Sonic hedgehog through Gli2 and Gli3 is required for the proper development of placental labyrinth

Sonic hedgehog (Shh) functions as a conserved morphogen in the development of various organs in metazoans ranging from Drosophila to humans. Here, we have investigated the potential roles and underlying mechanisms of Shh signaling in murine placentation. Immunostaining revealed the abundant expression of the main components of Shh pathway in both the trophectoderm of blastocysts and developing placentas. Disruption of Shh led to impaired vascularogenesis of yolk sac, less branching and malformation of placental labyrinth, thereby leading to a robust decrease in capacity of transplacental passages. Moreover, placenta-specific gene incorporation by lentiviral transduction of mouse blastocysts and blastocyst transplantation robustly knocked down the expression of Gli3 and Gli2 in placenta but not in embryos. Finally, Gli3 knockdown in Shh^−/− placentas partially rescued the defects of both yolk sac and placental labyrinth, and robustly restored the capacity of transplacental passages. Gli2 knockdown in Shh^+/− placentas affected neither the capacity of tranplacental passages nor the vascularogenesis of yolk sac, however, it partially phenocopied the labyrinthine defects of Shh^−/− placentas. Taken together, these results uncover that both Shh/Gli2 and Shh/Gli3 signals are required for proper development of murine placentas and are possibly essential for pregnant maintenance.

Serum uric acid and non-alcoholic fatty liver disease in non-hypertensive Chinese adults: the Cardiometabolic Risk in Chinese (CRC) study

OBJECTIVE

The causal relationship between serum uric acid (SUA) level and non-alcoholic fatty liver disease (NAFLD) has not yet been clarified. The objective of the study was to determine the association between SUA and NAFLD, as well as assess the interactions between SUA and other metabolic risk factors regarding NAFLD.

PATIENTS AND METHODS

The study samples related to a community-based health examination survey conducted in Central China. Initially, a total of 24,878 patients with medical examination were included. After excluding the individuals with confounding factors, the remaining 21,798 subjects with biomarkers available were included in the present study.

RESULTS

The data show that the risk of NAFLD significantly increased with the elevated SUA levels. Further adjustments for sex, age, and other confounding metabolic factors did not change the increasing trend of NAFLD risk. The odds ratios [ORs, 95% confidence interval (CI)] of NAFLD across the increasing quintiles of SUA were 1.00, 1,530 (1.174-1.995), 2.24 (1.714-2.886), 2.636 (2.019-3.441), and 3.714 (2.828-4.877) (p for trend < 0.0001). Also, significant interaction was found between SUA and prehypertension in relation to the NAFLD risk (p for interaction < 0.05).

CONCLUSIONS

SUA was significantly associated with NAFLD risk, independent of other metabolic risk factors, and SUA also had significant interaction with prehypertension regarding the risk of NAFLD.

Crystallization and characterization of cocrystals of piroxicam and 2,5-dihydroxybenzoic acid

Two cocrystals of piroxicam (PRX) and 2,5-dihydroxybenzoic acid (HBA) were found using a microfluidic cocrystal screening approach; one crystal contained an acetone (ACT) impurity.

Graphene enhanced evanescent field in microfiber multimode interferometer for highly sensitive gas sensing

Graphene based new physics phenomena are leading to a variety of stimulating graphene-based photonic devices. In this study, the enhancement of surface evanescent field by graphene cylindrical cladding is observed, for the first time, by using a graphene-coated microfiber multi-mode interferometer (GMMI). It is found theoretically and experimentally that the light transmitting in the fiber core is efficiently dragged by the graphene, hence significantly enhancing the evanescent fields, and subsequently improving the sensitivity of the hybrid waveguide. The experimental results for gas sensing verified the theoretical prediction, and ultra-high sensitivities of ~0.1 ppm for NH(3) gas detection and ~0.2 ppm for H(2)O vapor detection are achieved, which could be used for trace analysis. The enhancement of surface evanescent field induced by graphene may pave a new way for developing novel graphene-based all-fiber devices with compactness, low cost, and temperature immunity.

Hydrochlorothiazide-induced hyperuricaemia in the pharmacogenomic evaluation of antihypertensive responses study

OBJECTIVE

Elevations in uric acid (UA) and the associated hyperuricaemia are commonly observed secondary to treatment with thiazide diuretics. We sought to identify novel single nucleotide polymorphisms (SNPs) associated with hydrochlorothiazide (HCTZ)-induced elevations in UA and hyperuricaemia.

METHODS

A genome-wide association study of HCTZ-induced changes in UA was performed in Caucasian and African American participants from the pharmacogenomic evaluation of antihypertensive responses (PEAR) study who were treated with HCTZ monotherapy. Suggestive SNPs were replicated in Caucasians and African Americans from the PEAR study who were treated with HCTZ add-on therapy. Replicated regions were followed up through expression and pathway analysis.

RESULTS

Five unique gene regions were identified in African Americans (LUC7L2, ANKRD17/COX18, FTO, PADI4 and PARD3B), and one region was identified in Caucasians (GRIN3A). Increases in UA of up to 1.8 mg dL(-1) were observed following HCTZ therapy in individuals homozygous for risk alleles, with heterozygotes displaying an intermediate phenotype. Several risk alleles were also associated with an increased risk of HCTZ-induced clinical hyperuricaemia. A composite risk score, constructed in African Americans using the 'top' SNP from each gene region, was strongly associated with HCTZ-induced UA elevations (P = 1.79 × 10(-7) ) and explained 11% of the variability in UA response. Expression studies in RNA from whole blood revealed significant differences in expression of FTO by rs4784333 genotype. Pathway analysis showed putative connections between many of the genes identified through common microRNAs.

CONCLUSION

Several novel gene regions were associated with HCTZ-induced UA elevations in African Americans (LUC7L2, COX18/ANKRD17, FTO, PADI4 and PARD3B), and one region was associated with these elevations in Caucasians (GRIN3A).

Graphene-based D-shaped fiber multicore mode interferometer for chemical gas sensing

In this Letter, a graphene-coated D-shaped fiber (GDF) chemical gas sensor is proposed and demonstrated. Taking advantage of both the graphene-induced evanescent field enhancement and the in-fiber multimode interferometer, the GDF shows very high sensitivity for polar gas molecule adsorptions. An extinction ratio of up to 28 dB within the free spectrum range of ~30  nm in the transmission spectrum is achieved. The maximum sensitivities for NH₃ and H₂O gas detections are ~0.04 and ~0.1  ppm, respectively. A hybrid sensing scheme with such compactness, high sensitivity, and online monitoring capabilities may pave the way for others to explore a series of graphene-based lab-on-fiber devices for biochemical sensing.

Graphene Bragg gratings on microfiber

Graphene Bragg gratings (GBGs) on microfiber are proposed and investigated in this paper. Numerical analysis and simulated results show that the mode distribution, transmission loss, and central wavelength of the GBG are controllable by changing the diameter of the microfiber or the refractive index of graphene. Such type of GBGs with tunability may find important applications in optical fiber communication and sensing as all-fiber in-line devices.

Link between obesity and cancer: role of triglyceride/free fatty acid cycling

Obesity has long been suspected to be a risk factor for cancer. The relationship between body fat deposition and the pathogenesis of cancer has been the subject of many studies, however, no clear consensus has emerged linking these two biological processes. Recent epidemiological studies showed a strong association between cancer-related deaths and increased body-mass index. In fact, obesity has been identified as a cause for oesophageal, colon, uterine, kidney and post-menopausal breast cancers and also as a significant risk factor for the cancers of prostate, pancreas and non-Hodgkin lymphoma. Approximately 16-20% of cancer deaths in women and 14% of cancer deaths in men were found to be due to obesity. It is also recognized that there is a positive relationship between type-2 diabetes associated hyperinsulinemia and cancer incidence. Though the recent annual report in US finds that the incidence and mortality rates for many cancers have dropped in 2003 since 1975, this decline is mostly due to a substantial decrease in tobacco use among men. However, during the same period the rise in the prevalence of obesity might have contributed to the increased risk and incidence of prostate, liver, kidney, oesophageal and breast cancers. Whether the elevated cancer risk in obesity arises from similar modulation of parallel signaling/metabolic pathways during adipogenesis and oncogenesis has not been hitherto addressed. In this Review we would like to bring out the similarities between adipogenesis and oncogenesis and how this relationship at molecular level may be relevant for the development of effective therapeutics for obesity, diabetes and cancer. While adipogenesis is the process of formation of mature adipocytes or fat cells under normal physiological conditions, oncogenesis is a pathological process, which results in the uncontrolled growth of cells leading to cancer. Though, both these processes at surface seem to be totally different, we believe that there are important common denominators for these processes that need to be recognized. We will discuss the role of two such underlying factors - (1) malonyl-CoA, an important regulator of fatty acid metabolism and (2) triglyceride/free fatty acid (TG/FFA) cycling which is central to the generation of multiple signals for controlling various metabolic, physiological and signaling pathways in the cell.

Placental transfer and concentrations of cadmium, mercury, lead, and selenium in mothers, newborns, and young children

There is an emerging hypothesis that exposure to cadmium (Cd), mercury (Hg), lead (Pb), and selenium (Se) in utero and early childhood could have long-term health consequences. However, there are sparse data on early life exposures to these elements in US populations, particularly in urban minority samples. This study measured levels of Cd, Hg, Pb, and Se in 50 paired maternal, umbilical cord, and postnatal blood samples from the Boston Birth Cohort (BBC). Maternal exposure to Cd, Hg, Pb, and Se was 100% detectable in red blood cells (RBCs), and there was a high degree of maternal-fetal transfer of Hg, Pb, and Se. In particular, we found that Hg levels in cord RBCs were 1.5 times higher than those found in the mothers. This study also investigated changes in concentrations of Cd, Hg, Pb, and Se during the first few years of life. We found decreased levels of Hg and Se but elevated Pb levels in early childhood. Finally, this study investigated the association between metal burden and preterm birth and low birthweight. We found significantly higher levels of Hg in maternal and cord plasma and RBCs in preterm or low birthweight births, compared with term or normal birthweight births. In conclusion, this study showed that maternal exposure to these elements was widespread in the BBC, and maternal-fetal transfer was a major source of early life exposure to Hg, Pb, and Se. Our results also suggest that RBCs are better than plasma at reflecting the trans-placental transfer of Hg, Pb, and Se from the mother to the fetus. Our study findings remain to be confirmed in larger studies, and the implications for early screening and interventions of preconception and pregnant mothers and newborns warrant further investigation.

Linagliptin treatment in subjects with type 2 diabetes with and without mild-to-moderate renal impairment

AIMS

Renal disease is a frequent comorbidity of type 2 diabetes mellitus (T2DM) and an important factor complicating the choice of glucose-lowering drugs. The aim of this analysis was to evaluate the efficacy and safety of the dipeptidyl peptidase (DPP)-4 inhibitor linagliptin (5 mg/day) in mono, dual or triple oral glucose-lowering regimens in subjects with T2DM and mild or moderate renal impairment (RI).

METHODS

In this pooled analysis of three 24-week, placebo-controlled, phase 3 trials, subjects with mild (estimated glomerular filtration rate (eGFR) 60-<90 ml/min/1.73 m(2) , n = 838) or moderate RI (30-<60 ml/min/1.73 m(2), n = 93) were compared with subjects with normal renal function (≥90 ml/min/1.73 m(2), n = 1212).

RESULTS

Subjects with RI were older, had longer duration of diabetes, and increased prevalence of diabetes-related comorbidities. After 24 weeks, linagliptin achieved consistent placebo-corrected mean glycated haemoglobin (HbA1c) changes across the three renal function categories: normal (-0.63%; p < 0.0001), mild RI (-0.67%; p < 0.0001) and moderate RI (-0.53%; p < 0.01), with no inter-group difference (p = 0.74). Renal function with linagliptin remained stable across all categories. In linagliptin-treated subjects, overall adverse event (AE) rates and serious AE rates were similar to placebo. The incidence of hypoglycaemia with linagliptin and placebo was 11.1 versus 6.9%, 11.9 versus 9.0% and 15.9 versus 12.0% in the normal, mild RI and moderate RI categories, respectively.

CONCLUSIONS

This pooled analysis provides evidence that linagliptin is an effective, well-tolerated and convenient treatment in subjects with T2DM and mild or moderate RI.

Text prediction on structured data entry in healthcare: a two-group randomized usability study measuring the prediction impact on user performance

BACKGROUND

Structured data entry pervades computerized patient safety event reporting systems and serves as a key component in collecting patient-related information in electronic health records. Clinicians would spend more time being with patients and arrive at a high probability of proper diagnosis and treatment, if data entry can be completed efficiently and effectively. Historically it has been proven text prediction holds potential for human performance regarding data entry in a variety of research areas.

OBJECTIVE

This study aimed at examining a function of text prediction proposed for increasing efficiency and data quality in structured data entry.

METHODS

We employed a two-group randomized design with fifty-two nurses in this usability study. Each participant was assigned the task of reporting patient falls by answering multiple choice questions either with or without the text prediction function. t-test statistics and linear regression model were applied to analyzing the results of the two groups.

RESULTS

While both groups of participants exhibited a good capacity of accomplishing the assigned task, the results were an overall 13.0% time reduction and 3.9% increase of response accuracy for the group utilizing the prediction function.

CONCLUSION

As a primary attempt investigating the effectiveness of text prediction in healthcare, study findings validated the necessity of text prediction to structured date entry, and laid the ground for further research improving the effectiveness of text prediction in clinical settings.

Effects of progesterone and its metabolites on human granulosa cells

The corpus luteum (CL) is under control of gonadotrophic hormones and produces progesterone, which is necessary for endometrial receptivity. Recent studies have shown that progesterone and its metabolites are involved in cell proliferation and apoptosis of cancer cells. Here weanalyzed the role of progesterone and its meta-bolites on luteinized granulosa cells (LGC) by FACS analysis and quantitative Real-Time PCR. We detected the mRNA of the progesterone metabolizing genes SRD5A1, AKR1C1, and AKR1C2 in LGC. The stimulation of LGC with progesterone or progesterone metabolites did not show any effect on the mRNA expression of these genes. However, a downregulation of Fas expression was found to be accomplished by progesterone and human chorionic gonadotropin. Our findings do not support the concept of an effect of progesterone metabolites on LGCs. However, it suggests an antiapoptotic effect of hCG and progesterone during corpus luteum development by downregulation of Fas.

Metabolic signaling of insulin secretion by pancreatic β-cell and its derangement in type 2 diabetes

Pancreatic beta-cell is responsible for insulin secretion in response to the availability of nutrients. Type 2 diabetes mellitus (T2D) is the result of pancreatic b-cell failure to supply sufficient amount of insulin accompanied with decreased sensitivity of the body tissues to respond to insulin. The insulin secretion apparatus of beta-cell is uniquely equipped with multiple metabolic and signaling steps that are under rigorous control. The metabolic machinery of beta-cell is designed to sense the fluctuations in blood glucose level and supply insulin accordingly to the needs of body. Besides glucose, amino acids including glutamine and leucine and also fatty acids are known to either stimulate the beta-cell directly or potentiate the glucose stimulated insulin secretion (GSIS) response. Glucose metabolism dependent GSIS is linked with the production of ATP that is needed for K+ATP channel inhibition and influx of calcium, necessary for insulin granule exocytosis. Besides glucose metabolism, amino acid metabolism and lipid metabolism derived metabolites mediate the optimal glucose response of beta-cells to secrete insulin. Metabolites derived from nutrient secretagogues that directly or indirectly participate in the enhancement of GSIS are considered as metabolic coupling factors. In this review, we will discuss the regulation of insulin secretion by b-cell keeping the recent developments in metabolic signaling in focus. The relevant metabolic pathways in pancreatic beta-cell and their role in the control of fuel-stimulated insulin secretion will be reviewed to arrive at a consensus picture with respect to the metabolic signaling of insulin secretion.

From Software-Based To Knowledge-Based Policy Implementation and Compliance

Law-making is inextricably bound up with the developments of e-government. Yet translating legislation into administrative processes and services has been extremely complex, taking a long time and involving many manual tasks. This problem is further complicated by the increasing amount of legislation and the frequent changes of legislation. Recent technology innovations enable a shift from implementation and maintenance of e-government services by software configuration and engineering towards implementation and maintenance based on knowledge representation. Despite the many benefits such as faster, cheaper and easier implementation, adoption has been limited. In this paper we describe these developments and compare software-based with knowledge-based implementation and maintenance. Based on a case study, we identify success factors and challenges from moving towards knowledge-based implementation and maintenance in the aspects of motivation, architecture, technique, expertise and finance.

Abstract P6-12-09: Targeting deregulated cyclin E in inflammatory breast cancer via sequential combination therapy

Inflammatory breast cancer (IBC) is a rare, highly aggressive form of breast cancer, accounting for 2-5% of all breast cancers in the US and 10% of breast cancer deaths. Unfortunately, until recently this disease has not been studied extensively at the molecular/cellular level despite the compelling unmet need to develop more effective therapies. In spite of receiving aggressive multidisciplinary therapy (anthracycline-taxane-based neoadjuvant chemotherapy, modified-radical-mastectomy and adjuvant radiation therapy), only about 40% of IBC patients survive 5 years. The goal of this project is to identify new targets that can be exploited pharmacologically either in combination with current therapies or with other novel agents.

Previous work has identified tumor-specific low molecular weight forms of cyclin E, termed LMW-E, that are preferentially found in triple negative breast cancers (TNBC) and serve as a poor prognostic biomarker. As a result of cleavage, LMW-E preferentially accumulates in the cytoplasm where it exerts its pleiotropic oncogenic functions including deregulating the cell cycle. Furthermore, we have shown that TNBC cells harboring LMW-E are sensitive to CDK inhibitors.

To establish the clinical relevance of targeting the cyclin E/CDK2 axis in IBC, a pilot study was performed to determine the incidence of LMW-E. We performed IHC on 11 post-chemotherapy surgical specimens from MDACC. All tumors expressed cyclin E, 8 of which had predominantly cytoplasmic staining, indicative of LMW-E expression. These results are now being validated in a larger cohort of samples. These promising preliminary results led us to perform in vitro experiments to determine sensitivity to CDK2 inhibitors and characterize cell cycle profiles.

Similar to non-IBC breast cancers, IBC tumors can be ER-positive, TNBC or HER2-overexpressing; however, there are only TN-IBC or HER2+ cell lines. We utilized 2 cell lines for these studies, one of which is TN-IBC, the other of which is ER-negative and HER2-overexpressing. These cell lines were treated with a panel of CDK inhibitors to evaluate their sensitivity in both short-term and long-term assays. The long-term assay we developed called the high-throughput survival assay was used to examine combinations of agents for potential synergies using isobologram analysis. We have demonstrated chemotherapy-specific synergistic cell death when cells are first treated with CDK inhibitor in IBC and non-IBC cell lines.

Using flow cytometry, we have demonstrated that CDK inhibitors induce a G2/M arrest, which is further increased by sequential treatment with chemotherapy. Furthermore, combination treatment leads to cell death, as measured by sub-G1 DNA content.

Taken together, these studies provide solid evidence that targeting CDK2 is a promising strategy in treating IBC tumors that express cyclin E. Beyond these early pre-clinical advances, however, we demonstrated clear sequence-specificity for certain pairs of drugs, implying that future clinical studies should be designed taking into account the mechanism of action of cell cycle targeting drugs.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-12-09.

HMGB3 characterization in gastric cancer

Gastric cancer is a major health problem worldwide; it is the second most common cause of cancer death in the world. Recent studies indicate that the high-mobility group (HMG) of chromosomal proteins is associated with cancer progression. However, HMGB3 has been little studied. We analyzed the co-expression network between HMGB3 and differentially-expressed genes in the GSE17187 database, identifying the relevant transcription factors, and the conserved domain of HMGB3 to understand the underlying regulation mechanisms involved in gastric cancer. Thirty-one relationships between 11 differentially-expressed genes were included in a co-expression network; many of these genes have been identified as related to cancer, including TBX5 and TFR2. Further analysis identified nine transcription factors, these being GATA3, MZF1, GATA1, GATA2, SRY, REL, NFYB, NFYC, and NFYA, which could interact with HMGB3 to regulate target gene expression and consequently regulate gastric cancer cell proliferation, migration and invasion. The HMG-box domain was very similar in various species, with only a few amino acid changes, indicating conserved functions in HMG-box. This information helps to provide insight into the molecular mechanisms of HMGB3 in human gastric cancer.

Non-scarring patchy alopecia in patients with systemic lupus erythematosus differs from that of alopecia areata

Background

Non-scaring patchy alopecia associated with systematic lupus erythematosus (SLE) is sometimes mis-diagnosed as alopecia areata (AA).

Objectives

Our aim was to differentiate non-scarring patchy SLE alopecia features from patchy AA.

Methods

Clinical, dermatoscopic and histopathological data from 21 SLE patients with patchy alopecia were compared with data from 21 patients with patchy AA.

Results

Incomplete alopecia was common in SLE alopecia patches, while AA patches exhibited complete alopecia. Exclamation-mark hairs, black dots, broken hair and yellow dots were common to AA, while hair shaft thinning and hypopigmentation, angiotelectasis, peripilar sign, perifollicular red dots, white dots and honeycomb pigment patterns were more common in SLE. Interfollicular polymorphous vessels were the most common angiotelectasis presentation in the SLE alopecia patches, but interfollicular arborizing vessels were significantly more common in non-hair-loss-affected SLE regions and in AA hair-loss regions. During follow-up, increased vellus hair was the earliest feature that emerged after treatment both in SLE and AA, while the earliest feature that disappeared was hair shaft hypopigmentation in SLE and broken hair in AA. After treatment, no SLE patients had relapse of alopecia, while 41.7% of AA patients did.

Conclusion

Distinct clinical, dermatoscopic and histopathological features were found in SLE-associated alopecia regions, which were different from those of AA. Serological autoantibody tests are of value to confirm the differential diagnosis. Local angiotelectasis and vasculitis close to hair follicles may be involved in the pathogenesis of alopecia in SLE.

Molecular cloning, polymorphisms, and association analysis of the promoter region of the STAM2 gene in Wuchuan Black cattle

The STAM protein plays an important role in the cytokine-related JAK/STAT pathway. We selected the STAM2 gene as a candidate gene that could be linked to growth performance in analysis of a Chinese cattle breed (Wuchuan Black cattle). We examined genetic variants in the promoter region of the STAM2 gene and their associations with eight growth traits in 159 individuals. Seven SNPs, which included six new SNPs for the SNP database, were found. The core promoter region was identified with a bioinformatic software. This analysis also showed that the SNPs have a significant influence on the function and structure of the STAM2 promoter in terms of RNA secondary structure, CpG island, and transcription factor binding sites. Association analysis demonstrated that G-102A is significantly associated with withers height, heart girth, cannon circumference, chest width, and hip height in this population, which leads us to suggest that G-102A is a useful SNP marker for cattle growth performance. Animals with the genotype AA had higher mean values for withers height, cannon circumference, chest width, and hip height than those with GG and AG genotypes. This SNP of the STAM2 gene could be applied in marker-assisted selection for improving growth performance in cattle.

Linagliptin provides effective, well-tolerated add-on therapy to pre-existing oral antidiabetic therapy over 1 year in Japanese patients with type 2 diabetes

AIMS

To evaluate the long-term safety and efficacy of linagliptin as add-on therapy to one approved oral antidiabetic drug (OAD) in Japanese patients with type 2 diabetes mellitus and insufficient glycaemic control.

METHODS

This 52-week, multicentre, open-label, parallel-group study evaluated once-daily linagliptin 5 mg as add-on therapy to one OAD [biguanide, glinide, glitazone, sulphonylurea (SU) or α-glucosidase inhibitors (A-GI)] in 618 patients. After a 2-week run-in, patients on SU or A-GI were randomized to either linagliptin (once daily, 5 mg) or metformin (twice or thrice daily, up to 2250 mg/day) as add-on therapy. Patients receiving the other OADs received linagliptin add-on therapy (non-randomized).

RESULTS

Adverse events were mostly mild or moderate, and rates were similar across all groups. Hypoglycaemic events were rare, except in the SU group. Overall, 26 (5.8%) hypoglycaemic events were reported in patients receiving linagliptin (non-randomized). Hypoglycaemic events were similar for linagliptin and metformin added to A-GI (1/61 vs. 2/61, respectively) or SU (17/124 vs. 10/63, respectively). Significant reductions in glycated haemoglobin (HbA1c) levels (between -0.7 and -0.9%) occurred throughout the study period for the background therapy groups that received linagliptin (baseline HbA1c 7.9-8.1%). The decline in HbA1c levels was indistinguishable between linagliptin and metformin groups when administered as add-on therapy to A-GI or SU.

CONCLUSIONS

Once-daily linagliptin showed safety and tolerability over 1 year and provided effective add-on therapy leading to significant HbA1c reductions, similar to metformin, over 52 weeks in Japanese patients.

Effect of adjunctive roxithromycin therapy on interleukin-1β, transforming growth factor-β1 and vascular endothelial growth factor in gingival crevicular fluid of cyclosporine A-treated patients with gingival overgrowth

BACKGROUND AND OBJECTIVE

Systemic macrolide antibiotic administration has been shown to result in the elimination or reduction cyclosporine A-induced gingival overgrowth. Roxithromycin (ROX) is known to have anti-inflammatory, immunomodulatory and tissue reparative effects. This study was to evaluate the effect of adjunctive ROX therapy on cyclosporine A-induced gingival overgrowth and interleukin (IL)-1β, transforming growth factor (TGF)-β1 and vascular endothelial growth factor (VEGF) levels in gingival crevicular fluid of renal transplant patients.

MATERIAL AND METHODS

Thirty-one patients with clinically significant overgrowth and 16 periodontally healthy subjects were included in this randomized, double-blind, placebo-controlled, parallel-arm study. Patients received scaling and root planing (SRP) at baseline and randomized to take either ROX or placebo for 5 d. The clinical parameters, including plaque index, papillary bleeding index, probing depth and gingival overgrowth scores, were recorded. The amounts of IL-1β, TGF-β1 and VEGF in gingival crevicular fluid were detected by ELISA. Periodontal parameters as well as gingival crevicular fluid biomarker levels were evaluated at baseline and at 1 and 4 wk post-therapy.

RESULTS

Following SRP plus ROX and SRP plus placebo therapy, significant improvements in clinical periodontal parameters of both study groups were observed (p < 0.025). In the ROX group, adjunctive ROX therapy resulted in a greater gingival overgrowth scores reduction compared with those in the placebo group at 4 wk (p < 0.017). Initial amounts of IL-1β, TGF-β1 and VEGF for both the ROX and placebo groups were significantly higher than those for healthy subjects (p < 0.017), with no statistical difference between the two study groups. At 1 and 4 wk post-therapy, significant decreases in the amounts of IL-1β, TGF-β1 and VEGF were observed in both study groups when compared with baseline (p < 0.025), but there was no difference in the levels of IL-1β and VEGF between the two study groups. The amount of decrease in TGF-β1 levels for the ROX group was statistically significant compared to that for the placebo group at 4 wk after treatment (p < 0.017).

CONCLUSION

Our study indicated that combination of ROX with non-surgical therapy improves gingival overgrowth status and decreases gingival crevicular fluid TGF-β1 levels in patients with severe gingival overgrowth. The reduction of gingival crevicular fluid TGF-β1 following ROX therapy suggests an anti-inflammatory/immunomodulatory effect of ROX on the treatment of cyclosporine A-induced gingival overgrowth.

The human MTHFR rs4846049 polymorphism increases coronary heart disease risk through modifying miRNA binding

BACKGROUND AND AIMS

Abnormal functioning of 5,10-methylenetetrahydrofolate reductase (MTHFR) enhances the risk for coronary heart disease (CHD). Here, we tested whether a single-nucleotide polymorphism (SNP) located in the 3' untranslated region (UTR) of MTHFR was associated with CHD susceptibility by affecting microRNAs binding.

METHODS AND RESULTS

We first analyzed in silico the SNPs localized in the 3' UTR of MTHFR for their ability to modify miRNA binding. We observed that rs4846049 (G > T) was a potential candidate SNP to modulate miRNAs:MTHFR mRNA complex, with the greatest changed binding free energy for has-miR-149. Based on luciferase analysis, hsa-miR-149 inhibited the activity of the reporter vector carrying -T allele, but not -G allele. We further conducted a case-control study (654 vs 455) in a Chinese Han population. rs4846049 was significantly associated with increased risk for CHD. In addition, the T allele was associated with decreased levels of HDL-cholesterol and apoA. Finally, we observed a reduced MTHFR protein level in peripheral blood mononuclear cells of CHD patients with TT carriers compared to GG carriers of rs4846049.

CONCLUSION

Our results suggest that rs4846049 (G > T) of MTHFR is associated with increased risk for CHD. We also identified a potentially pathogenetic mechanism of SNP-modified posttranscriptional gene regulation by miRNAs to MTHFR.

The roles of mesenchymal stem cells in gastric lesion and regeneration: applications in gastric diseases

In recent years, many studies have focused on the roles of mesenchymal stem cells (MSCs) due to their contribution to tissue regeneration and tumorigenesis. However, the full profile of the roles of MSCs in gastric diseases has not been established. In this review, we aim to provide an overview on the roles of MSCs on cell lesion and regeneration in gastric diseases, including gastric ulcer, premalignant conditions and cancer. We will also discuss the mechanisms underlying the behaviors of MSCs in these diseases.

Genome-wide association analyses suggest NELL1 influences adverse metabolic response to HCTZ in African Americans

Hydrochlorothiazide (HCTZ) is one of the most widely prescribed antihypertensive medications. Although it is well known that HCTZ is associated with hyperglycemia and hypertriglyceridemia, the mechanisms underlying these adverse effects are not well understood. We performed a genome-wide association study and meta-analysis of the change in fasting plasma glucose and triglycerides in response to HCTZ from two different clinical trials: the Pharmacogenomic Evaluation of Antihypertensive Responses and the Genetic Epidemiology of Responses to Antihypertensive studies. Two single-nucleotide polymorphisms (rs12279250 and rs4319515 (r²=0.73)), located at 11p15.1 in the NELL1 gene, achieved genome-wide significance for association with change in fasting plasma triglycerides in African Americans, whereby each variant allele was associated with a 28 mg dl⁻¹ increase in the change in triglycerides. NELL1 encodes a cytoplasmic protein that contains epidermal growth factor-like repeats and has been shown to represses adipogenic differentiation. These findings may represent a novel mechanism underlying HCTZ-induced adverse metabolic effects.

The development and application of a blocking ELISA kit for the diagnosis of infectious coryza

A blocking enzyme-linked immunosorbent assay (B-ELISA) kit for the diagnosis of infectious coryza was developed in this study. The kit was based on a recently described blocking ELISA that uses monoclonal antibodies to achieve specificity for antibodies to either Haemophilus paragallinarum serovar A or serovar C. The results showed that the B-ELISA kit detected 96 and 90%, respectively, of chickens vaccinated or challenged with H. paragallinarum serovar A. When used on chickens vaccinated or challenged with H. paragallinarum serovar C, the kit detected 77 and 40%, respectively, as positive. The majority of sera from vaccinated chickens were still positive on the serovars A and C ELISAs 4 months after vaccination. Based on pen trial data, the serovar A B-ELISA kit had a sensitivity of 95% and a specificity of 100%. The serovar C B-ELISA kit had a sensitivity of 73% and a specificity of 100%. A range of field sera was examined with the kit, generating results that correlated with the known vaccination/disease history of the flocks examined. As freeze drying the monoclonal antibodies and the conjugate had some effect on optimal working concentration, the kit used liquid solutions of these two reagents. The kit could be stored for 7 days at 37 degrees C, 10 months at 4 degrees C and more than 1 yearat -20 degrees C. Our results suggest that the kit would be a useful aid in the diagnosis of infectious coryza in China and other countries where H. paragallinarum serovars A and C are the predominant or sole serovars.

Further studies on the use of a polymerase chain reaction test for the diagnosis of infectious coryza

Further information is reported on the use of a polymerase chain reaction (PCR) test for the diagnosis of infectious coryza in China. The majority of sinus swabs taken from artificially infected chickens and stored in glycerol-enriched phosphate-buffered saline were still positive by PCR after storage for 180 days at either 4 degrees C or - 20 degrees C. Storage of swabs in either saline or nutrient broth was not as effective. Traditional culture failed to detect H. paragallinarum after storage for 3 days, regardless of storage medium or storage temperature. With dry swabs, the PCR could detect H. paragallinarum after storage for 7 days or longer at either 4 degrees C or - 20 degrees C, while traditional culture could not. In PCR tests on 64 artificially-challenged chickens, all were positive by PCR at the six sampling dates up to 18 days post-challenge. Traditional culture gave a similar result. Both PCR and culture detected 50% or less of chickens as positive at 21 and 24 days post challenge. Antibiotic treatment reduced the ability of both culture and the PCR test to detect H. paragallinarum. The value of the PCR test and its superiority over traditional culture for the diagnosis of infectious coryza has been confirmed in these experiments.

[A randomized clinical trial of preoperative neoadjuvant chemotherapy followed by surgery in the treatment of stage III non-small cell lung cancer]

BACKGROUND

To explore the feasibility and toxicity of preoperative neoadjuvant chemotherapy followed by surgery in the treatment of stage III NSCLC and to evaluate its effects on tumor response, resection rate, tumor downstaging, and survival rate.

METHODS

From Jan. 1990 to Jan. 2001, 624 patients were randomly devided into group A ( preoperative neoadjuvant chemotherapy group) and group B ( control group, without neoadjuvant chemotherapy) . Group A had 314 patients and group B had 310 cases. The patients in group A were give 2 cycles of neoadjuvant chemotherapy, and operations were performed in 4 weeks after finishing the last chemotherapy. Twenty-one patients were given bronchial artery intervensional chemotherapy. The other 293 cases were given intravenous chemotherapy. The regimens included MVP in 68 cases, CAP in 36 cases, EP in 67 cases, VIP in 20 cases, Gem+ DDP in 30 cases, NVB+ DDP in 32 cases, Taxol+ NVB in 30 cases, and Taxol+ DDP in 10 cases. The patients in group B were firstly operated. Thoracic radiation therapy of 50-55 Gy was g iven in the patients with N1 and N2 disease both in group A and group B.

RESULTS

The tumor response to induction chemotherapy was 73. 57%( 231/ 314) in group A. The tumor downstaging was 43. 63%( 137/ 314) . The histological complete response was 15. 92%( 50/ 314) . The resection rate was 97. 69% in group A, and 91. 94% in group B. No significant differences of blood loss, operative complications and mortality were observed between the group A and group B. The 1-, 3-, 5- and 10-year survival rates were 89. 35%, 67. 46% , 34. 39% and 29. 34% in group A, and 87. 53%, 51. 54%, 24. 19% and 21. 64% in group B respectively. The long-term survival rate in group A was remarkably higher than that in group B ( P < 0. 01) .

CONCLUSIONS

The results demonstrate that the preoperative neoadjuvant chemotherapy is safe and effective. It is helpful to decrease the tumor staging , to increase the resection rate of the tumor, and to improve the long-term survival rate and life qualities of patients with stage III NSCLC.