Intracellular inhibition of human neutrophil elastase by orally active pyrrolidine-trans-lactams

Described are the acylation binding of trans-lactam 1 to porcine pancreatic elastase, the selection of the SO2Me activating group for the lactam N which also confers metabolic stability in hamster liver microsomes, the introduction of aqueous solubility through the piperidine salt 9, the in vivo oral activity of 9 and its bioavailability, and the introduction of 9 as an intracellular neutrophil elastase inhibitor.

Genetic control of susceptibility to Porphyromonas gingivalis-induced alveolar bone loss in mice

Periodontal disease affects a large percentage of the human population. Resorption of the alveolar bone of the jaw is a pivotal sequela of periodontal disease, because this bone is the attachment site for the periodontal ligaments that anchor the teeth. Using a murine model in which alveolar bone loss is induced by oral infection with Porphyromonas gingivalis, a gram-negative bacterium associated with human adult periodontal disease, we provide evidence suggesting that susceptibility to such bone loss is a genetically determined trait. AKR/J, DBA/2J, and BALB/cByJ or BALB/cJ mice were highly susceptible, while A/J, A/HeJ, 129/J, SJL/J, and C57BL/6J mice were much more resistant. When susceptible BALB/cJ and BALB/cByJ mice were crossed to resistant strains, two patterns were observed. (BALBc/ByJ x C57BL/6J)F(1) offspring were susceptible, suggesting C57BL/6J has recessive resistance alleles, while (BALB/cJ x A/J)F(1) mice were all resistant, suggesting that A/J mice have dominant resistance alleles. These results suggest a tractable genetic basis for P. gingivalis-induced alveolar bone loss and open the possibility of exploiting the mouse model to identify loci important for host susceptibility and resistance to periodontal disease.

Formal justifications for compulsory psychiatric detention

The formal justifications for all detentions under s.2 of the Mental Health Act 1983 within an inner-city mental health trust were examined over a 12-month period. The study explored: the nature of the justifications for detention; the extent to which these were associated with patient characteristics; and the extent to which the two medical practitioners involved in each case agreed on the justifications. The justifications reflected a greater emphasis on the protection of the individual concerned rather than the protection of others. A content analysis of the textual justifications revealed five broad themes: the nature of the risk posed by the patient; the patient's capacity to provide informed consent; their need for hospitalization; their lack of consent to informal admission; and their reliability or likely compliance. There was a significant association between patients' sex, ethnic group, diagnosis and the nature of risk indicated in the documentation, but further research is needed to clarify the nature of this association. The study found that in nearly a quarter of cases, the two professionals did not agree about whether or not the patient presented a danger to others. This lack of agreement was not associated with any patient or professional characteristics, and may reflect the complexity of this area of risk assessment. The authors suggest that the issue of 'risk' needs to be addressed in a more sophisticated manner within the Mental Health Act. Specifically, further guidance is needed as to the nature and levels of risk that constitute grounds for detention. Further guidance is also needed regarding the issues that need to be recorded on the legal documentation for detention.

Ultrastructural and molecular analysis of Bowman's layer corneal dystrophies: an epithelial origin?

PURPOSE

Two mutations (R555Q and R124L) in the BIGH3 gene have been described in anterior or Bowman's layer dystrophies (CDB). The clinical, molecular, and ultrastructural findings of five families with CDB was reviewed to determine whether there is a consistent genotype:phenotype correlation.

METHODS

Keratoplasty tissue from each patient was examined by light and electron microscopy (LM and EM). DNA was obtained, and exons 4 and 12 of BIGH3 were analyzed by polymerase chain reaction and single-stranded conformation polymorphism/heteroduplex analysis. Abnormally migrating products were analyzed by direct sequencing.

RESULTS

In two families with type I CDB (CDBI), the R124L mutation was defined. There were light and ultrastructural features of superficial granular dystrophy and atypical banding of the "rod-shaped bodies" ultrastructurally. Patients from three families with "honeycomb" dystrophy were found to carry the R555Q mutation and had characteristic features of Bowman's dystrophy type II (CDBII).

CONCLUSIONS

There is a strong genotype:phenotype correlation among CBDI (R124L) and CDBII (R555Q). LM and EM findings suggest that epithelial abnormalities may underlie the pathology of both conditions. The findings clarify the confusion over classification of the Bowman's layer dystrophies.

Intermediate care. A new way through

The development of intermediate care, which will keep patients out of hospital, depends on co-operation between specialists and primary care organisations. Community hospitals and some nursing homes will have to take on new roles as community treatment centres. Action is needed to unlock budgets currently tied up in hospital services. The potential for consultants and GPs to work together to commission services needs to be unleashed. Clinical criteria should be established for referral to these services.

Adhesion molecule deficiencies increase Porphyromonas gingivalis-induced alveolar bone loss in mice

Alveolar bone resorption can be induced in specific-pathogen-free mice by oral infection with Porphyromonas gingivalis (P. J. Baker, R. T. Evans, and D. C. Roopenian, Arch. Oral Biol. 39:1035-1040, 1994). Here we used a mouse strain, C57BL/6J, which is relatively resistant to P. gingivalis-induced bone loss to examine whether partial or complete deletion of various adhesion molecules would increase susceptibility. Complete deletion of P-selectin or nearly complete lack of expression of intercellular adhesion molecule 1 (ICAM-1) led to increased susceptibility to bone resorption after oral infection, while a hypomorphic defect in beta(2)-integrins did not. Both the total amount of bone lost and the number of sites at which there was significant loss were increased in mice deficient in either ICAM-1 or P-selectin. Each of the three adhesion molecule deficiencies was sufficient to decrease P. gingivalis-specific serum immunoglobulin G responses, but lower antibody titers did not lead to increased bone loss in partially beta(2)-integrin-deficient mice. In conclusion, P-selectin and ICAM-1 deficiencies increase susceptibility to and severity of alveolar bone loss after P. gingivalis infection. This finding underscores the importance of innate immunity in protection against P. gingivalis-induced alveolar bone resorption.

The use of reaction time measures to evaluate nonword reading in primary progressive aphasia

We reported on a subject with nonfluent primary progressive aphasia (PPA), NL, who demonstrated an impaired ability to make rhyme judgments (Dowhaniuk, Dixon, Roy, Black, & Square, in press). Our hypothesis was that these deficits represent a precursor to phonological alexia. However, no definitive evidence supported the existence of a phonological reading impairment as NL made relatively few errors reading nonwords. To further evaluate NL's nonword reading, nonword and real word reaction times were compared. NL's reaction times were significantly longer for only nonwords compared to the slowest control subject. We then assessed the first two stages of processing involved in nonword reading (Coltheart, 1996). NL did not demonstrate deficits with graphemic parsing or phoneme assignment. His continuing problems with auditory rhyme judgments support the presence of a phonological processing deficit not specific to reading. We conclude that reaction time measures allow for the detection of subtle nonword reading deficits.

Characterization of the human and mouse HEY1, HEY2, and HEYL genes: cloning, mapping, and mutation screening of a new bHLH gene family

Many basic helix-loop-helix (bHLH) transcription factors are known as key regulators of embryonic development or differentiation in various species. We have isolated and characterized three new hairy-related bHLH transcription factor genes from mouse and human (hairy and Enhancer-of-split related with YRPW motif; HEY1, HEY2, and HEYL). All three HEY genes have a similar genomic structure with five exons. Together with a highly related Drosophila homologue, they form a new bHLH gene subfamily that is different from both hairy and the known vertebrate Hes and Her genes. While the overall structure with the bHLH domain, Orange domain, and WRPW motif is similar, the last motif is changed to KPYRPWG in Hey1/2 and absent in HeyL. This and other sequence features suggest Hey proteins to have unique functional properties. The genes were mapped by fluorescence in situ hybridization and RH mapping to the following human chromosomes: (HEY1) 8q21, (HEY2) 6q21, and (HEYL) 1p34.3. Based on expression patterns and map location, HEY genes are candidates for several human or mouse disease loci. However, initial screening of DNA from affected individuals for two human disorders and four mouse mutants did not reveal any diagnostic alterations in the coding regions.

Sex and relationships following childbirth: a first report from general practice of 131 couples

Changes in a couple's sexual relationship following childbirth may be more significant than previous studies have suggested. Around 50% of first-time parents in this study described their sex life as 'poor' or 'not very good' eight months after the birth of their baby, and one in five said that they would like help for this. First-time parents rating their general relationship as 'poor' or 'not very good' rose from 1% before pregnancy to 20% eight months after childbirth. Changes in the general relationship and the quality of sex life were associated in these couples.

Heterogeneity of Porphyromonas gingivalis strains in the induction of alveolar bone loss in mice

These experiments examine alveolar bone loss in a model in which specific pathogen-free mice are exposed orally with Porphyromonas gingivalis. Alveolar bone loss was induced as a result of a specific infection with P. gingivalis, rather than other environmental antigens. Infection with live P. gingivalis was required, as significant bone loss did not follow gavage with formalin-killed P. gingivalis. The virulence of different strains of P. gingivalis was compared. Two laboratory strains of the bacteria (ATCC 53977 and W50) and a mutant strain lacking the 43-kDa fimbrillin (strain DPG3) induced bone loss. P. gingivalis 381, however, did not induce bone loss. There was a strong immunoglobulin G (IgG) antibody response to infection with each strain but a significant serum IgA response only to strain 381. These studies show that in mice with a background oral microflora bone loss is induced by a specific infection with P. gingivalis and that bacterial strain variation is important in determining whether alveolar bone loss will ensue.

Molecular, genetic and physiological analysis of Cladosporium resistance gene function in tomato

Characterization of the DNA sequence of 4 tomato leaf mould disease resistance genes (Cf-2, Cf-4, Cf-5 and Cf-9) leads to the prediction that they encode C-terminally membrane anchored glycopeptides with many extracytoplasmic leucine rich repeats (LRRs). The N terminal LRRs are variable between the Cf-genes, suggesting a role in specificity, and the C terminal LRRs are more conserved, suggesting a role in signal transduction. Genetic analysis has revealed several Rcr genes that are required for Cf-gene function; their isolation will help us understand how Cf-genes work. Cf-9 confers responsiveness to pathogen-encoded Avr9 peptide on introduction to tobacco. Tobacco suspension cultures carrying the Cf-9 gene produce reactive oxygen species in response to Avr9 peptide, whereas untransformed cultures do not. The significance of these observations is discussed.