Weight Retention Predictors for Taiwanese Women at Six-Month Postpartum

The purpose of this study was to identify factors potentially associated with weight retention measured 6 months after childbirth. A descriptive correlative design was used to systematically women who had given birth at a medical center located in northern Taiwan. Questionnaires were mailed to 810 subjects and a total of 602 valid questionnaires were collected, representing a response rate of 74.32%. The results of this study included: The average body mass index (BMI) was 21.5 (SD = 3.32) at pre-pregnancy, and 22.48 (SD = 3.39) at 6 months after childbirth. Average weight retention was 2.42 kg. Overweight and obese conditions increased among subjects from 18.27% pre-pregnancy to 27.57% at 6 months after childbirth. Significant predictors of weight retention identified in this study included gestational weight gain (GWG), perceived body image satisfaction, and pre-pregnancy weight, which, together, explained 34.5% of postpartum weight retention variance. Determinant factors identified by the analysis highlight the need for bodyweight management intervention during pregnancy as well as through the first 6-month postpartum as a way to reduce obesity and the incidence of obesity-related diseases.

Tunable S-band erbium-doped triple-ring laser with single-longitudinal-mode operation

We propose and demonstrate a tunable and stable single-longitudinal-mode (SLM) erbium fiber laser with a passive triple-ring cavity structure in S-band operation. The proposed laser is fundamentally structured by using three different lengths of ring cavities, which serve as the mode filters. When a mode-restricting intracavity fiber Fabry-Perot tunable filter (FFP-TF) is combined, the proposed resonator can guarantee a tunable and stable SLM laser oscillation. Moreover, the performances of the output power, wavelength stability, tuning range, and side-mode suppression ratio (SMSR) are studied.

Geriatric fear of falling measure: Development and psychometric testing

Development of the geriatric fear of falling measure (GFFM) was based on a previous qualitative study of Taiwanese community-dwelling elders. Relevant parameters or items for assessing subscales were identified and tested in a three-stage process: item development, content validity testing and reliability testing. The GFFM was tested on two groups of community-dwelling elders in Taiwan (N=100 and 384) to examine validity and reliability. Good test-retest, internal consistency and inter-rater reliability were found. Confirmatory factor analysis and good overall model fits supported construct validity of the GFFM. Although these data are preliminary, the GFFM could be used as a quick screening instrument to evaluate fear of falling and an outcome indicator of nursing interventions.

A randomized clinical trial of the effectiveness of a discharge planning intervention in hospitalized elders with hip fracture due to falling

AIM

The objective of this study was to examine the effectiveness of a discharge plan in hospitalized elderly patients with hip fracture due to falling.

BACKGROUND

Hip fractures are an important cause of morbidity and mortality among older people. Hip fracture patients require ongoing medical and long-term care services. Discharge plan services can play a very important role for these patients, since the services improved their outcome conditions.

METHODS

Hip fracture patients aged 65 years and older (n = 126), hospitalized due to falling and discharged from a medical centre in northern Taiwan, were randomly assigned to either a comparison group (the routine care) or experimental group (the discharge planning intervention). The outcomes used to determine the effectiveness of the intervention were: length of hospitalized stay, rate of readmission, repeat falls and survival, and activities of daily living.

RESULTS

The discharge planning intervention decreased length of stay, rate of readmission and rate of survival and improved activities of daily living for intervention group compared with those of control group. Mean total SF-36 scores of patients in the experimental group were higher than for the control group and both groups had improved quality of life.

CONCLUSION

The discharge planning benefited older people with hip fractures.

RELEVANCE TO CLINICAL PRACTICE

A discharge planning intervention by a nurse can improve physical outcomes and quality of life in hip fracture patients.

Managing fear of falling: Taiwanese elders’ perspective

The purpose of this study is to explore the underlying theoretical framework of managing fear of falling (FOF) among elders. A grounded theory approach was used. A purposive sample of 25 community-dwelling elders who admitted FOF was interviewed. Theoretical sampling was used to saturate the emergent concepts. Analysis of audiotaped interview transcripts generated a managing FOF process. Managing FOF is a dynamic process with consequences that are impacted by the level and which strategies are used with satisfaction by the elderly and supported by family/significant others. The study findings suggest that understanding the process of managing FOF from the perspective of elders is a significant first step in assisting them to prevent from falling.

Home environmental hazards among community-dwelling elderly persons in Taiwan

The purposes of this study were to determine the prevalence and variables that best predict home environmental hazards among the community-dwelling elderly in Taiwan. An assessment was made of the home environments of 1212 people aged 65 years and older, chosen by cluster sampling from registered households in northern Taiwan. Environmental hazards were found in the majority of homes ( 60.4 % ) where community-dwelling elderly people lived. The bathroom was the most common site for environmental hazards. Significant predictors of potential home environmental hazards were: living in an urban area ( OR = 4.36, 95 % confidence interval ( CI = 3.29, 5.76 ) , poor awareness of one ' s health status ( OR = 1.86, 95 % CI = 1.31, 2.64 ) , family dysfunction ( OR = 1.77, 95 % CI = 1.21, 2.59 ) , fear of falling ( OR = 1.65, 95 % CI = 1.19, 2.28 ) , being older ( >/= 75 years, OR = 1.47, 95 % CI = 1.11, 1.96 ) , poor gait ( OR = 10.76, 95 % CI = 4.48, 25.84 ) and poor balance ( OR = 3.03, 95 % CI = 1.14, 8.09 ) . Most elderly persons do not live in a risk-free home environment. The recognition and removal of environmental hazards is imperative to the well-being of the elderly.

Renovation of epithermal neutron beam for BNCT at THOR

Heading for possible use for clinical trial, THOR (Tsing Hua Open-pool Reactor) at Taiwan was shutdown for renovation of a new epithermal neutron beam in January 2003. In November 2003, concrete cutting was finished for closer distance from core and larger treatment room. This article presents the design base that the construction of the new beam is based on. The filter/moderator design along the beam is Cd(0.1cm)+Al(10 cm)+FLUENTAL (16 cm)+Al(10 cm)+FLUENTAL(24 cm)+Void(18 cm)+Cd(0.1cm)+Bi(10 cm) with 6 cm Pb as reflector. Following the filter/moderator is an 88 cm long, 6 cm thick Bi-lined collimator with Li(2)CO(3)-PE at the end. The collimator is surrounded by Li(2)CO(3)-PE and Pb. The calculated beam parameters under 2 MW at the beam exit is phi(epi) = 3.4 x 10(9) n/cm(2)/s, Df/phi(epi) = 2.8 x 10(-11) cGy cm(2)/n, Dgamma/phi(epi) = 1.3 x 10(-11) cGy cm(2)/n, and J+/phi = 0.8. For a phantom placed 10 cm from beam exit, MCNP calculation shows that the advantage depth is 8.9 cm, and advantage ratio is 5.6 if boron concentration in tumor and normal tissue are assumed to be 65 and 18 ppm. The maximum dose rate for normal tissue is 50 cGy/min. The maximum therapeutic ratio is 6. The construction of the beam is scheduled to be finished by the end of April 2004.

Neutrophil elastase induces IL-8 synthesis by lung epithelial cells via the mitogen-activated protein kinase pathway

The sequestration of neutrophils in the lung and the release of proinflammatory mediators, including neutrophil elastase, are responsible for sepsis-induced microvascular permeability and alveolar epithelial cell damage. To assess the underlying mechanism, human neutrophil elastase (0.01-0.5 microg/ml) was added to cultured A549 epithelial cells in the presence or absence of inhibitors. IL-8 was analyzed by ELISA or by RT-PCR to measure the IL-8 synthesis capacity. Mitogen-activated protein kinase (MAPK) activity was detected by Western blot analysis. Neutrophil elastase dose-dependently increased IL-8 release from cultured A549 epithelial cells. Pretreatment with a specific elastase inhibitor, elastase inhibitor II (at 0.5, 5, and 50 microg/ml), dose-dependently inhibited neutrophil elastase-induced IL-8 release. The activities of MAPK, p38, and extracellular signal-regulated kinase (ERK) were upregulated by neutrophil elastase. Nuclear transcriptional factor-kappa B (NF-kappaB) and activator protein 1 (AP-1) were also activated. These responses were significantly inhibited by elastase inhibitor II. A specific inhibitor of p38 MAPK (SB203580) and an NF-kappaB inhibitor (pyrrolidine dithiocarbamate), but not an ERK inhibitor (PD 98059), significantly inhibited neutrophil elastase-induced IL-8 release and mRNA expression. The specific tyrosine kinase inhibitor, genistein, and the protein kinase C (PKC) inhibitor, Ro 31-8220, also inhibited IL-8 release and mRNA expression as well as p38 and NF-kappaB activation. There was no significant effect by the protein kinase A inhibitor, H-89, on neutrophil elastase-induced IL-8 synthesis or p38 MAPK activation. Our results indicate that neutrophil elastase activates p38 MAPK which upregulates NF-kappaB and AP-1 activities, thus inducing IL-8 mRNA expression and protein synthesis. Tyrosine kinase and PKC are implicated in neutrophil elastase activation of the MAPK pathway.

Effectiveness of home visit falls prevention strategy for Taiwanese community-dwelling elders: randomized trial

The purpose of this research was to examine the effect of a multifactorial intervention to prevent falls by increasing self-efficacy to prevent falls, improving the knowledge of medication safety, and decreasing the number of environmental risks in older persons dwelling in the community. A sample of 120 cognitively intact residents of this community who were 65 years of age and older were recruited into a two-group pretest-post-test experimental design and randomly assigned to an experimental group and a comparison group (60 in each group). The intervention was delivered, and data were collected during three home visits in a 4-month period. (1) Experimental subjects improved their fall self-efficacy, environmental safety, and knowledge of medication safety significantly (p < 0.01) as compared with those in the comparison group at post-test; (2) the incidence of falls was reduced at post-test in both groups compared to pretest scores, and the falling was more serious in the comparison group at post-test compared to that in the experimental group. The results can help community health professionals to individualize their interventions to the specific needs of the elderly, thus helping to prevent falls among community-dwelling elders.

[Nursing experience: a new elderly resident in a nursing home]

Demographic changes in the population mean that relocation from community settings to long-term care institutions will steadily increase among elderly adults. As part of a normal aging process, these adults will experience change in their adaptation abilities, especially among those who experience physical or psychological function impairment. In this case report, the author describes an elderly woman with osteoarthritis who had to severely restrict her daily activities. Her move into a nursing home caused problems in terms of self-esteem and adjusting to a new environment. After providing appropriate nursing management and support, the patient's functional ability and physical challenges improved to the point that she was able to return to her family home.

Role of mitochondrial superoxide dismutase in contraction-induced generation of reactive oxygen species in skeletal muscle extracellular space

Contractions of skeletal muscles produce increases in concentrations of superoxide anions and activity of hydroxyl radicals in the extracellular space. The sources of these reactive oxygen species are not clear. We tested the hypothesis that, after a demanding isometric contraction protocol, the major source of superoxide and hydroxyl radical activity in the extracellular space of muscles is mitochondrial generation of superoxide anions and that, with a reduction in MnSOD activity, concentration of superoxide anions in the extracellular space is unchanged but concentration of hydroxyl radicals is decreased. For gastrocnemius muscles from adult (6–8 mo old) wild-type ( Sod2+/+) mice and knockout mice heterozygous for the MnSOD gene ( Sod2+/-), concentrations of superoxide anions and hydroxyl radical activity were measured in the extracellular space by microdialysis. A 15-min protocol of 180 isometric contractions induced a rapid, equivalent increase in reduction of cytochrome c as an index of superoxide anion concentrations in the extracellular space of Sod2+/+and Sod2+/-mice, whereas hydroxyl radical activity measured by formation of 2,3-dihydroxybenzoate from salicylate increased only in the extracellular space of muscles of Sod2+/+mice. The lack of a difference in increase in superoxide anion concentration in the extracellular space of Sod2+/+and Sod2+/-mice after the contraction protocol supported the hypothesis that superoxide anions were not directly derived from mitochondria. In contrast, the data obtained suggest that the increase in hydroxyl radical concentration in the extracellular space of muscles from wild-type mice after the contraction protocol most likely results from degradation of hydrogen peroxide generated by MnSOD activity.

Regional vulnerability after traumatic brain injury: gender differences in mice that overexpress human copper, zinc superoxide dismutase

Neuronal loss was quantified in both cortical and subcortical brain regions after traumatic brain injury in male and female nontransgenic (nTg) and transgenic (Tg) mice that overexpress human copper, zinc superoxide dismutase. Mice were euthanized at 7 days after a controlled cortical impact injury. Sections of brain were processed for immunolocalization of NeuN, a neuronal nuclear antigen, and the complement type 3 receptor, a marker of microglia/macrophages, and stained for iron. Cortical lesion volume and neuronal loss in the medial and/or lateral ventroposterior thalamic nuclei were significantly less in the nTg female compared to the nTg male (P = 0.0373 and P = 0.0023, respectively). In contrast, in CA3 of the hippocampus and laterodorsal thalamic nucleus (LD), there were no gender differences in neuronal loss between these nTg groups. Cortical lesion volume was significantly reduced in Tg males compared to nTg males (P = 0.0137) and was unchanged in the Tg females compared to the nTg females. Neuronal loss was attenuated in the CA3 and LD in the Tg females compared to the nTg females (P = 0.0252 and P = 0.0244, respectively). A similar protection was not observed in the Tg males. Microglial activation paralleled the pattern of neuronal loss and was most consistently aligned with iron deposition in the cortex and hippocampus. No overt differences were found in the pattern of microglial activation or iron staining between nTg and Tg mice nor between genders. Our findings demonstrate that neuroprotection, afforded by overexpression of copper, zinc superoxide dismutase, exhibits both regional and gender specificity.

Genetic modification of prenatal lethality and dilated cardiomyopathy in Mn superoxide dismutase mutant mice

Mn superoxide dismutase (MnSOD), a mitochondrial antioxidant enzyme, has been shown to be essential for animal survival. MnSOD mutant mice (Sod2-/- mice) on the CD1 background develop severe dilated cardiomyopathy and usually die within 10 d after birth. To characterize better the phenotype and understand the mechanism of superoxide-mediated tissue damage in Sod2-/- mice, congenic Sod2-/- mice on inbred backgrounds were generated to ensure genetic homogeneity. When generated on a C57BL/6J background (B6<Sod2-/->), more than half of the fetuses develop severe dilated cardiomyopathy by embryonic day 15 and die in the uterus. Those that survive to term usually die within 24 h. In contrast, Sod2-/- mice on DBA/2J (D2<Sod2-/->) and B6D2F1 (B6D2F1<Sod2-/->) backgrounds develop normally throughout gestation and do not develop dilated cardiomyopathy. However, the D2<Sod2-/-> mice do develop a severe metabolic acidosis and survive for only up to 12 d after birth. B6D2F1<Sod2-/->) mice have a milder form of metabolic acidosis and can survive for up to 3 weeks. The marked difference in lifespans and the development of dilated cardiomyopathy in the B6 but not the D2 or B6D2F1 backgrounds indicate the possible existence of genetic modifiers that provide protection to the developing hearts in the absence of MnSOD.

Strain-dependent high-level expression of a transgene for manganese superoxide dismutase is associated with growth retardation and decreased fertility

Manganese superoxide dismutase (MnSOD) is essential in protecting mitochondria against the damaging effects of superoxide radicals (O(2)(*-)), and increased expression of MnSOD protects cells and transgenic animals from various forms of oxidative stress. In addition, increased levels of MnSOD have been shown to slow down cell growth and induce differentiation. To study the effects of high MnSOD levels in vivo, we generated a series of transgenic mice using a mouse genomic sequence under control of the endogenous promoter. Four transgenic lines produced by pronuclear DNA injection exhibited up to 2-fold elevated MnSOD levels in brain and heart. However, using an embryonic stem cell approach, a line having 10-fold elevated MnSOD levels in the brain and 6- to 7-fold elevated levels in the heart and kidney was generated. Surprisingly, the genetic background of this transgenic line influenced the expression level of the transgene, with DBA/2 (D2) and C57BL/6 (B6) mice exhibiting low- and high-level transgene expression, respectively. This difference was the result of an increased transcription rate of the transgene. High-level MnSOD expression in B6 animals was associated with small size, male infertility, and decreased female fertility. These features are absent on the D2 background and indicate that high levels of MnSOD activity may interfere with normal growth and fertility.

Influence of leptin on changes in body fat during growth in African American and white children

OBJECTIVE

The aim of this study was to determine whether initial levels or temporal changes in fasting leptin were associated with longitudinal changes in body-fat mass in children.

RESEARCH METHODS AND PROCEDURES

The study group consisted of 85 children (42 white and 43 African American) with a mean initial age of 8.1 +/- 0.1 years. The children had between three and six annual visits for repeated measurements of body composition by DXA and fasting leptin level. Fat mass and fasting leptin level were not normally distributed and were log-transformed. Data were analyzed using SAS Proc mixed growth models, with log fat as the dependent variable.

RESULTS

Initial leptin level was a significant predictor of the change in fat mass over time (p < 0.0001), with high initial leptin levels resulting in increased fat gain, independent of initial fat levels. This relationship remained significant when the data were analyzed separately by race (whites, p < 0.0001; African Americans, p = 0.008). The relationship between the initial level of leptin and the change in fat mass was not modified by race, sex, or Tanner Stage. The rate of change in leptin during the study was significantly related to the rate of change in fat mass in African Americans (p = 0.008) but not in whites (p = 0.490).

DISCUSSION

In conclusion, high fasting leptin level at the start of the study was significantly associated with increasing fat mass in this cohort, indicating that the children may be developing resistance to the effects of leptin.

Knockout mice heterozygous for Sod2 show alterations in cardiac mitochondrial function and apoptosis

Heart mitochondria from heterozygous (Sod2(-/+)) knockout mice have a 50% reduction in manganese superoxide dismutase (MnSOD) activity. The decrease in MnSOD activity was associated with increased mitochondrial oxidative damage as demonstrated by a decrease in the activities of iron sulfhydryl proteins sensitive to oxygen stress (aconitase and reduced nicotinamide adenine dinucleotide-oxidoreductase). Mitochondrial function was altered in the Sod2(-/+) mice, as shown by decreased respiration by complex I and an increase in the sensitivity of the permeability transition to induction by calcium and t-butylhydroperoxide. The increased induction of the permeability transition in heart mitochondria from Sod2(-/+.)mice was associated with increased release of cytochrome c and an increase in DNA fragmentation. Cardiomyocytes isolated from neonatal Sod2(-/+) and Sod2(-/-) mice were more sensitive to cell death than cardiomyocytes from Sod2(+/+) mice after t-butylhydroperoxide treatment, and this increased sensitivity was prevented by inhibiting the permeability transition with cyclosporin A. These experiments demonstrate that MnSOD may play an important role in the induction of the mitochondrial pathway of apoptosis in the heart, and this appears to occur primarily through the permeability transition.

Postrepression activation of NF-kappaB requires the amino-terminal nuclear export signal specific to IkappaBalpha

One of the most prominent NF-kappaB target genes in mammalian cells is the gene encoding one of its inhibitor proteins, IkappaBalpha. The increased synthesis of IkappaBalpha leads to postinduction repression of nuclear NF-kappaB activity. However, it is unknown why IkappaBalpha, among multiple IkappaB family members, is involved in this process and what significance this feedback regulation has beyond terminating NF-kappaB activity. Herein, we report an important IkappaBalpha-specific function dictated by its amino-terminal nuclear export sequence (N-NES). The IkappaBalpha N-NES is necessary for the postinduction export of nuclear NF-kappaB, which is a critical event in reestablishing a permissive condition for NF-kappaB to be rapidly reactivated. We show that although IkappaBalpha and another IkappaB member, IkappaBbeta, can enter the nucleus and repress NF-kappaB DNA-binding activity during the postinduction phase, only IkappaBalpha allows the efficient export of nuclear NF-kappaB. Moreover, swapping the N-terminal region of IkappaBbeta for the corresponding IkappaBalpha sequence is sufficient for the IkappaB chimera protein to export NF-kappaB similarly to IkappaBalpha during the postinduction state. Our findings provide a mechanistic explanation of why IkappaBalpha but not other IkappaB members is crucial for postrepression activation of NF-kappaB. We propose that this IkappaBalpha-specific function is important for certain physiological and pathological conditions where NF-kappaB needs to be rapidly reactivated.

Longitudinal changes in body fat in African American and Caucasian children: influence of fasting insulin and insulin sensitivity

Obesity is associated with hyperinsulinemia and reduced insulin sensitivity, both risk factors for type 2 diabetes. However, it is not clear whether these risk factors occur as a result of obesity or whether they contribute to the development of obesity. The aims of this study were to determine whether baseline (first visit) or changes in insulin measures over time were associated with longitudinal changes in body fat mass during growth in children. The study group consisted of 137 children (83 Caucasian and 54 African American) with a mean age of 8.1 yr at baseline. The children returned for 3-6 annual visits for measurement of fasting insulin, insulin sensitivity (Si), and acute insulin response (AIR) from the tolbutamide-modified frequent sampling iv glucose tolerance test and for determination of body composition by dual energy x-ray absorptiometry. Data were analyzed using SAS Proc mixed growth models. Total fat mass increased with time by 15.6%/yr (P = 0.013), but the rate of increase was not significantly influenced by race, sex, or Tanner stage. However, fasting insulin (positive effect), Si (negative effect), and AIR (positive effect) were significantly associated with the rate of increase in fat mass. In conclusion, in this cohort of children, growth-related increases in body fat were significantly associated with increases in fasting insulin and AIR and decreases in Si.

Growth of visceral fat, subcutaneous abdominal fat, and total body fat in children

OBJECTIVE

To examine the patterns of growth of visceral fat, subcutaneous abdominal fat, and total body fat over a 3- to 5-year period in white and African American children.

RESEARCH METHODS AND PROCEDURES

Children (mean age: 8.1 +/- 1.6 years at baseline) were recruited from Birmingham, Alabama, and those with three or more repeated annual measurements were included in the analysis (N = 138 children and 601 observations). Abdominal adipose tissue (visceral and subcutaneous) was measured using computed tomography. Total body fat and lean tissue mass were measured by DXA. Random growth curve modeling was performed to estimate growth rates of the different body fat compartments.

RESULTS

Visceral fat and total body fat both exhibited significant growth effects before and after adjusting for subcutaneous abdominal fat and lean tissue mass, respectively, and for gender, race, and baseline age (5.2 +/- 2.2 cm(2)/yr and 1.9 +/- 0.8 kg/yr, respectively). After adjusting for total body fat, the growth of subcutaneous abdominal fat was not significant. Whites showed a higher visceral fat growth than did African Americans (difference: 1.9 +/- 0.8 cm(2)/yr), but there was no ethnic difference for growth of subcutaneous abdominal fat or total body fat. There were no gender differences found for any of the growth rates.

DISCUSSION

Growth of visceral fat remained significant after adjusting for growth of subcutaneous abdominal fat, implying that the acquisition of the two abdominal fat compartments may involve different physiologic mechanisms. In contrast, growth of subcutaneous abdominal fat was explained by growth in total body fat, suggesting that subcutaneous fat may not be preferentially deposited in the abdominal area during this phase of growth. Finally, significantly higher growth of visceral fat in white compared with African American children is consistent with cross-sectional findings.

Manganese superoxide dismutase signals matrix metalloproteinase expression via H2O2-dependent ERK1/2 activation

Manganese-superoxide dismutase (Sod2) removes mitochondrially derived superoxide (O(2)) at near-diffusion limiting rates and is the only antioxidant enzyme whose expression is regulated by numerous stimuli. Here it is shown that Sod2 also serves as a source of the intracellular signaling molecule H(2)O(2). Sod2-dependent increases in the steady-state levels of H(2)O(2) led to ERK1/2 activation and subsequent downstream transcriptional increases in matrix metalloproteinase-1 (MMP-1) expression, which were reversed by expression of the H(2)O(2)-detoxifying enzyme, catalase. In addition, a single nucleotide polymorphism has recently been identified (1G/2G) at base pair--1607 that creates an Ets site adjacent to an AP-1 site at base pair --1602 and has been shown to dramatically enhance transcription of the MMP-1 promoter. Luciferase promoter constructs containing either the 1G or 2G variation were 25- or 1000-fold more active when transiently transfected into Sod2-overexpressing cell lines, respectively. The levels of MMP-2, -3, and -7 were also increased in the Sod2-overexpressing cell lines, suggesting that Sod2 may function as a "global" redox regulator of MMP expression. In addition, Sod2(-/+) mouse embryonic fibroblasts failed to respond to the cytokine-mediated induction of the murine functional analog of MMP-1, MMP-13. This study provides evidence that the modulation of Sod2 activity by a wide array of pathogenic and inflammatory stimuli may be utilized by the cell as a primary signaling mechanism leading to matrix metalloproteinase expression.

Absence of mitochondrial superoxide dismutase results in a murine hemolytic anemia responsive to therapy with a catalytic antioxidant

Manganese superoxide dismutase 2 (SOD2) is a critical component of the mitochondrial pathway for detoxification of O2(-), and targeted disruption of this locus leads to embryonic or neonatal lethality in mice. To follow the effects of SOD2 deficiency in cells over a longer time course, we created hematopoietic chimeras in which all blood cells are derived from fetal liver stem cells of Sod2 knockout, heterozygous, or wild-type littermates. Stem cells of each genotype efficiently rescued hematopoiesis and allowed long-term survival of lethally irradiated host animals. Peripheral blood analysis of leukocyte populations revealed no differences in reconstitution kinetics of T cells, B cells, or myeloid cells when comparing Sod2(+/+), Sod2(-/-), and Sod2(+/-) fetal liver recipients. However, animals receiving Sod2(-/-) cells were persistently anemic, with findings suggestive of a hemolytic process. Loss of SOD2 in erythroid progenitor cells results in enhanced protein oxidative damage, altered membrane deformation, and reduced survival of red cells. Treatment of anemic animals with Euk-8, a catalytic antioxidant with both SOD and catalase activities, significantly corrected this oxidative stress-induced condition. Such therapy may prove useful in treatment of human disorders such as sideroblastic anemia, which SOD2 deficiency most closely resembles.

Upregulation of inducible nitric oxide synthase and cytokine secretion in peripheral blood monocytes from pulmonary tuberculosis patients

SETTING

Peripheral blood monocytes (PBM) are the main source of alveolar macrophages, which have an upregulation of inducible nitric oxide synthase (iNOS) in pulmonary tuberculosis (TB). TNF-alpha and IL-1 beta are thought to be involved in the immune response to mycobacterial infection.

OBJECTIVE

To identify whether iNOS expression and cytokine release of PBM are upregulated and have a connection in TB infection.

DESIGN

The expression of iNOS immunoreactivity on PBM from TB patients and normal subjects was measured by loading with anti-macrophage iNOS polyclonal primary antibody analyzed by flow cytometry. Expression of iNOS mRNA in PBM was detected by RT-PCR. The spontaneous generation of nitrite and cytokines (IL-1 beta and TNF-alpha) by cultured monocytes was also determined.

RESULTS

Compared to normal subjects, iNOS immuno-reactivity, the capacity for spontaneous nitrite generation and the level of TNF-alpha or IL-1 beta secretion of PBM were significantly higher in TB patients. The amount of nitrite, TNF-alpha and IL-1 beta released from PBM of TB patients was inhibited by NG-monomethyl-L-arginine (L-NMMA), a competitive inhibitor of NOS. The level of iNOS immunoreactivity on PBM was highly correlated with nitrite generation both in all the subjects studied and in TB patients alone. Spontaneous TNF-alpha production showed a stronger correlation with nitrite production than with IL-1 beta.

CONCLUSION

The NO and cytokine synthase activities of monocytes appear to be concomitantly upregulated in response to mycobacterial infection. The enhanced NO generation by monocytes in TB patients may play an autoregulatory role in amplifying the synthesis of pro-inflammatory cytokines.

Cellular and molecular responses to topoisomerase I poisons. Exploiting synergy for improved radiotherapy

The efficacy of topoisomerase (Topo) I-active drugs may be improved by better understanding the molecular and cellular responses of tumor compared to normal cells after genotoxic insults. Ionizing radiation (IR) + Topo I-active drugs (e.g., Topotecan) caused synergistic cell killing in various human cancer cells, even in cells from highly radioresistant tumors. Topo I poisons had to be added either during or immediately after IR. Synergy was caused by DNA lesion modification mechanisms as well as by concomitant stimulation of two pathways of cell death: necrosis (IR) + apoptosis (Topo I poisons). Cumulative data favor a mechanism of synergistic cell killing caused by altered DNA lesion modification and enhanced apoptosis. However, alterations in cell cycle regulation may also play a role in the synergy between these two agents in certain human cancers. We recently showed that NF-kappa B, a known anti-apoptotic factor, was activated in various cancer cells after poisoning Topo I using clinically active drugs. NF-kappa B activation was dependent on initial nuclear DNA damage followed by cytoplasmic signaling events. Cytoplasmic signaling leading to NF-kappa B activation after Topo I poisons was diminished in cytoplasts (lacking nuclei) and in CEM/C2 cells that expressed a mutant Topo I protein that did not interact with Topo I-active drugs. NF-kappa B activation was intensified in S-phase and blocked by aphidicolin, suggesting that activation was a result of double-strand break formation due to Topo I poisoning and DNA replication. Dominant-negative I kappa B expression augmented Topo I poison-mediated apoptosis. Elucidation of molecular signal transduction pathways after Topo I drug-IR combinations may lead to improved radiotherapy by blocking anti-apoptotic NF-kappa B responses. Recent data also indicate that synergy caused by IR + Topo I poisons is different from radiosensitization by beta-lapachone (beta-lap), a "reported" Topo I and II-alpha poison in vitro. In fact, beta-lap does not kill cells by poisoning either Topo I or II-alpha in vivo. Instead, the compound is "activated" by an IR (damage)-inducible enzyme, NAD(P)H:quinone oxidoreductase (NQO1), a gene cloned as x-ray-inducible transcript #3, xip3. Unlike the lesion modification pathway induced by IR + Topo I drugs, beta-lap kills cells via NQO1 futile cycle metabolism. Downstream apoptosis caused by beta-lap appears to be noncaspase-mediated, involving calpain or a calpain-like protease. Thus, although Topo I poisons or beta-lap in combination with IR both synergistically kill cancer cells, the mechanisms are very different.

Genetic dissection of region associated with behavioral abnormalities in mouse models for Down syndrome

Two animal models of Down syndrome (human trisomy 21) with segmental trisomy for all (Ts65Dn) or part (Ts1Cje) of human chromosome 21-homologous region of mouse chromosome 16 have cognitive and behavioral abnormalities. To compare these trisomies directly and to assess the phenotypic contribution of the region of difference between them, Ts65Dn, Ts1Cje, and a new segmental trisomic (Ms1Ts65) for the region of difference (APP: to Sod1) have been generated as littermates and tested in parallel. Although the performance of Ts1Cje mice in the Morris water maze is similar to that of Ts65Dn mice, the reverse probe tests indicate that Ts65Dn is more severely affected. By contrast, the deficits of Ms1Ts65 mice are significantly less severe than those of Ts65Dn. Therefore, whereas triplication of Sod1 to Mx1 plays the major role in causing the abnormalities of Ts65Dn in the Morris water maze, imbalance of APP: to Sod1 also contributes to the poor performance. Ts65Dn mice are hyperactive and Ts1Cje mice are hypoactive; the activity of Ms1Ts65 mice is not significantly above normal. These findings indicate that genes in the Ms1Ts65 trisomic region must interact with others in the Ts1Cje region to produce hyperactivity in Ts65Dn mice.