50-kDa secreted protein than epithelial cells. As ESF age in vitro the relative abundance of PEDF/EPC-1 mRNA declines, as does the level of PEDF/EPC-1 protein secreted into cell culture medium. Treatment with PEDF/EPC-1 protein had no effect on ESF proliferation but did inhibit anchorage-dependent and anchorage-independent proliferation of endometrial carcinoma cells in a dose- and time-dependent manner. These findings imply that an age-related loss of PEDF/EPC-1 expression by ESF could eliminate a negative regulator of cancer cell growth and, thereby, contribute to the age-related increase in cancer incidence.

Influenza surveillance in England and Wales: October 1997 to June 1998

Influenza caused low levels of mortality and morbidity in England and Wales in the 1997/98 season. Influenza viruses of the H3N2 and H1N1 subtypes were isolated in small numbers from community and hospital patients in November and December. Their numbers subsequently increased to peak in February, H1N1 a week or two before H3N2. Most of the H1N1 isolates were similar to the A/Bayern/7/95-like virus, included in the vaccine recommended for 1997-98, whereas most H3N2 isolates were A/Sydney/5/97-like, a virus not covered by the season's vaccine but recommended for 1998/99. Consultation rates in general practice for influenza-like illnesses remained low until early February, when a small increase coincided with the increase in laboratory confirmed influenza. Fewer deaths directly attributed to influenza were registered during the surveillance period than in recent years. Localised outbreaks occurred in schools and nursing homes towards the end of the winter.

A field trial of detection and treatment of nerve function impairment in leprosy--report from national POD pilot project

As part of a collaborative project between the Ministry of Health of China (MOH) and The Leprosy Mission International (TLMI) on leprosy rehabilitation and prevention of disability (POD), a total of 1407 patients was monitored for possible nerve function impairment (NFI) through standardized clinical nerve function assessment between May 1995 and February 1998. Of these, 191 patients were found to have NFI and were put on a fixed regimen of prednisolone. In this study, 36.7% of NFI occurred before diagnosis of leprosy, 35.6% developed during MDT and 25.7% after their release from MDT. Overall, 7.5% (105 out of 1407) of all patients, or 55.9% of patients with NFI, suffered from silent neuropathy. Of the affected nerves, 62.6% had silent neuropathy. Sensory impairment responded to prednisolone satisfactorily, giving a recovery rate of 73.8%, 76.5% and 81.0% in ulnar, median and posterior tibial nerve, respectively. Sensibility in patients even with a NFI duration longer than 6 months made significant improvement (p < 0.05). Motor function improvement was less satisfactory, especially in ulnar and c. popliteal nerve. The possible reasons are analysed. Our findings with regard to sensibility changes confirm that once it becomes clinically detectable, NFI is no longer at the 'early' stage. More sensitive tests are necessary to detect real 'early' sensory impairment in the field. Our study also indicates that with well-trained field staff and proper equipment for nerve function assessment, early detection and treatment of NFI can be practical and effective.

Selective potentiation of gynecologic cancer cell growth in vitro by electromagnetic fields

OBJECTIVE

Epidemiological data suggest that exposure to electromagnetic fields (EMF) may increase the risk of various cancers. We evaluated EMF effects on the in vitro growth response of human cell lines isolated from various reproductive tract tissues. We also assessed the effects of EMF on cisplatin- or paclitaxel-induced cytotoxicity.

METHODS

Endometrial, ovarian, and prostate cancer cell lines as well as immortalized endometrial stromal cells and immortalized ovarian epithelial cells were exposed continually to EMF. Proliferation was assessed by the metabolic activity assay, MTT, direct cell counting, and anchorage-independent colony formation in soft agar. Cytotoxicity induced by cisplatin or paclitaxel was assessed using the MTT assay.

RESULTS

Continuous exposure to EMF at field strengths of 2 G enhanced proliferation of two human prostate and three endometrial, but only one ovarian, cancer cell lines. EMF enhanced metabolic activity of cancer cells within 96 h and increased absolute cell number (anchorage-dependent proliferation) and colony-forming efficiency (anchorage-independent proliferation) over sham-treated controls. EMF had no effect on cytotoxicity induced by the chemotherapeutic agents Taxol or cisplatin.

CONCLUSIONS

Continuous exposure to EMF can enhance growth rates of transformed cells for some human epithelial cancers. Cancer cells from the steroid sex hormone regulated tissues of endometrium and prostate appeared to be more responsive to EMF than cells from ovarian cancers.

Advance directives in a correctional setting

Using advance directives to preconsent to mental health treatment is a promising approach to contending with the quandary posed by patients suffering from severe mental health illness, particularly those in a prison setting. The implementation of advance directives represents unfamiliar territory because it focuses on the patient's ability to preconsent to treatment rather than the commonly interpreted prerefusal of treatment. The challenge of consenting in the prison system generates a set of unique problems. The environment in which the instrument is signed can impose significant pressures and therefore result in a viable legal challenge. The prison setting is the most coercive environment in which a patient can be treated, particularly when the patient is mentally ill. Mentally ill prisoners signing preconsent for treatment advance directives have an opportunity for unprecedented relief yet may also experience pressure to select treatments desirable to the prison staff.

Identification of the structural region of taxol that may be responsible for cytokine gene induction and cytotoxicity in human ovarian cancer cells

PURPOSE

Interleukin-8 (IL-8) is a pleiotropic chemokine with both chemoattractant and angiogenic properties. In addition to its cytotoxic effects on ovarian cancer cells, taxol can transcriptionally activate genes such as IL-8 that may play a role in tumorigenesis. Utilizing IL-8 as a prototypic marker of tumor-derived modulators of growth, we undertook a systematic study of taxol and 11 structurally modified taxol analogs to identify the region of the taxane skeleton responsible for IL-8 gene induction.

METHODS

The human ovarian cancer cell line OVCA-420 was exposed to taxol or taxol analogs. IL-8 gene induction was assessed by Northern blot analysis after 6 h and cytotoxicity after 72 h.

RESULTS

Changes in the southern hemisphere (C-1 to C-4) of the taxane skeleton had greater effects on IL-8 induction than changes in the northern hemisphere (C-7 to C-11). Some of the taxol analogs modified at positions C-1 and/or C-2 with increased hydrophobicity induced IL-8 expression more than threefold over that induced by taxol or taxotere and more than 20-fold over control cells. Cells that failed to induce IL-8 gene expression in response to taxol were only marginally responsive to the analogs unless first primed with IL-1beta. Modifications to the northern hemisphere did not alter taxol's effect on IL-8 expression in human cells, but did influence TNFalpha expression in murine macrophage cells, suggesting species and/or gene specificity. We found a direct correlation between IL-8 induction and cytotoxicity, in that analogs that dramatically upregulated IL-8 expression proved to be the most cytotoxic, inhibiting cell survival by > 90%.

CONCLUSION

Taken together our results demonstrate that changes in the southern hemisphere of the taxane skeleton influence both the gene induction and cytotoxic potential of taxol in human ovarian cancer cells.

Geographical distribution of tuberculosis notifications in national surveys of England and Wales in 1988 and 1993: report of the Public Health Laboratory Service/British Thoracic Society/Department of Health Collaborative Group

BACKGROUND

The geographical distribution of tuberculosis in England and Wales and changes since 1983 were examined using data from the 1988 and 1993 national surveys of tuberculosis notifications.

METHODS

Notification rates for England and Wales in 1988 and 1993 were calculated for geographical areas using Office for National Statistics (ONS) mid year population estimates. Those for the standard regions and the Greater London boroughs were calculated for the main ethnic groups. Those for the counties and local authorities were calculated for all ethnic groups combined. These were compared using data from the 1983 national survey as a baseline.

RESULTS

Wide regional variations in notification rates persist with Greater London having the highest rates. Rates in the ethnic group from the Indian subcontinent (ISC) were high in all regions, whilst those of the white ethnic group varied fourfold. Twenty seven of the 33 London boroughs showed increased rates in 1993 compared with 1988. In general, those local authority areas with high rates had high proportions of notifications in individuals of ISC ethnic origin, emphasising the continuing important contribution of ethnic minority groups to local tuberculosis rates. The number of local authority areas with notification rates four times the national average increased, but the number of areas with low or zero rates increased even more.

CONCLUSIONS

The distribution of tuberculosis in England and Wales continues to vary markedly by geographical area. The distribution is becoming increasingly polarised with a growth in the number of areas with very high rates of notifications and a greater increase in the number of areas with very few notifications. Patients from ethnic minorities continued to contribute a substantial and increasing proportion of all reported tuberculosis cases in most regions in 1988 and 1993. These findings have important implications for the provision of tuberculosis services in England and Wales.

The origin and loss of the ubiquitin activating enzyme gene on the mammalian Y chromosome

Mammalian sex chromosomes are thought to be descended from a homologous pair of autosomes: a testis-determining allele which defined the Y chromosome arose, recombination between the nascent X and Y chromosomes became restricted and the Y chromosome gradually lost its non-essential genetic functions. This model was originally inferred from the occurrence of few Y-linked genetic traits, pairing of the X and Y chromosomes during male meiosis and, more recently, the existence of X-Y homologous genes. The comparative analysis of such genes is a means by which the validity of this model can be evaluated. One well-studied example of an X-Y homologous gene is the ubiquitin activating enzyme gene ( UBE1 ), which is X-linked with a distinct Y-linked gene in many eutherian ('placental') and metatherian (marsupial) mammals. Nonetheless, no UBE1 homologue has yet been detected on the human Y chromosome. Here we describe a more extensive study of UBE1 homologues in primates and a prototherian mammal, the platypus. Our findings indicate that UBE1 lies within the X-Y pairing segment of the platypus but is absent from the human Y chromosome, having been lost from the Y chromosome during evolution of the primate lineage. Thus UBE1 illustrates the key steps of 'autosomal to X-specific' evolution of genes on the sex chromosomes.

Influenza surveillance in England and Wales: October 1996 to June 1997

This report summarises information collected for the surveillance of influenza in England and Wales during the winter of 1996/97. Consultations for 'influenza and influenza-like illness' with sentinel general practitioners in England and Wales began to increase towards the end of November and peaked at the start of January. In England, consultations for 'aggregated respiratory disease' (ARD) began to increase a little earlier, perhaps as a result of increased respiratory syncytial virus activity, but also peaked in early January. Influenza A (H3N2) viruses were first detected in early October, but rarely until November, and activity peaked in early January, coinciding with the peak in consultations for flu-like illness. A few influenza B viruses were detected in late November and early December, and substantial activity was recorded in mid-January. Approximately equal numbers of influenza A(H3N2) and B viruses were identified over the winter as a whole, and circulating strains were antigenically similar to those included in the vaccine for 1996/97. Although influenza activity was 'moderate' in terms of consultations and laboratory confirmed infections, a large peak in death registrations occurred at the same time as influenza A(H3N2) virus activity peaked. The number of deaths during the winter was similar to that seen in 1989/90, when the last severe influenza epidemic occurred in England and Wales.

Tuberculosis in England and Wales in 1993: results of a national survey. Public Health Laboratory Service/British Thoracic Society/Department of Health Collaborative Group

BACKGROUND

A national survey of tuberculosis notifications in England and Wales was carried out in 1993 to determine the notification rate of tuberculosis and the trends in the occurrence of disease by ethnic group in comparison with the findings of similar surveys in 1978/79, 1983, and 1988. The prevalence of HIV infection in adults notified with tuberculosis in the survey period was also estimated.

METHODS

Clinical, bacteriological, and sociodemographic information was obtained on all newly notified cases of tuberculosis in England and Wales during the six months from 2 January to 2 July 1993. The prevalence of HIV infection in 16-54 year old patients with tuberculosis notified throughout 1993 was assessed using "unlinked anonymous" testing supplemented by matching of the register of patients with tuberculosis with that of patients with AIDS reported to the PHLS AIDS centre. Annual notification rates were calculated using population estimates from the 1993 Labour Force Survey.

RESULTS

A total of 2706 newly notified patients was eligible for inclusion in the survey of whom 2458 were previously untreated the comparable figures for 1988 were 2408 and 2163. The number of patients of white ethnic origin decreased from 1142 (53%) in 1988 to 1088 (44%) in 1993 whereas those of patients of Indian, Pakistani, or Bangladeshi (Indian subcontinent (ISC)) ethnic origin increased from 843 (39%) in 1988 to 1014 (41%) and those of "other" (non-white, non-ISC) ethnic origins increased from 178 (8%) to 356 (14%). The largest increase was seen in the black African ethnic group from 37 in 1988 to 171 in 1993. Forty nine per cent of patients had been born abroad and the highest rates were seen in those who had recently arrived in this country. The overall annual notification rate for previously untreated tuberculosis in England and Wales increased between 1988 and 1993 from 8.4 to 9.2 per 100,000 population. The rate declined in the white, Indian, and black Caribbean ethnic groups and increased in all other groups. In the white group the rate of decline has slowed since the last survey: in several age groups the rates were higher in 1993 than 1988 but the numbers in these groups were small. Thirty six (4.1%) of the 882 previously untreated respiratory cases were resistant to isoniazid and three (0.3%) to isoniazid and rifampicin. Sixty two (2.3%) adults aged 16-54 years were estimated to be HIV-infected. Evidence of under-reporting of HIV positive tuberculosis patients was found.

CONCLUSIONS

The number of cases and annual notification rate for previously untreated tuberculosis increased between 1988 and 1993. Although the decline in rates in the white population has continued, the rate of decline has slowed. The high rates in the ISC ethnic group population have continued to decline since 1988 whereas rates in the black African group have increased. An increased proportion of cases were found among people born abroad, particularly those recently arrived in this country. In previously untreated cases the level of drug resistance remains low and multi-drug resistance is rare. A small proportion of adults with tuberculosis were infected with HIV but there may be selective undernotification of tuberculosis in these patients.

SB-216641 and BRL-15572--compounds to pharmacologically discriminate h5-HT1B and h5-HT1D receptors

Despite only modest homology between h5-HT1B and h5-HT1D receptor amino acid sequences, these receptors display a remarkably similar pharmacology. To date there are few compounds which discriminate between these receptor subtypes and those with some degree of selectivity, such as ketanserin, have greater affinity for other 5-HT receptor subtypes. We now report on two compounds, SB-216641 (N-[3-(2-dimethylamino) ethoxy-4-methoxyphenyl]-2'-methyl-4'-(5-methyl-1,2,4-oxadiazol-3-yl)-(1,1'-biphenyl)-4-carboxamide) and BRL-15572 3-[4-(3-chlorophenyl) piperazin-1-yl]-1,1-diphenyl-2-propanol), which display high affinity and selectivity for h5-HT1B and h5-HT1D receptors, respectively. In receptor binding studies on human receptors expressed in CHO cells, SB-216641 has high affinity (pKi = 9.0) for h5-HT1B receptors and has 25-fold lower affinity at h5-HT1D receptors. In contrast, BRL-15572 has 60-fold higher affinity for h5-HT1D (pKi = 7.9) than 5-HT1B receptors. Similar affinities for these compounds were determined on native tissue 5-HT1B receptors in guinea-pig striatum. Functional activities of SB-216641 and BRL-15572 were measured in a [35S]GTPgammaS binding assay and in a cAMP accumulation assay on recombinant h5-HT1B and h5-HT1D receptors. Both compounds were partial agonists in these high receptor expression systems, with potencies and selectivities which correlated with their receptor binding affinities. In the cAMP accumulation assay, results from pK(B) measurements on the compounds again correlated with receptor binding affinities (SB-216641, pK(B) = 9.3 and 7.3; BRL-15572, pK(B) = <6 and 7.1, for h5-HT1B and h5-HT1D receptors respectively). These compounds will be useful pharmacological agents to characterise 5-HT1B and 5-HT1D receptor mediated responses.

NF-kappa B as a target for anti-inflammatory gene therapy: suppression of inflammatory responses in monocytic and stromal cells by stable gene transfer of I kappa B alpha cDNA

One of the most challenging issues of anti-inflammatory gene therapy is the complexity of inflammatory pathways. Transcription factor NF-kappa B plays a pivotal role in activation of multiple inflammatory molecules, and therefore represents the logical target for intervention. We evaluated the feasibility of suppressing the inflammatory responses in different cell lines through specific inhibition of NF-kappa B by gene transfer of I kappa B alpha, the naturally occurring intracellular inhibitor of NF-kappa B. The I kappa B alpha overexpressing cells were established using retroviral gene transfer or stable transfection with the wild-type (wt) I kappa B alpha cDNA. In all cell types, overexpression of wt I kappa B alpha resulted in a profound (> 100-fold) increase of the I kappa B alpha message and a moderate (two- to three-fold) increase of the I kappa B alpha protein. The effects of the I kappa B alpha overexpression on the NF-kappa B activation and the inflammatory responses varied significantly in different cell lines. In conditionally immortalized human endometrial stromal cells, overexpression of I kappa B alpha prevented both interleukin-1 (IL-1)-inducible degradation of endogenous I kappa B alpha protein and activation of NF-kappa B. Accordingly, induction of cytokines interleukin-8 (IL-8) and Gro gamma was markedly suppressed. In monocytic THP-1 cells, both lipopolysaccharide (LPS)-inducible degradation of I kappa B alpha and NF-kappa B activation were only partially inhibited by overexpression of exogenous I kappa B alpha cDNA. None the less, the LPS-induced transcription of IL-1 beta and secretion of cytokines interleukin-6 (IL-6) and IL-8 were virtually abolished. In epithelial HT-29 cells, no inflammatory responses were inhibited. These results demonstrate the range of responses in various cell lines to gene transfer of I kappa B alpha and indicate the feasibility of suppression of inflammatory responses in appropriate target cells and their progeny by suppression of NF-kappa B.

PHLS work on the surveillance and epidemiology of tuberculosis

The re-emergence worldwide of tuberculosis as a major threat to public health and continuing and changing challenges in the control of tuberculosis in England and Wales provide the basis for the designation, by the PHLS, of tuberculosis as a priority area. In addition to the mycobacteriology reference services provided by the PHLS in England and Wales (summarised in an accompanying article) the PHLS contributes to the control of tuberculosis through its surveillance and other epidemiological work. This article summarises the range of this work, emphasising the collaborative nature of the effort required for surveillance, prevention, and control of tuberculosis.

Golf club shaft impalement: case report of a zone III neck injury

Impalement occurs when a portion of the body is penetrated by a rigid object. These injuries incorporate aspects of both blunt and penetrating type injuries in that the object or the body at time of impact is traveling at relatively low velocity and the energy is dissipated over a short distance. Impalement injuries have been described for most body cavities. Evaluation of these injuries can be uniquely challenging. We present a case of impalement of the neck from an object previously unreported in the literature, a golf club shaft.

Influenza surveillance in England and Wales: October 1995 to June 1996

This report summarises information collected for the surveillance of influenza virus infection in England and Wales from October 1995 to June 1996 (weeks 40/95 to 25/96). Total respiratory disease' activity, as reported by the Birmingham Research Unit of the Royal College of General Practitioners, rose to peaks in weeks 48/95, 51/95, and 01/96. The first peak coincided with a peak in "influenza and flu-like illness'. The subsequent peaks were accounted for by an increase in reports of acute bronchitis, including bronchiolitis, and may have been associated with the annual rise in infections with respiratory syncytial virus. Influenza A virus was responsible for most infections, with moderate activity occurring in the early part of the winter, peaking in December (week 48/95). Influenza A subtype H3N2 predominated until week 07/96, after which subtype H1N1 accounted for most infections. Influenza activity was first seen in central and northern England, followed by the south of England, Wales, and Scotland. Circulating influenza viruses were antigenically similar to the components of the 1995/96 vaccine. International surveillance during 1995/96 has led to a different H3N2 component being included in the influenza vaccine recommended for 1996/97.

GR127935 acts as a partial agonist at recombinant human 5-HT1D alpha and 5-HT1D beta receptors

In this study we have investigated the functional activity of GR127935 (2-methyl-1,2,4 oxadiazol-3-yl)-biphenyl-[4-carboxylic acid 4-methoxy-3-(4-methyl-piperazine-1-yl]-amide) at human 5-HT1D alpha and 5-HT1D beta receptors which have been expressed in a Chinese Hamster Ovary (CHO) cell line. Using [35S] GTP gamma S binding to cell membranes as a measure of receptor-G protein coupling. GR127935 showed partial agonist activity in both 5-HT1D alpha and 5-HT1D beta receptor expressing cells (Emax: 29 and 31% above basal control; pEC50: 8.6 and 9.7, respectively). GR127935 also acted as a potent antagonist at the 5-HT1D alpha (app. pA2 8.5) and 5-HT1D beta (app. pA2 9.1) receptors. From studies measuring cAMP accumulation in cultured CHO cells GR127935 also displayed partial agonism, as well as acting as a potent antagonist at the 5-HT1D alpha receptors which stimulate cAMP levels and 5-HT1D beta receptors which inhibit cAMP levels (app. pA2 8.6 and 9.7, respectively). The 5\-HT1-like receptor antagonist methiothepin showed negative intrinsic activity at both receptors in the [35S]GTP gamma S binding assay only. From studies using the receptor alkylating agent EEDQ (N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline) the 5-HT1D alpha cell line displayed a lack of receptor reserve but it was evident in the 5-HT1D beta cell line. In previous studies we have also shown that agonist stimulation of 5-HT1D alpha receptors increases cAMP levels which may be due to high receptor expression. Further investigation using up to 1 microM EEDQ to reduce 5-HT1D alpha receptor number did not reveal an underlying inhibitory adenylyl cyclase response. In conclusion, GR127935 acts as a partial agonist, as well as a potent antagonist, at the human 5-HT1D alpha and 5-HT1D beta receptors when expressed in CHO cells.

Legionnaires' disease surveillance: England and Wales, 1995

One hundred and sixty cases of legionnaires' disease were reported to the PHLS Communicable Disease Surveillance Centre in 1995. Twenty cases (13%) were known to have died. Ninety cases (56%) were associated with travel (in the United Kingdom or abroad), four were associated with a stay in hospital, and the remaining 66 were presumed to have acquired infection in the community. One hundred and twenty-three cases (77%) occurred sporadically. Three community outbreaks and one outbreak at an industrial site were detected in England and Wales. One outbreak and five clusters were detected among visitors to Turkey, Spain, and Italy. Seven cases and one outbreak of nonpneumonic legionellosis were also reported. Cases of travel associated legionnaires' disease continue to account for the largest proportion of the total reported in 1995 and the number of hospital acquired cases continues to decline. A cause for concern in 1995 was a fall in the proportion of cases diagnosed by culture of the organism (from 16% in 1994 to only 9% in 1995). This corresponded with a small increase in the proportion of cases diagnosed solely by detection of antigen to L. pneumophila serogroup 1 in urine.

Opportunist mycobacteria in England and Wales: 1982 to 1994

Three thousand and fifty-two infections with opportunist mycobacteria were reported to the PHLS Communicable Disease Surveillance Centre from 1982 to 1994. The commonest reported species was Mycobacterium avium-intracellulare (MAI), followed by M. kansasii and M. malmoense. The annual totals of opportunist mycobacteria increased steadily over this period, mostly, but not exclusively, due to an increase in reports of MAI associated with HIV infection. There were also increases in reports of MAI not associated with HIV infection, and in reports of M. malmoense. The increase in reports of opportunist mycobacteria was seen throughout England and Wales, but underreporting of MAI infection in the National Health Service Thames regions appears to have increased in recent years. Continued referral of isolates of opportunist mycobacteria to one of the PHLS regional centres for mycobacteriology or the Mycobacterium Reference Unit, and reporting to CDSC, is essential for the surveillance of these infections.