Angiotensin II modulates the activity of the Na+/K+ATPase in eel kidney

We have previously shown that angiotensin II (Ang II) has a role at the level of the eel gill chloride cell regulating sodium balance, and therefore osmoregulation; the purpose of the present study was to extend these findings to another important osmoregulatory organ, the kidney. By catalytic histochemistry Na(+)/K(+)ATPase activity was found in both sea water (SW)- and freshwater (FW)-adapted eel kidney, particularly at the level of both proximal and distal tubules. Quantitation of tubular cell Na(+)/K(+)ATPase activity, by imaging, gave values in SW-adapted eels which were double those found in FW-adapted eels (Student's t-test: P<0.0001). This was due to a reduced number of positive tubules present in FW-adapted eels compared with SW-adapted eels. By conventional enzymatic assay, the Na(+)/K(+)ATPase activity in isolated tubular cells from SW-adapted eels showed values 1.85-fold higher those found in FW-adapted eels (Student's ttest: P<0.0001). Perfusion of kidney for 20 min with 100 nM Ang II provoked a significant increase (1.8-fold) in Na(+)/K(+)ATPase activity in FW, due to up-regulation of Na(+)/K(+)ATPase activity in a significantly larger number of tubules (Student's t-test: P<0.0001). The effect of 100 nM Ang II in SW-adapted kidneys was not significant. Stimulation with increasing Ang II concentrations was performed on isolated kidney tubule cells: Ang II provoked a dose-dependent stimulation of the Na(+)/K(+)ATPase activity in FW-adapted eels, reaching a maximum at 100 nM (1.82-fold stimulation), but no significant effect was found in SW-adapted eels (ANOVA: P<0.001 and P>0.05 respectively). Isolated tubule cells stimulated with 100 nM Ang II showed a significant generation of inositol trisphosphate (InsP(3)) and an increment in calcium release from intracellular stores. In conclusion, our results suggest that tubular Na(+)/K(+)ATPase is modulated by environmental salinity, and that Ang II has a role in regulating its activity in FW-adapted eels, probably through an InsP(3)-dependent mechanism.

Endothelin-2 synthesis is stimulated by the type-1 tumour necrosis factor receptor and cAMP: comparison with endothelin-converting enzyme-1 expression

ABSTRACT The synthesis of the vasoconstrictor peptide endothelin-2 (ET-2) is dependent on hydrolysis of the biologically inactive intermediate big ET-2 by an endothelin-converting enzyme (ECE). Here, mechanisms inducing ET-2 synthesis have been investigated using the human renal adenocarcinoma cell line (ACHN). Synthesis of ET-2 by ACHN cells was inhibited by phosphoramidon (IC(50( congruent with11 microM). To determine whether ET-2 synthesis occurs in parallel with the metallopeptidase ECE-1, a putative processing peptidase for big ET-2, changes in the levels of their mRNAs were compared by semi-quantitative RT-PCR under conditions causing the upregulation of ET-2 synthesis. Tumour necrosis factor-alpha (TNFalpha), forskolin and a cell-permeable cAMP analogue (dibutyryl cAMP) caused concentration-dependent increases in ET-2 synthesis. Combination of forskolin or dibutyryl cAMP with TNFalpha produced a significantly greater increase in ET-2 production than these agents alone, indicating that adenylate cyclase and TNFalpha induce ET-2 synthesis by separate signalling pathways. Studies using receptor selective TNFalpha mutants, (125(I-TNFalpha binding and TNF receptor mRNA showed that type-1 TNF receptors mediate the ET-2 response to TNFalpha. PreproET-2 mRNA levels were increased by TNFalpha at 1 h and 2 h, but returned to control levels at 4 h. Treatment with forskolin significantly increased preproET-2 mRNA levels after 1 h and 4 h. ACHN cells expressed ECE-1b and ECE-1c, but not the ECE-1a isoform of this peptidase. RT-PCR for the combined isoforms ECE-1b/c/d showed TNFalpha to increase mRNA levels at 2 h and 4 h. Forskolin had no effect on ECE-1b/c/d mRNA levels. Thus, expression of ET-2 and ECE-1b/c/d mRNAs in ACHN cells do not display the co-ordinated regulation observed with typical peptide prohormone processing enzymes and their substrates.

A novel diagnosis of left paraduodenal hernia through laparoscopy

A congenital intraperitoneal hernia, also known as a "paraduodenal hernia," is an extremely rare cause of intestinal obstruction. These hernias, which are caused by variations in intestinal rotation, present with symptoms ranging from intermittent abdominal pain to acute obstruction. Preoperative diagnosis is rare, and conventional treatment is usually by laparotomy. Laparoscopic diagnosis and repair has recently been reported in Japan. We present as case of a left paraduodenal hernia diagnosed and treated laparoscopically and a review of the literature.

Perinatal predictors of growth at six months in small for gestational age babies

Poor growth in childhood is associated with a number of later complications and early recognition may enable early intervention to improve outcomes. Approximately 20% of small for gestational age (SGA) babies remain small at two years. Most catch up growth occurs in the first 6 months and smallness at 6 months predicts later small size in the majority of cases. There are no previous reports of perinatal predictors of size at 6 months in SGA babies. The aim of this study was to identify the perinatal factors associated with small size at 6 months in infants who were SGA at birth (birthweight < 10th%). SGA infants had assessments of length, weight, and head circumference performed at three monthly intervals by the same researcher. Detailed perinatal data was collected in all cases. Abnormal size was defined as a length, weight or head circumference measurement < 10th% for 6 months corrected age. Infants were considered to show failure of catch-up growth if measurements at 6 months were further below the population mean than birth measurements. Two hundred and forty eight babies were recruited of whom 203 (82%) completed followup at 6 months. Forty (20%) babies were short, and in logistic regression shortness at 6 months was predicted by shortness at birth and male sex. Thirty one (16%) had weight < 10th% and low weight was predicted in logistic regression by early gestation at diagnosis of SGA (median 30.8 weeks in those who were under weight and 33.9 weeks in those of normal weight p < 0.0001). Thirty seven (18%) had a low head circumference which was predicted by small head size at birth. Three quarters of the babies who were short, underweight, or had low head circumference at 6 months also showed failure of catch-up growth. Shortness and small head circumference at 6 months were predicted by shortness and small head circumference at birth, especially in boys. Underweight was predicted by early detection of SGA antenatally. Most SGA babies who remained small at 6 months failed to show catch up growth after birth.

A preliminary study determining the feasibility of electromagnetic tracking for kinematics at the ankle joint complex

OBJECTIVE

To determine the feasibility of using electromagnetic tracking (EMT) for quantifying three-dimensional kinematics at the ankle joint complex (AJC).

METHODS

AJC kinematics were recorded in 10 normal healthy adults, and 10 rheumatoid arthritis patients presenting with AJC instability and deformity who were undergoing footwear and orthotic intervention.

RESULTS

Kinematics in normal subjects had strong face validity, curve shape showing moderate (n=9), good (n=8) or excellent (n=4) agreement with data from seven published studies. The range of motion about the x-axis (15.2 degrees ) was similar to reference values (17.0 degrees ), but our technique underestimated rotations about the y- (8.1 degrees vs 14.0 degrees ) and z-axes (7.7 degrees vs 12.2 degrees ). In the rheumatoid arthritis pronated foot group, eversion and internal rotation during the stance phase of gait were between 2 and 5 times greater than for normal subjects. The use of a corrective foot orthosis in this group restored normal kinematics, reducing maximum eversion and internal rotation by 57 and 68%, respectively.

CONCLUSION

A new technique for measuring kinematics at the AJC is described. Based upon the findings of this pilot study, EMT may be useful for diagnosing AJC dysfunction and quantifying the mechanical efficacy of footwear and orthosis interventions.

Epidemiology and genetic theories in the etiology of congenital talipes equinovarus

The exact genetic mechanism of inheritance of congenital talipes equinovarus (CTEV) has been extensively investigated using family studies and other epidemiological methods, but to date no conclusive result has been reached. This may be due to the presence of a number of inheritance patterns, a number of different etiologies presenting as the same morphological condition, or complex gene-environment interactions. Indeed, a number of epidemiological factors have also been implicated in the etiology. While epidemiological studies can suggest inheritance patterns, only by identification of specific genes, can inheritance patterns be proven. This article reviews the epidemiological work on the etiology of CTEV and discusses some of the epidemiological principles involved.

Administration of low-dose aspirin to mothers with small for gestational age fetuses and abnormal umbilical Doppler studies to increase birthweight: a randomised double-blind controlled trial

OBJECTIVE

To determine whether antenatal treatment (for > or = 14 days) with 100 mg aspirin daily, given to mothers with small for gestational age fetuses and abnormal umbilical Doppler, will increase birthweight.

DESIGN

Randomised, double-blind placebo controlled trial.

SETTING

A tertiary referral centre.

PARTICIPANTS

Ninety-nine women, of whom 65 were treated for > or = 14 days (32 with aspirin and 33 with placebo) and comprised the study group. The entry criteria were: singleton pregnancy with ultrasound evidence of a small for gestational age fetus (abdominal circumference < 10%); previous anatomy scan < 20 weeks and no evidence of fetal abnormality; gestation between 24 and 36 weeks; umbilical artery Doppler resistance index > 95% for gestation; no previous aspirin treatment in pregnancy; and no contra-indication to aspirin treatment.

RESULTS

The mean duration of treatment was 30 days for aspirin treated, and 29 for placebo. No difference was found in birthweight or other measures of fetal growth or newborn morbidity between those treated with aspirin or placebo. Compliance, assessed by thromboxane B2 analysis, showed almost complete suppression of thromboxane B2 in aspirin treated women.

CONCLUSION

Low-dose aspirin did not increase birthweight in pregnancies where the fetus has abnormal umbilical Doppler and is thought to be small for gestational age.

Statewide replication of predictive validation for the Multnomah Community Ability Scale

The Multnomah Community Ability Scale is a 17 item instrument that case managers can use to rate levels of functioning for clients with severe mental illness. Prior work in a large urban community mental health center showed that the instrument predicted subsequent involuntary hospitalization. The current project involved some 2,487 clients of community mental health programs throughout Oregon. This replication study again showed that low scores on the instrument predicted subsequent psychiatric hospitalization.

Endothelin-1 is induced by cytokines in human vascular smooth muscle cells: evidence for intracellular endothelin-converting enzyme

Endothelin-1 (ET-1) is the predominant endothelin isopeptide generated by the vascular wall and therefore appears to be the most important peptide involved in regulation of cardiovascular events. Many pathologic conditions are associated with elevations of ET-1 in the blood vessel wall. Because these conditions are often cytokine driven, we examined the effects of a mixture of cytokines on ET-1 production in human vascular smooth muscle cells (VSMCs) derived from internal mammary artery and saphenous vein (SV). Incubation of IMA and SV VSMCs with tumor necrosis factor-alpha (10 ng/ml) and interferon-gamma (1000 U/ml) in combination for up to 48 h markedly elevated the expression of mRNA for prepro-ET-1 and the release of ET-1 into the culture medium. This cytokine-stimulated release of ET-1 was inhibited by a series of dual endothelin-converting enzyme (ECE)/neutral endopeptidase inhibitors, phosphoramidon, CGS 26303, and CGS 26393, with an accompanying increase in big ET-1 release but with no effect on expression of mRNA for prepro-ET-1. These same compounds were 10 times more potent at inhibiting the conversion of exogenously applied big ET-1 to ET-1. ECE-1b/c mRNA is present in SV VSMCs, however no ECE-1a is present in these cells. Thus VSMCs most probably contain, like endothelial cells, an intracellular ECE responsible for the endogenous synthesis of ET-1. Under the influence of pro-inflammatory mediators the vascular smooth muscle can therefore become an important site of ET-1 production, as has already been established for the dilator mediators nitric oxide, prostaglandin I2, and prostaglandin E2.

The expression of endothelin-1 and endothelin-converting enzyme-1 (ECE-1) are independently regulated in bovine aortic endothelial cells

The endopeptidase called endothelin-converting enzyme-1 (ECE-1) is thought to play a physiological role in endothelin-1 (ET-1) biosynthesis. For human ECE-1, differential splicing of messenger RNA (mRNA) results in the synthesis of three isoforms, termed ECE-1a, ECE-1b, and ECE-1c. The isoform(s) responsible for the hydrolysis of the biosynthetic intermediate big ET-1 in endothelial cells have yet to be assigned. To investigate whether the expression of mRNAs for preproET-1 and ECE-1 are regulated in parallel, a variety of conditions were used to compare levels of ET-1 synthesis by bovine aortic endothelial cells (BAECs) with levels of mRNA for preproET-1, ECE-1a, ECE-1c, and the combined ECE-1 isoforms (ECE-1a/b/c). Stimulation of BAECs with tumor necrosis factor-alpha or transforming growth factor-beta increased ET-1 synthesis, and treatment of BAECs with 2-chloroadenosine or staurosporine caused concentration-dependent reductions in ET-1 synthesis. Estimates of mRNA levels by reverse transcription-polymerase chain reaction (RT-PCR) with linear cycling conditions showed changes in preproET-1 expression to correlate well with ET-1 secretion. In contrast, RT-PCR analysis of ECE-1 expression by using primer pairs to measure ECE-1a, ECE-1c, or all the ECE-1 isoforms simultaneously showed no correlation between their mRNA levels and those of preproET-1. This indicates that under the conditions investigated, expression of ECE-1 is not coordinated with ET-1 synthesis in BAECs.

Ultrasonographic measurement of liver length in the small-for-gestational-age fetus

OBJECTIVE

Our purpose was to measure fetal liver size in small-for-gestational-age fetuses diagnosed by ultrasonography and to determine whether the small abdominal circumference used to diagnose small for gestational age is the result of a small liver.

STUDY DESIGN

Ninety-eight pregnant women who were diagnosed as having a fetus that was small for gestational age were included. All had a fetal ultrasonographic measurement of abdominal circumference <10th percentile for gestational age. Measurements were made of the length of the right lobe of the fetal liver within 2 weeks of delivery. The liver length measurements were compared with data collected from a normal population that had been previously published by the authors. The group of fetuses with liver length measurements <10th percentile for gestational age were compared with those with liver length measurements within normal limits.

RESULTS

Liver length measurements were >10th percentile in 80 fetuses (82%). Eighteen fetuses (18%) had small liver lengths, and this group had significantly smaller antenatal ultrasonographic measurements of head, abdomen, and femur. They were smaller at birth with smaller placentas and they had a higher perinatal mortality rate.

CONCLUSION

The small abdominal circumference measurement that is the mainstay of ultrasonographic diagnosis of small for gestational age is thought to be a reflection of fetal liver size. This study questions that assumption. The majority of small-for-gestational-age fetuses in this small study did not have small liver lengths. The small abdominal circumference measurement may reflect a reduction in size of other intra-abdominal organs, reduced amounts of fat, or possibly an elevated diaphragm because of poor lung growth.

NMR structure of C-terminally tagged gramicidin channels

A biotin group was covalently attached to the C terminus of gramicidin A (gA) through a linker arm comprising a glycine residue with either one (gAXB) or two caproyl groups (gAXXB). High-resolution two-dimensional NMR spectroscopy was used to determine the structure of these modified gA analogues and [Lys16]gramicidin A (gA-Lys) in sodium dodecyl-d25 sulphate micelles. Gated gA ion channels based on linking a receptor group to these gA analogues have been used recently as a component in a sensing device. The conformations of the gA backbones and amino acid side chains of lysinated gA and biotinylated gA in detergent micelles were found to be almost identical to that of native gA, i.e. that of an N-terminal to N-terminal (head to head) dimer formed by two right-handed, single-stranded beta 6.3 helices. The biotin tail of the gAXB and gAXXB and the lysine extremity of gA-Lys appeared to lie outside the micelle. Thus it appears that the covalent attachment of functional groups to the C terminus of gA does not disrupt the peptide's helical configuration. Further, single channel measurements of all three gA analogues showed that functioning ion channels were preserved within a membrane environment.

Obituary: Meredith Joan Smith (Nee Clark)

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Comparison of the regulation of endothelin-2 and endothelin-converting enzyme-1 b [correction of beta] by forskolin and TNF-alpha in ACHN cells

The effects on the expression and secretion of ET-2 of forskolin and tumor necrosis factor-alpha (TNF-alpha) were investigated using the human renal adenocarcinoma (ACHN) cell line. For comparison, changes in endothelin-converting enzyme-1 b (ECE-1 b) [corrected] mRNA were also determined. Treatment for 4 with TNF-alpha (3 ng/ml), forskolin (30 microM), or the combination caused significant increases in ET-2 release, TNF-alpha alone or in combination with forskolin increased ET-2 mRNA levels at 1 h and 2 h. After 4 h the expression of ET-2 mRNA was comparable to control levels. In contrast to ET-2, ECE-1 b [corrected] mRNA levels were increased by TNF-alpha only at 4 h. Forskolin increased expression of ET-2 mRNA at 1 and 4 but had no significant effect on expression of ECE-beta. These data suggest that expression of ET-2 and ECE-1 b [corrected] mRNA is regulated differently in ACHN cells.

Studies of endothelin-converting enzyme in bovine endothelial cells and vascular smooth-muscle cells: further characterization of the biosynthetic process

Endothelin-1 (ET-1) is synthesized by a number of cell types, including endothelial, epithelial, and smooth muscle cells. Initial biosynthesis occurs as a protein precursor, preproendothelin-1 (preproET-1). This is processed intracellularly to the inactive intermediate big ET-1, which is hydrolyzed by endothelin-converting enzyme (ECE) to generate ET-1, but the precise identity of the physiologically relevant ECE has yet to be confirmed. Although ET-1 is synthesized in the constitutive secretory pathway, many features of the selective processing of proET-1 are comparable to those of peptide hormones. We describe here experimental investigations aimed at defining the regulation of ET-1 synthesis and its relationship to the biosynthesis of ECE.

Cloning of bovine preproadrenomedullin and inhibition of its basal expression in vascular endothelial cells by staurosporine

The cDNA encoding preproadrenomedullin (preproAM) was cloned using reverse transcriptase polymerase chain reaction (RT-PCR) and 5' rapid amplification of cDNA ends from total RNA from bovine aortic endothelial cells (BAEC). Bovine preproAM cDNA shows high sequence homology with human, porcine and rat preproAM. Bovine-specific primers derived from this sequence were used in RT-PCR to study regulation of this gene. Treatment of BAEC or a human endothelial cell line (Ea.hy 926) with the non-selective protein kinase inhibitor staurosporine resulted in significantly reduced preproAM mRNA levels. The reduction in preproAM mRNA appeared to be absolute when Ea.hy 926 cells were exposed to 100 nM staurosporine for 2 h. However, this dramatic reduction could not be reproduced by treatment with the protein kinase A (PKA) inhibitor H-89, or the protein kinase C (PKC) inhibitors chelerythrine chloride and bisindolylmaleimide I. These observations suggest that activation of a novel staurosporine-sensitive protein kinase is necessary for basal expression of the preproAM gene in these cells.