Retinol binding protein in rainbow trout: molecular properties and mRNA expression in tissues

Retinoids are important regulatory signaling molecules during embryonic development. The molecular properties of rainbow trout (Oncorhynchus mykiss) retinol-binding protein (rtRBP), the specific retinol carrier in vertebrate plasma, were studied to elucidate its role in transporting retinols to developing fish oocytes. A 954-nucleotide rtRBP cDNA was cloned from the liver coding for a 176-amino-acid (aa) mature protein, with an estimated molecular mass of 20,267 Da. The nucleotide sequence suggests a putative 16-aa signal peptide and shows all the aa residues that were previously identified as critical for the retinol binding pocket. Five of the eight amino acid residues that are associated with the interaction of RBP and transthyretin in mammalian and non-mammalian species are conserved. The deduced aa sequence of rtRBP shows 60-66% identity with zebrafish, chicken, mouse, rat, horse, bovine, and human RBPs and 56% identity with Xenopus RBP. Northern blot analysis revealed a approximately 1.1-kb hepatic mRNA transcript. RBP is highly expressed in the liver, but low levels were also detected in the spleen, kidney, ovary, and brain. In the rainbow trout, 17beta-estradiol treatment led to a decrease in the RBP mRNA signal relative to that of the controls. The efficacy of the 17beta-estradiol treatment was verified by an induction of vitellogenin (VTG) mRNA expression in the liver and occurrence of VTG in the plasma.

Regulation of gonadotropin subunit genes in tilapia

A steroidogenic tilapia gonadotropin (taGtH=LH) was purified from pituitaries of hybrid tilapia (Oreochromis niloticus x O. aureus) and a homologous RIA was established. This RIA enabled the study of the endocrine regulation of GtH release, the transduction pathways involved in its secretion and its profile during the spawning cycle. Discrepancies between steroid and taGtH peaks during the cycle led to the conclusion that an additional gonadotropin similar to salmonid FSH operates early in the cycle. In order to identify this hormone and to study the endocrine control of synthesis of all gonadotropin (GtH) subunits, a molecular approach was taken. The cDNA sequences and the entire gene sequences encoding the FSHbeta and LHbeta subunits, as well as an incomplete sequence of the glycoprotein hormone alpha subunit (GPalpha), were cloned. Salmon gonadotropin-releasing hormone (sGnRH) elevated mRNA steady-state levels of all three GtH subunits in cultured pituitary cells. Pituitary adenylate cyclase-activating polypeptide (PACAP) and neuropeptide Y (NPY) also stimulated the expression of these subunits and potentiated the effect of GnRH, except that NPY did not affect FSHbeta. The GnRH and NPY effects were found to be mediated mainly through protein kinase C (PKC), while protein kinase A (PKA) cascade was involved to a lesser extent. Mitogen-activated protein kinase (MAPK) cascade takes part in mediating GnRH effects, possibly via PKC. Testosterone (T) and estradiol (E2), but not 11-ketotestosterone (KT), are able to elevate GPalpha and LHbeta mRNAs in pituitary cells of early maturing or regressing males. Low levels of T exposure are associated with elevated FSHbeta mRNA in cells of mature fish, while higher levels suppress it, but elevate LHbeta mRNA. In vivo observations also showed the association of low T levels with increased FSHbeta mRNA and high T levels with elevated LHbeta mRNA. In accordance with these findings, analysis of LHbeta and FSHbeta 5' gene-flanking regions revealed on both gene promoters a GtH-specific element (GSE), half site estrogen response elements (ERE), cAMP response element (CRE) and AP1. In vitro experiments showed that recombinant human activin-A leads to higher levels of GPalpha, FSHbeta and LHbeta mRNAs in pituitary cell culture. Porcine inhibin marginally decreased the mRNA levels of GPalpha and FSHbeta, but at a low level (1 ng/ml) it stimulated that of LHbeta. These results shed some light on certain hypothalamic and gonadal hormones regulating the expression of GtH subunit genes in tilapia. In addition, they provide evidence for their differential regulation, and insight into their mode of action.

Characterization of tilapia FSHbeta gene and analysis of its 5' flanking region

The objective of the current study was to unveil molecular mechanisms underlying transcriptional regulation of the FSHbeta gene expression in the pituitary of tilapia (Oreochromis mossambicus). The full-length sequence of tilapia FSHbeta (tFSHbeta) gene was determined. Its transcriptional unit (2.7 kb) exhibits the conserved genomic organization, i.e. three exons and two introns. Primer extension and RT-PCR analysis revealed heterogeneity of the tFSHbeta transcripts, due to alternate mRNA splicing and multiple initiation sites for transcription. Examination of the 5' flanking region (5'FR) of the tFSHbeta gene identified potential CAAT and TATA promoter proximal elements as well as several sequences of cis-acting motifs known to dictate inducible and tissue-specific transcriptional regulation in other gonadotropin genes. Chimeric constructs containing 1.7 kb of the tFSHbeta 5'FR fused to a luciferase (LUC) reporter gene were transiently transfected into primary culture of tilapia pituitary cells. The tFSHbeta-LUC construct was efficiently expressed under basal conditions and was rapidly induced by GnRH stimulation. Our data indicate that the 5'FR contains a functional promoter, which is responsive to GnRH treatment. In addition, 5' deletion analysis showed that the 1.7 kb, DNA sequence of the FSHbeta 5'FR encompasses both positive and negative regulatory elements.

Survey of patient satisfaction in adult psychiatric outpatient clinics

A client satisfaction survey was undertaken in two adult psychiatric outpatient clinics. The anonymous self-report questionnaire covering demographic, setting and satisfaction with service variables was endorsed by 203 participants. The mean age of the subjects was 42.5 +/- 19 years, with a small majority (58.6%) of females. Overall satisfaction with psychiatric care was high (79.8%). None of the demographic or setting variables correlated significantly with satisfaction. Psychoeducation was significantly correlated with level of satisfaction with services. These findings further emphasize the importance of psychoeducation by service providers in mental health.

Anxiety among Israeli soldiers during the Gulf War

The impact of stress was investigated among Israeli soldiers during the Gulf War. The study included 40 healthy young adults in active service. Their scores on the Hamilton Anxiety Rating Scale were evaluated during the first week of the war. Our subjects were divided into two equal sub-groups (N=20); combatants and auxiliary personnel. Higher levels of anxiety were found among the combatants. Factor analysis revealed three differing factors: arousal symptoms, numbing and distraction. We discuss the possible explanations for these differences.

The insanity defense: examination of the extent of congruence between psychiatric recommendation and adjudication

The insanity plea is a known defense often utilized in courts of law. In such cases the accused may be referred for an outpatient psychiatric examination or for hospital observation. In this study, we examined the extent of the accord between the medical recommendations of the forensic unit of the Yehuda Abarbanel Mental Health Center and judicial decisions. It was found that in 99.4% of the cases, the court accepted the psychiatric recommendation. In only 2 cases the recommendations were not accepted. We discuss this issue and recommend improvements and strengthening of the relationship between the psychiatric and court systems.

Differential expression of three different prepro-GnRH (gonadotrophin-releasing hormone) messengers in the brain of the european sea bass (Dicentrarchus labrax)

The expression sites of three prepro-gonadotrophin-releasing hormones (GnRHs), corresponding to seabream GnRH (sbGnRH: Ser(8)-mGnRH, mammalian GnRH), salmon GnRH (sGnRH: Trp(7)Leu(8)-mGnRH), and chicken GnRH-II (cGnRH-II: His(5)Trp(7)Tyr(8)-mGnRH) forms were studied in the brain of a perciform fish, the European sea bass (Dicentrarchus labrax) by means of in situ hybridization. The riboprobes used in this study correspond to the three GnRH-associated peptide (GAP)-coding regions of the prepro-GnRH cDNAs cloned from the same species (salmon GAP: sGAP; seabream GAP: sbGAP; chicken GAP-II: cIIGAP), which show little oligonucleotide sequence identity (sGAP versus sbGAP: 42%; cIIGAP versus sbGAP: 36%; sGAP versus cIIGAP: 41%). Adjacent paraffin sections (6 mm) throughout the entire brain were treated in parallel with each of the three anti-sense probes and the corresponding sense probes, demonstrating the high specificity of the hybridization signal. The results showed that both sGAP and sbGAP mRNAs had a broader expression in the olfactory bulbs, ventral telencephalon, and preoptic region, whereas cIIGAP mRNA expression was confined to large cells of the nucleus of the medial longitudinal fascicle. In the olfactory bulbs, both the signal intensity and the number of positive cells were higher with the sGAP probe, whereas sbGAP mRNA-expressing cells were more numerous and intensely stained in the preoptic region. Additional isolated sbGAP-positive cells were detected in the ventrolateral hypothalamus. These results demonstrate a clear overlapping of sGAP- and sbGAP-expressing cells in the forebrain of the European sea bass, in contrast to previous reports in other perciforms showing a clear segregation of these two cell populations.

First-night effect of melatonin treatment in patients with chronic schizophrenia

The first-night effect (FNE) is the tendency for individuals to sleep worse than normal during their first night of polysomnographic sleep evaluation. FNE reflects the adaptive increase of alertness and perhaps the stress resulting from an unfamiliar sleeping environment. This effect is usually absent in patients with chronic schizophrenia. Melatonin (N-acetyl-5-methoxy-tryptamine), the hormone secreted by the pineal gland at night, has been found to improve sleep in elderly patients with insomnia and recently in patients with chronic schizophrenia. The authors used FNE as a marker to explore the neurobehavioral responses of patients with chronic schizophrenia to melatonin treatment. In a randomized, double-blind, crossover trial, 14 patients with chronic schizophrenia were administered melatonin (2 mg in a controlled-release formulation) or placebo for 3 weeks with a 1-week washout between treatment periods. Polysomnography was performed during the last two consecutive nights of each treatment period. The following significant FNEs were observed with melatonin treatment: (1) rapid eye movement sleep latency was longer; (2) sleep efficiency was lower; and (3) the duration of wakefulness during sleep was lower on the first night than on the second night. These effects were not found when the patients received a placebo. The FNE was manifested regardless of whether melatonin was administered before or after the placebo treatment period. For the first time, these results show that melatonin treatment exaggerates FNE in patients with chronic schizophrenia, thereby suggesting an improved ability of these patients to mobilize alertness in unfamiliar surroundings.

The "re-entry group"--a transitional therapeutic framework for mentally ill patients discharged from the hospital to community clinics

An effective transition of the psychiatric patient from the hospital to the community clinic is vital to the continuity of care. This study shows a short-term group, the "re-entry group," to be more effective in this transition than are patients discharged from a psychiatric hospital by the traditional process. We used a psychoeducational approach to facilitate active participation and compliance with outpatient therapy. Outcome variables included absorption of patients into the clinic, continued therapy, compliance with treatment, rehospitalization, level of knowledge regarding illness and medication, quality of rehabilitation, and attitude towards treatment.

The effectiveness of olanzapine in treatment-refractory schizophrenia when patients are nonresponsive to or unable to tolerate clozapine

OBJECTIVE

This multicenter, open-label study was designed to assess the efficacy and tolerability of olanzapine in patients with chronic schizophrenia who are resistant to therapy with classic neuroleptic agents and are either not responsive to or unable to tolerate clozapine.

METHODS

Patients received olanzapine orally once daily for 18 weeks at doses ranging from 5 to 25 mg. The primary efficacy measure was change in the total score on the Positive and Negative Syndrome Scale (PANSS) from baseline to end point. Secondary efficacy measures were the total score on the Brief Psychiatric Rating Scale (BPRS); the PANSS positive, negative, general psychopathology, and mood subscores; and the Clinical Global Impression improvement score. Also recorded were spontaneously reported adverse events; extrapyramidal symptoms (assessed by the Abnormal Involuntary Movement Scale, Simpson-Angus Scale, and Barnes Akathisia Scale); vital signs; and clinical laboratory test results.

RESULTS

Forty-eight patients were treated with olanzapine; of these, 45 were assessable over the full 18-week study period. Total scores on the PANSS and BPRS were reduced from baseline by an average of 17.7 (14.2%) and 9.8 points (20.2%), respectively. Eighteen patients (40.0%) experienced a treatment response, defined as a reduction in PANSS total score of > or = 20%. A total of 25 patients (55.6%) achieved a similar reduction in BPRS total score. Significant reductions were seen in both the positive and negative symptom scores on the PANSS (P < 0.001). Olanzapine was well tolerated, with minimal treatment-emergent adverse events or clinically relevant changes in vital signs or clinical laboratory test results. No clinically significant blood dyscrasias were observed in olanzapine-treated patients, including those who had discontinued clozapine because of treatment-associated leukopenia or neutropenia.

CONCLUSION

The results of this study suggest that olanzapine may be of benefit in patients who are refractory to or unable to tolerate clozapine.

Is melatonin treatment effective for tardive dyskinesia?

BACKGROUND

Tardive dyskinesia is a severe and disabling side effect of conventional antipsychotic treatment, with incidence rates reaching a high of 50% in chronically institutionalized populations. On the basis of recent studies showing some benefit of antioxidants, we evaluated the effect of melatonin, the most potent naturally occurring antioxidant, on tardive dyskinesia in patients with chronic schizophrenia.

METHOD

Nineteen patients (8 men, 11 women), aged a mean +/- SD 74.0+/-9.5 years with chronic DSM-IV schizophrenia of 31.3+/-7.0 years' duration, were randomly assigned in a double-blind, placebo-controlled, crossover trial to receive slow-release melatonin, 2 mg/day, or placebo for 4 weeks. After a 2-week washout period, the patients were switched to the other treatment arm for an additional 4 weeks. The Abnormal Involuntary Movement Scale (AIMS) was administered at baseline, 4 weeks, 6 weeks, and 10 weeks. Regular administration of antipsychotic and other medications was kept unchanged throughout the study.

RESULTS

Mean AIMS scores did not change significantly from baseline in either treatment arm. All patients completed the study, and there were no side effects or adverse events.

CONCLUSION

Supraphysiologic doses of melatonin do not positively affect tardive dyskinesia. Considering that melatonin is a safe drug, further studies are needed of higher doses and in patients with shorter disease duration before its use in the treatment of tardive dyskinesia is ruled out.

Melatonin improves sleep quality of patients with chronic schizophrenia

BACKGROUND

Accumulating evidence indicates decreased melatonin levels in patients with schizophrenia. Insomnia, mainly difficulty in falling asleep at night, is commonly reported in this population. Association of insomnia with low or abnormal melatonin rhythms has been repeatedly documented. Melatonin is an endogenous sleep promoter in humans. We hypothesized that insomnia in patients with schizophrenia may be partially due to diminished melatonin output. In this study, we measured melatonin output in patients with chronic schizophrenia and assessed the effects of melatonin replacement on their sleep quality.

METHOD

In a randomized, double-blind, cross-over, clinically based trial, 19 patients with DSM-IV schizophrenia who were treated with the normal treatment regimen were given melatonin (2 mg, controlled release) or placebo for 2 treatment periods of 3 weeks each with 1 week washout between treatment periods (7 weeks total). For measuring endogenous melatonin production, urine was collected from each patient every 3 hours between 9:00 p.m. and 9:00 a.m. Actigraphy was performed for 3 consecutive nights at the end of each period. Activity- and rest-derived sleep parameters were compared for the whole population with treatment arm as the intervening variable. A separate analysis was performed for patients subgrouped into high versus low sleep efficiency.

RESULTS

All patients had low melatonin output. Melatonin replacement significantly improved rest-derived sleep efficiency compared with placebo (83.5% vs. 78.2%, p = .038) in this population. Improvement of sleep efficiency was significantly greater (p < .0014) in low-efficiency (80% vs. 67%) than high-efficiency sleepers (88% vs. 90%). In addition, during melatonin therapy, tendencies toward shortened sleep latency (by 40 minutes, p < .056) and increased sleep duration (by 45 minutes, p < .078) were observed in low- but not high-efficiency sleepers.

CONCLUSION

Melatonin improves sleep efficiency in patients with schizophrenia whose sleep quality is low.

Reproductive development of male and female tilapia hybrids (Oreochromis niloticus x O. aureus) and changes in mRNA levels of gonadotropin (GtH) Ibeta and IIbeta subunits

A study was carried out in tilapia in order to see whether the gonadotropin (GtH) beta subunits show distinct patterns of expression at different stages of their reproductive development. Male and female tilapia hybrids (Oreochromis niloticus x O. aureus) were collected at various times of the year, and a number of parameters were measured in order to establish the reproductive state of the fish. Circulating testosterone (T), estradiol (E(2)) and 11 ketotestosterone (11KT) levels were assayed, gonads were removed for calculation of gonadosomatic index (GSI) values and histological studies, and RNA was extracted from the pituitaries for measurement of GtH Ibeta and IIbeta mRNA levels. In maturing fish of both sexes, the circulating steroid levels were positively correlated with each other (r(2) = 0.66-0.91) and in males, also with the GSI values (r(2) = 0.68). A positive correlation was also seen in these fish between GSI values and the prevalence of spermatocytes and spermatids (r(2) = 0.54). In maturing females, the maximal oocyte diameter was positively correlated with circulating E(2) levels (r(2) = 0.63), while GSI values showed no correlation; this presumably relates to the cycling nature of this asynchronous spawner. In regressing fish of both sexes, no clear correlation between these reproductive parameters was seen. In all fish, the GtH Ibeta mRNA levels were highest in fish with steroids ranging 1-10 ng T or E(2)/ml for males or females, respectively, and were lower in fish with steroids at higher or lower levels. In fish with high steroid levels, the IIbeta mRNA levels were also high, and in regressed males the increases were positively correlated. Exposure of cultured pituitary cells to either steroid (T at >10 nM, or E(2) at >1 nM) was followed by a decrease in the steady-state levels of the Ibeta transcript, while those of IIbeta were left unaltered. In situ hybridization studies revealed that in pituitaries of both sexes, the cells producing each of these mRNAs are located in a distinct location. These results suggest that gonadal steroids may exert differential feedback mechanisms at the level of the pituitary to control transcription of each GtH beta subunit in distinct cell types specific for each hormone.

A trial of L-deprenyl for the treatment of neuroleptic-induced parkinsonism

This study examined the potential of L-Deprenyl, a selective monoamine oxidase-B (MAO-B) inhibitor, for the treatment of neuroleptic-induced parkinsonism (NIP). Thirty-one consecutive schizophrenic or schizophreniform patients were treated with haloperidol in a flexible dose design. Nineteen of them developed NIP and were administered adjunctive L-Deprenyl 10 mg/d for six weeks in an open fixed-dose design. One patient had to be withdrawn from the study because of exacerbation of the NIP. Severity of NIP was mild to moderate throughout the whole study period in all other cases. Five patients were considered to require biperiden 2-4 mg/d in addition to L-Deprenyl after two weeks of treatment, although they did not differ from the other 13 patients in any of the variables studied. A significant improvement in NIP was found in both groups of patients, with no psychotic exacerbation or a change in the dosage of haloperidol. These findings suggest that selective MAO-B inhibitors may be effective in some patients with mild to moderate NIP.

Outcome of psychogeriatric intervention in an old-age home: a 3 years follow-up study

Psychogeriatrics and especially psychiatric services in nursing and old-age homes are sorely lacking in research. Four years ago we developed and implemented a model for service delivery for old-age homes within our hospitals' catchment area. In the first year of operation 48 of 373 residents (13%) were evaluated and treated by a psychogeriatrician. The aim of the present study was to evaluate outcome of these patients three years later. All patients and medical records were re-assessed. During the three-year period 16/48 subjects (33.3%) passed away; of these half were previously diagnosed as suffering from a major depressive episode. None of the subjects who died had attempted suicide. Following a preliminary diagnosis of affective spectrum disorder, 4/48 patients (8.3%) were re-diagnosed at follow up as suffering from dementia. Full or partial remission of the original symptomatology was achieved in 18/32 surviving subjects (50.7%); mostly depressed or anxious patients. We conclude that although mortality rate among elderly psychiatric patients is high persistent interventions lead to successful remission in the majority of patients.

Human leukocyte antigen typing, response to neuroleptics, and clozapine-induced agranulocytosis in jewish Israeli schizophrenic patients

The atypical antipsychotic agent clozapine is known to be effective in schizophrenic patients refractory to other medications; however, it induces agranulocytosis in approximately 1-2%. In Jews, this complication is associated with the haplotype HLA B38,DR4,DQ3. The aim of the present study was to determine which human leukocyte antigen (HLA) antigens are involved in clozapine-induced agranulocytosis. We performed HLA typing in 88 Jewish Israeli schizophrenic patients and in 127 ethnically matched healthy individuals. Thirty-eight patients responsive to standard antipsychotic medications were treated with haloperidol, and 50 refractory patients received clozapine. A trend was noted for elevated rates of HLA B38 among control individuals and clozapine-treated patients of Ashkenazi origin compared to individuals of non-Ashkenazi origin, but the findings failed to reach statistical significance. No association was found between HLA class I antigens and the response to haloperidol or clozapine. Neutropenia developed in two clozapine-treated patients and agranulocytosis in one. Two of these three patients were of Ashkenazi origin, and both demonstrated the HLA B38 phenotype. Although the findings did not reach a statistical significance because of the small number of patients, they may support an association between clozapine-induced neutropenia/agranulocytosis and Ashkenazi origin and the HLA B38 phenotype. The rate of agranulocytosis in our sample (2%) is similar to the usual cumulative risk of agranulocytosis but in contrast to its high frequency among Jewish American patients. One possible explanation for this difference is the high rate of Ashkenazi patients in the American sample and the preponderance of non-Ashkenazi patients in our population.

Preparation and characterization of recombinant dolphin fish (Coryphaena hippurus) growth hormone

Dolphin fish (Coryphaena hippurus) growth hormone (dfGH) cDNA encoding the mature protein was cloned in a pET11a expression vector and expressed in Escherichia coli BL21 cells upon induction with isopropyl-1-thio-beta-d-galactopyranoside as an insoluble protein. The expressed protein, contained within the inclusion-body pellet, was solubilized in 4.5 M urea, refolded at pH 11.3 in the presence of catalytic amounts of cysteine, and purified to homogeneity, as evidenced by SDS-PAGE. Gel filtration on a Superdex column under nondenaturing conditions and amino-terminal analysis showed the purified protein to be monomeric methionyl-dfGH. Binding assays of the (125)I-labeled dfGH to dolphin fish liver microsomal fraction resulted in high specific binding characterized by a K(a) of 0.77 nM(-1) and a B(max) of 285 fmol/mg microsomal fraction protein. The purified dfGH was capable of stimulating proliferation of FDC-P1-B9 cells transfected with rabbit growth hormone (GH) receptor. The maximal effect of dfGH was identical to that of human GH but their respective EC(50) values were 28 nM versus 0.095 nM.

Possible interactions between gonadotrophs and somatotrophs in the pituitary of tilapia: apparent roles for insulin-like growth factor I and estradiol

The unique organization of the teleost pituitary, in which cells are grouped according to their characteristic hormone, makes this a suitable model for studying pituitary paracrine interactions. In a number of fish, including tilapia, there are variations in the circulating levels of the gonadotropins and GH, which are elevated during the reproductive season, suggesting interactions between the reproductive and growth axes. The aim of this study was to investigate paracrine interactions between the gonadotrophs and somatotrophs in the tilapia pituitary. Initially, dispersed pituitary cells were separated on a density gradient in which the gonadotrophs were found in the least dense fractions, and the somatotrophs were concentrated in the densest fraction. After 4 days in culture, cells in the least dense fractions showed characteristic cytoplasmic extensions not seen in the somatotrophs, which appeared small and failed to form aggregates; somatotrophs were found, however, attached to other non-GH cells. Staining of the nuclei with 4,6-diaminidino-2-phenyl-dihydrochloride revealed that the isolated somatotrophs had undergone nuclear condensation and fragmentation typical of apoptosis. Addition of either estradiol or human recombinant insulin-like growth factor I (IGF-I; 10 nM) to the somatotroph cultures increased the number of cell aggregates and reduced the number of condensed or fragmented nuclei. Immunocytochemical studies on pituitary sections revealed IGF-I immunoreactivity in regions of the proximal pars distalis that stain with gonadotropin IIbeta antisera and also in regions of the rostral pars distalis characteristic of corticotrophs; immunoreactive IGF-I was never seen in the region of the somatotrophs. Incubation of cells from the different fractions with testosterone (10 nM; 24 h) revealed that cells of the least dense fractions, which were rich in gonadotrophs, possessed aromatizing ability, which was absent in the somatotroph-enriched fraction. These results suggest that estradiol and IGF-I, both generated from cells other than the somatotrophs, may exert antiapoptotic effects and thus possibly control the size of this population of cells.