Leptin, insulin, insulin-like growth factors and their binding proteins in cord serum: insight into fetal growth and discordancy

OBJECTIVE

Singleton infants with intrauterine growth restriction have an adaptive hormonal profile characterized by decreased levels of IGF-1, IGF-2, IGFBP-3 and insulin and elevated levels of IGFBP-1 and IGFBP-2. This study examined the association between cord serum levels of six growth factors and anthropometric features at birth in twins in order to determine the intrauterine growth factor interactions and to characterize the specific hormonal profile of small discordant twins.

DESIGN

Prevalent case-control study.

PATIENTS

Twenty pairs of discordant twins (5 monozygotic, 15 dizygotic) and 20 pairs of concordant twins (6 monozygotic, 14 dizygotic) matched for gestational age.

MEASUREMENTS

Cord blood levels of IGF-1, IGF-2, IGFBP-1, IGFBP-3, insulin, leptin and anthropometric measurements at birth. Intra- and inter-pair differences and correlation coefficients were calculated, and the data were fitted to multivariate regression models.

RESULTS

In both discordant and concordant groups, the smaller twins had a significantly lower level of IGF-1 (P < 0.03) and significantly higher level of IGFBP-1 (P < 0.02) than their larger cotwins. IGFBP-1 was inversely correlated with IGF-1 (P < 0.05). Insulin levels were significantly higher in the smaller discordant than the smaller concordant twins (P < 0.001) and in the larger discordant than the larger concordant twins (P < 0.004). Among the monozygotic twins, the leptin level was significantly higher in the larger discordant than the larger concordant twins (P < 0.025). Percentage birth weight discordancy was statistically correlated with twin-pair differences in IGF-1 and IGFBP-1.

CONCLUSIONS

Of the six factors studied, IGF-1 appears to be the main indicator of intrauterine growth. Twin discordancy may involve compensatory rather than adaptive mechanisms or a multihormone relative resistance syndrome.

A remote and highly conserved enhancer supports amygdala specific expression of the gene encoding the anxiogenic neuropeptide substance-P

The neuropeptide substance P (SP), encoded by the preprotachykinin-A (PPTA) gene, is expressed in the central and medial amygdaloid nucleus, where it plays a critical role in modulating fear and anxiety related behaviour. Determining the regulatory systems that support PPTA expression in the amygdala may provide important insights into the causes of depression and anxiety related disorders and will provide avenues for the development of novel therapies. In order to identify the tissue specific regulatory element responsible for supporting expression of the PPTA gene in the amygdala, we used long-range comparative genomics in combination with transgenic analysis and immunohistochemistry. By comparing human and chicken genomes, it was possible to detect and characterise a highly conserved long-range enhancer that supported tissue specific expression in SP expressing cells of the medial and central amygdaloid bodies (ECR1; 158.5 kb 5' of human PPTA ORF). Further bioinformatic analysis using the TRANSFAC database indicated that the ECR1 element contained multiple and highly conserved consensus binding sequences of transcription factors (TFs) such as MEIS1. The results of immunohistochemical analysis of transgenic lines were consistent with the hypothesis that the MEIS1 TF interacts with and maintains ECR1 activity in the central amygdala in vivo. The discovery of ECR1 and the in vivo functional relationship with MEIS1 inferred by our studies suggests a mechanism to the regulatory systems that control PPTA expression in the amygdala. Uncovering these mechanisms may play an important role in the future development of tissue specific therapies for the treatment of anxiety and depression.

Cardioprotection mediated by urocortin is dependent upon PKCε activation

Urocortin (Ucn) is an endogenous cardioprotective agent that protects against the damaging effects of ischemia and reperfusion injury in vitro and in vivo. We have found that the mechanism of action of Ucn involves both acute activation of specific target molecules, and using Affymetrix (Santa Clara, CA) gene chip technology, altered gene expression of different end effector molecules. Here, from our gene chip data, we show that after a 24 h exposure to Ucn, there was a specific increase in mRNA and protein levels of the protein kinase C epsilon (PKCepsilon) isozyme in primary rat cardiomyocytes compared with untreated cells and in the Langendorff perfused ex vivo heart. Furthermore, a short 10 min exposure of these cells to Ucn caused a specific translocation/activation of PKCepsilon in vitro and in the Langendorff perfused ex vivo heart. The importance of the PKCepsilon isozyme in cardioprotection and its relationship to cardioprotection produced by Ucn was assessed using PKCepsilon-specific inhibitor peptides. The inhibitor peptide, when introduced into cardiomyocytes, caused an increase in apoptotic cell death compared with control peptide after ischemia and reperfusion. When the inhibitor peptide was present with Ucn, the cardioprotective effect of Ucn was lost. This loss of cardioprotection by Ucn was also seen in whole hearts from PKCepsilon knockout mice. These findings indicate that the cardioprotective effect of Ucn is dependent upon PKCepsilon.

Technical Note: Technique for Dissection and Analysis of the Rumen in Young Calves

This paper discusses a technique used to evaluate rumen development in young calves, including removal, dissection, and analysis of tissue. The method allowed for examination of the different sacs of the rumen (dorsal, ventral, cranial, and caudal) using scanning electron microscopy to measure papillae denseness and histology slides to measure papillae length and width. Computer software was used to produce accurate measurements of papillae. The rumens of young calves were dissected, and samples were taken from the cranial, caudal, ventral, and dorsal sections. Calves were part of a nutrition research study, and dietary treatments did have an effect on development measurements such as length, width, and papillae denseness.

HER-2 and cancer antigen 125 evaluation in ovarian borderline tumors by immunohistochemistry and fluorescence in situ hybridization

The study determined the expression of cancer antigen (CA) 125 and HER-2 in 45 borderline ovarian tumors (BOTs) and investigated the correlation of these biologic markers with histologic type, clinical stage, and outcome. The level of CA 125 protein was assessed using DAKO's M-11 clone antibody in immunohistochemistry (IHC) assays (Carpinteria, CA). The HER-2 protein expression was assessed in IHC assays using the HercepTest (DAKO), and the HER-2 gene copy number per cell was investigated through fluorescence in situ hybridization (FISH) assays using VYSIS' PathVysion DNA Probe (Downers Grove, IL). Expression of the CA 125 protein was detected in 49% of the samples (22 out of 45 tumors) and significantly associated with the serous histologic type. However, CA 125 expression did not associate with clinical stage or outcome. Protein overexpression or gene amplification of HER-2 was not found. However, abnormal FISH results were detected in 16% (seven out of 45 patients) of specimens comprising extranumerary copies of HER-2 and/or chromosome 17 per cell. Abnormal FISH results were found to be independent of CA 125 expression and histologic type whereas they positively associate with advanced clinical stage. Our data show that HER-2 is not altered in BOTs, and the presence of aneusomy for chromosome 17 and HER-2 may predict tumor progression.

Clinical characteristics of 110 miliary tuberculosis patients from a low HIV prevalence country

SETTING

A university teaching hospital in Karachi, Pakistan.

OBJECTIVE

To define the clinical characteristics and outcome of miliary tuberculosis (TB) patients from a low human immunodeficiency virus (HIV) prevalence country.

DESIGN

Review of adult miliary TB patients admitted between 1994 and 2001. Clinical characteristics of those dying from miliary TB were compared with those of the survivors.

RESULTS

Most of the 110 cases reviewed were middle aged or elderly, with a female preponderance. An underlying medical condition was present in 47%. Presenting symptoms were of several weeks' duration, and mostly constitutional (fever and weight loss). Common laboratory findings included anaemia (62%), lymphopaenia (71%), hyponatraemia (74%), elevated serum alkaline phosphatase (57%) and hypoalbuminaemia (92%). Typical miliary pattern was observed in 77% of radiographs. Sputum smear and culture were positive in respectively 36% and 52% of those tested. Biopsy was performed in selected patients. Mean hospital stay was 8.8 days, and mortality was 30%. Those who died were significantly older than survivors and had a more fulminant course. Presence of altered mental status, lung crackles, leucocytosis, thrombocytopaenia and the need for ventilation were associated with increased mortality.

CONCLUSION

Miliary TB carries a high mortality. It should be considered in patients who present with prolonged systemic symptoms. A positive TB culture or biopsy is needed to establish a diagnosis.

Effects of amounts and degradability of dietary protein on lactation, nitrogen utilization, and excretion in early lactation Holstein cows

Five treatment diets varying in crude protein (CP) and rumen undegradable protein (RUP) were calculated to supply a postruminal lysine to methionine ratio of about 3:1. Diets were fed as a total mixed ration to 65 Holstein cows that were either primiparous (n = 28) or multiparous (n = 37) from 21 to 120 d in milk to determine effects on lactation and nitrogen utilization. Crude protein % and calculated RUP (% of CP) of diets [on a dry matter (DM) basis] were: 1) 19.4, 40 (HPMU), 2) 16.5, 34 (LPLU), 3) 16.8, 40 (LPMU), 4) 16.8, 46 (LPHU), 5) 17.2, 43 (LPHU + UREA), which is the result of adding 0.4% of the diet DM as urea to LPHU. The corn silage-based treatment diets contained an average of 24% acid detergent fiber and 1.6 Mcal/kg net energy of lactation. Milk urea nitrogen (MUN) concentrations and body weights (BW) were used to calculate predicted amounts of urinary nitrogen (N) using the relationship: urinary N (g/d) = 0.0259 x BW (kg) x MUN (mg/dl). Cows fed HPMU had greater CP and RUP intakes, which resulted in higher concentrations of plasma urea nitrogen, rumen ammonia, MUN, and predicted urinary N. Milk yield, fat yield, fat percent, protein yield, and protein percent were not significantly different among treatments. Parity primarily affected parameters that were related to body size and not measurements of N utilization. The interaction of treatment and parity was not significant for any measurements taken. In this study, cows fed LPHU had significantly lower MUN and predicted urinary N without limiting production. These results demonstrate the potential to optimize milk production while minimizing N excretion in lactating dairy cattle.

Neurobehavioral and autonomic effects of hammock positioning in infants with very low birth weight

PURPOSE

This study was designed to determine whether supine positioning of infants born preterm in a hammock instead of the prone position affects their neuromuscular maturity, growth, and autonomic stability.

METHODS

Twenty healthy infants who were born premature with very low birth weight (VLBW) (<1500 g) were randomized into two groups. Subjects were pair-matched for weight (difference less than 100 g), gestational age (difference less than eight days), and postnatal age (difference less than eight days). Ten infants were placed supine in a hammock for three hours daily for ten consecutive days, and ten infants were maintained nested in the prone position. Neuromuscular maturity (based on three neurological parameters adopted from the Ballard examination), heart rate, respiratory rate, and weight gain (g/cal) were compared between the groups.

RESULTS

Compared with nested prone positioning, supine positioning in a hammock was associated with a higher neuromuscular maturity score (p < 0.003) and a more relaxed condition, as expressed by lower heart rate and respiratory rate (p < 0.05 and p < 0.01, respectively).

CONCLUSIONS

Maintaining infants who were born preterm with VLBW in the supine position in a hammock may positively affect their autonomic stability and neuromuscular maturity.