Immunomodulation of autoimmune and inflammatory diseases with intravenous immunoglobulin

Intravenous immunoglobulin (IVIg) has been used in the treatment of primary and secondary antibody deficiencies for over two decades. Since the early 1980s, the therapeutic efficacy of IVIg has been established in idiopathic thrombocytopenic purpura, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, dermatomyositis and Kawasaki syndrome, and the prevention of graft versus host disease in recipients of allogeneic bone marrow transplants. Its use has also been reported in a large number of other autoimmune and systemic inflammatory conditions. In this review, we discuss the mechanisms by which IVIg exerts immunomodulatory effects in immune pathologies.

Endogenous GD3 ganglioside induces apoptosis in U-1242 MG glioma cells

GD3 ganglioside induces apoptosis in several cell types, but the molecular events through which this occurs are largely unknown. We investigated the apoptotic effects of GD3 expression using U-1242 MG glioblastoma cells, as these cells synthesize almost exclusively GM3 and GM2 but not GD3. To express GD3 under the control of the TetOn system with minimum leakage, we modified the system by constructing a single tri-cistronic retrovirus vector containing three genes separated by two internal ribosome entry sites: (a) transcriptional silencer, tTS; (b) mutant of reverse transcriptional activator, rtTA2(S)-M2 (provided by H. Bujard, Heidelberg, Germany); and (c) enhanced green fluorescent protein (EGFP), as an indicator of the tri-cistronic gene expression. Using flow cytometry, we selected glioma cells (U1242MG-GD3 clone) that express high levels of GD3 in response to doxycycline. Expression of GD3 was associated with apoptosis as verified by annexin-V binding, TdT-mediated dUTPnick end-labelling assay (TUNEL), and EGFP degradation. GD3-induced apoptosis occurred via caspase-8 activation, as GD3 caused cleavage of caspase-8 and inhibition of caspase-8 activation by zlETD-fmk minimized GD3-induced apoptosis.

A study on intranatal care practices in a district of West Bengal

A study was conducted at Birbhum district of West Bengal among mothers who delivered in last one year to generate area-specific community-based data on the proportion of home deliveries, assistance during conduction of delivery and the intranatal care practices followed in the district. A multistage 40 cluster sampling method was used to study 320 mothers in the district. 37.81% deliveries were conducted at home. About 25% deliveries were conducted by untrained birth attendants, unqualified practitioners or relatives and friends. In 85.13% of home deliveries, DDK was not used. 68.6% home deliveries were conducted on the floor without any clean covering sheet. Though a clean instrument was used to cut the cord in 86.78% of home deliveries, a clean cord tie was used in only 24.89% cases. In 36.36% home deliveries, something was applied on the cord stump. High proportion of deliveries assisted by untrained persons and high magnitude of faulty intranatal care practices observed in the study require urgent and appropriate intervention.

Routine primary immunization: status in two district of West Bengal

The study was conducted at Birbhum and Purba Medinipur districts of West Bengal to assess the routine primary immunization coverage following 40 cluster sampling technique was used to study 320 children in each of the districts. BCG coverage was found to be 79.69% at Birbhum and 84.38% at Purba Medinipur. Only 62.81% children at Birbhum and 67.81% children at Purba Medinipur received all the three primary doses of DPT. Regarding OPV, coverage with three primary doses were only 65% and 66.88% at Birbhum and Purba Medinipur respectively. Measles vaccine coverage was very poor at both the districts, 55.94% at Birbhum and 62.5% at Purba Medinipur. Full primary immunization was observed 53.13% and 61.56% in Birbhum and Purba Medinipur respectively. High drop-out rate was identified as a major deficiency in both the districts. Of the children who received at least one routine vaccine, more than 1/3rd at Birbhum and more than 1/4 th at Purba Medinipur did not turn up later for completion of their primary vaccine doses. It is evident that routine immunization coverage was poor in both the districts and it seems there has been no improvement in situation for last few years. It will influence not only the child morbidity and mortality situation but also will jeopardize the paralytic polio eradication programme. Urgent intervention should be undertaken to address the large number of non-immunized children as well as high proportion of drop-outs.

Levels of common antigens in determining pathogenicity of Curvularia eragrostidis in different tea varieties

AIMS

Pathogenicity of Curvularia eragrostidis, a foliar fungal pathogen of tea was studied in 24 commercially cultivated tea varieties by analysing the antigenic patterns of host and pathogen with the help of immunoserological techniques.

METHODS AND RESULTS

Initial testing by cut shoot inoculation technique followed by whole plant inoculation technique showed that among the varieties tested, TV12 was the most susceptible and TV25 most resistant. Antigen preparations from tea varieties, fungal pathogens (C. eragrostidis and Lasiodiplodia theobromae) and a nonpathogen (Gliocladium virens) were compared by immunodiffusion, immunoelectrophoresis and indirect ELISA to detect common antigens shared by host and pathogen. Common antigens were detected by immunodiffusion and immunoelectrophoresis only among susceptible varieties and the pathogens. Such antigens were not found between the pathogens and the resistant varieties and also between nonpathogens and tea varieties. However, ELISA revealed the presence of low level of common antigens between all combinations. A certain minimum level of antigens was present for compatible host-pathogen interaction. Indirect labelling of antibodies with fluorescein isothiocyanate (FITC) showed that cross-reactive antigens were found to be concentrated mainly in the epidermal cells and also spread throughout the cortical cells.

CONCLUSION

Pathogenicity of C. eragrostidis to different varieties of tea was found to be related to the level of common antigens present between host and pathogen.

SIGNIFICANCE AND THE IMPACT OF THE STUDY

Indirect ELISA proved to be valuable in screening commercially cultivated varieties of tea for their susceptibility to C. eragrostidis.

An epidemiological study of injury in mines: implications for safety promotion

The role of various factors in coal mine-related injuries was investigated using a case-control design. The study setting was two neighbouring underground coal mines in India. Cases comprised mine workers (n = 150) who had sustained a prior mine-related injury from a population of 1000 underground workers. Controls were selected from those mineworkers with no history of a prior mine-related injury using frequency matching (n = 150) from the same source population. Data were collected from the cases and controls using a structured survey questionnaire. Based on the responses of the participants, each factor was grouped into three categories. High-low plots and Chi-square tests were conducted to explore the differences between the cases and controls. Bivariate logistic regression was run to estimate the crude odds of injuries, while multivariate logistic regression estimated the adjusted odds of injuries to the workers for the various variable categories. High-low plots and the Chi-square test clearly revealed that the cases and controls significantly differed in their responses for the variables studied. Accident-involved workers take more risks, are negatively affected, job dissatisfied, feel more production pressure, job stress, work hazards and are less job involved and are more dissatisfied with safety environment and social climate of the mines compared to the controls. The multivariate odds of injuries to high risk taking, negatively affected and job dissatisfied workers are 1.21, 9.34 and 2.00 times more compared to their lowest counterparts. Similarly, workers satisfied with the overall safety practice and safety equipment availability and maintenance are 1.5 and 3.12 times less likely to be injured than the workers with little or no satisfaction with the above factors. It is therefore concluded that negative affectivity and job dissatisfaction are the two major personal level factors that contribute more towards accident/injury in the mines studied. Identification and elimination/reduction of negative attitudes are of utmost importance.

Evaluation of management of Graves' disease in District General Hospital: achievement of consensus guidelines

The management of Graves' disease in a District General Hospital was audited. A local care pathway was designed, which was inclusive of diagnosis, treatment and follow-up. This was then compared with consensus guidelines proposed by the Royal College of Physicians. Forty-six patients with Graves' disease attended the endocrine clinic. The diagnosis was based on clinical and biochemical features of autoimmune thyrotoxicosis, a raised thyroid-stimulating hormone receptor antibody (TRAB) and a diffusely increased uptake in thyroid technetium scan. They were treated for 18 months with antithyroid medications, which was subsequently discontinued provided satisfactory euthyroid state was achieved. Patients were followed up to assess remission and relapse status. The audit suggested that care pathway was in keeping with the guidelines. A few excess TRAB tests were requested. The relapse rate was 42% in our series and one-third of them (33%) chose to continue medical therapy.

Self-consistent solution of two-dimensional poisson and Schrödinger wave equations for nanoscale MOSFET approaching ballistic limit

A numerical solution of the potential distribution of two-dimensional Poisson equation and Schrödinger wave equation under a set of boundary conditions has been obtained for a deep submicron and nanoscale MOSFET. The output characteristics can be found out by simply solving the two-dimensional Poisson equation under specific boundary conditions governed by the physics of the device. The channel potential profile has been presented. It is seen that the classical model underestimates the channel voltage and hence the longitudinal electric field in the channel as compared to that obtained through the quantum mechanical approach. For the purpose of validation, the results obtained on the basis of our model have been compared and contrasted with reported experimental result.

Role of L-lysine HCl in adoptive immune therapy towards development of suitable tuberculosis vaccination

L-Lysine HCI is being proposed to be a possible biocompatible adjuvant to enhance immune response by virtue of its probable non-specific bridging action and cellular proliferation properties. This proposal has been tried to be substantiated by designing an in vitro culture protocol, varying the concentration of L-lysine HCI and its further in vivo application. Splenic lymphocyte population has been extracted from mice and co-cultured with extracted mice macrophage population in presence of either Bacille Calmette Guerrin (BCG) or Hepatitis B surface antigen (HbsAg) and added L-lysine hydrochloride in culture media. Post incubation of these cultures, "taught" cell population has been adoptively transferred in naïve mice. These mice were then challenged by respective antigen dose, Change in Immune response with this challenge was noted. Antibody titre was followed in all the experiments as a measure of immune response. In adoptive immune transfer experiment of with HbsAg (AIT-HbsAg), similar to that with BCG (AIT-BCG), after the incubation period, antibody titre was higher in added lysine containing cultures in comparison with the control ones. Post transfer followed by antigen challenge, in AIT-BCG the expected augmentation in immune response was hardly visible. But in AIT-HbsAg, with the help of lysine booster, the animals responded better as far as the antibody titre is concerned.

An evaluation of routine immunization coverage in some districts of West Bengal and Assam

A coverage evaluation survey was carried out in the five districts of West Bengal and Goalpara district of Assam during the period from November 2002 to April 2003 through 40 clusters sampling technique. Results revealed that highest coverage with routine immunization was in Paschim Medinipur (82.5%) followed by Kolkata (71.6%), Malda (65.3%), 24 Parganas South (61.9%) districts of West Bengal. Murshidabad district of West Bengal had only 41.3% coverage while poorest coverage was observed in Goalpara district (27.2%) of Assam. "Not aware of the need for routine immunization" was the main reason for not being vaccinated with all the UIP vaccines. Vaccination was given mainly through government hospitals in Kolkata while it was administered mainly through subcentres in the other rural districts.

Nicotine induced alterations on reproductive organs of female rats under protein deficient condition

Nicotine causes decrement in body weight, reduction in ovarian and uterine weight, irregularity in estrous cycle and histological damage in ovary and uterus in rats maintained on normal (18% casein) and protein restricted diet (5% casein). The degree of nicotine toxicity increases in protein inadequacy.

Differential deletions of chromosome 3p are associated with the development of uterine cervical carcinoma in Indian patients

BACKGROUND

Deletions in chromosome 3 occur frequently in uterine cervical carcinoma (CA-CX). The common consensus regions deleted during CA-CX development are not well defined, and have not been correlated with tumour progression.

AIMS

To define specific regions of chromosome 3 deleted during development of CA-CX and to correlate these with clinicopathological data.

METHODS

Deletion mapping of chromosome 3 was done in seven cervical intraepithelial neoplasia (CIN) and 43 primary CA-CX samples using 20 highly polymorphic microsatellite markers.

RESULTS

Deletions of chromosome 3 were significantly associated with tumour progression. High frequencies (33-53%) of loss of heterozygosity (LOH) were found in 3p26.1, 3p22.3, 3p21.2, and 3p13, suggesting the location of putative tumour suppressor genes (TSGs) in these regions. Among these four regions, deletions in 3p21.2 were suggested to occur early during CA-CX development. A significant correlation was found between LOH at 3p26.1 and 3p22.3 with tumour progression from stage I/IIB to stage III/IV. No association was found with the highly deleted regions and human papillomavirus positivity, parity, or menopausal status. Microsatellite size alteration was seen in only seven of the samples. However, rare biallelic alterations were seen in and around the highly deleted regions. Loss of normal copy of chromosome 3 and interstitial alterations in chromosome 3p were seen in some samples.

CONCLUSION

These four regions on chromosome 3p may be differentially deleted during specific stages of CA-CX development. The putative TSGs located in these regions may have a cumulative effect on tumour progression.

Role of L-lysine HCl in immunopotentiation towards development of suitable tuberculosis vaccination

L-Lysine HCl is being proposed to be a possible biocompatible adjuvant to enhance immune response by virtue of its probable non-specific bridging action and cellular proliferation properties. This proposal has been tried to be substantiated by carrying out experimentation where L-lysine HCl has been used as an adjuvant (various groups based on mode of application and frequency of booster dose were designed) in tuberculosis vaccination experiments with heat killed Mycobacterium tuberculosis (MTB) and Bacille Calmette Guerin (BCG). Antibody titre has been followed in all the experiments as a measure of immune response. Amongst the various groups designed, group 1A (L-lysine HCl was given at a separate site as that of the antigen; lysine booster was given to this group intermittently, i.e. lysine given on 0th, 7th, 14th, 21st days of immunization) came out as the stand-alone leader. This mode and frequency of application was then compared with a group which received a standard adjuvant, viz. alhydrogel. Results were obtained which showed the following order in terms of decreasing antibody titre: alhydrogel group > lysine group > control group. Considering the biocompatible nature of lysine in comparison with the reportedly hazardous nature of alum adjuvants, we propose L-lysine HCl as a probable adjuvant in vaccination.

Effect of ischaemia & aglycaemia on the synaptic transmission in neonatal rat spinal cord in vitro

BACKGROUND & OBJECTIVES

In vitro models of anoxia have revealed severe changes in neuronal functions after ischaemia but not after aglycaemia, although hypoglycaemia produced severe neuronal dysfunctions sometimes leading to coma. The present study was therefore undertaken to examine and compare the effects of aglycaemia with that of ischaemia on synaptic transmission in vitro.

METHODS

Spinal cord from the neonatal rat was isolated, hemisected and placed in a chamber perfused with standard physiological solution. The stimulation of a dorsal root elicited monosynaptic (MSR) and polysynaptic (PSR) reflex potentials in the segmental ventral root. The effects of suprefusing glucose free medium (aglycaemia) and superfusing glucose free and O2 free medium (ischaemia) were examined on these reflexes.

RESULTS

Superfusion of aglycaemic solution did not alter the magnitude of MSR or PSR in the first 15 min and subsequently there was a time-dependent depression of the reflexes (P < 0.05). The ischaemic solution depressed the reflexes in a time-dependent manner from the very beginning. The 50 per cent depression of the reflexes occurred around 25 and 15 min, for aglycaemia and ischaemia, respectively. In the presence of Mg2+, the aglycaemia-induced depression of MSR was completely blocked but the ischaemic response was attenuated partially as the reflex was abolished by 80 min.

INTERPRETATION & CONCLUSION

The results of the present study indicate that the aglycaemia and ischaemia depressed the synaptic transmission to the same extent though there were differences in their onset and progress. Aglycaemia involves N-methyl-D-aspartate (NMDA) receptor-dependent (Mg2+ sensitive) mechanism, while ischaemia-induced depression involves other mechanisms in addition to NMDA.

Association of deletion in the chromosomal 8p21.3-23 region with the development of invasive head & neck squamous cell carcinoma in Indian patients

BACKGROUND & OBJECTIVES

Deletions in chromosome 8 (chr.8) have been shown to be necessary for the development of head and neck squamous cell carcinoma (HNSCC). Attempts have been made in this study to detect the minimal deleted region in chr.8 associated with the development of HNSCC in Indian patients and to study the association of clinicopathological features with the progression of the disease.

METHODS

The deletion mapping of chr.8 was done in samples from 10 primary dysplastic lesions and 43 invasive squamous cell carcinomas from the head and neck region of Indian patients to detect allelic alterations (deletion or size alteration) using 12 highly polymorphic microsatellite markers. The association of the highly deleted region was correlated with the tumour node metastasis (TNM) stages, nodal involvement, tobacco habit and human papilloma virus (HPV) infection of the samples.

RESULTS

High frequency (49%) of loss of heterozygosity (LOH) was seen within 13.12 megabase (Mb) region of chromosomal 8p21.3-23 region in the HNSCC samples, whereas the dysplastic samples did not show any allelic alterations in this region. The highest frequency (17%) of microsatellite size alterations (MA) was observed in the chr.8p22 region. The loss of short arm or normal copy of chr.8 and rare bi-allelic alterations were seen in the stage II-IV tumours (939, 5184, 2772, 1319 and 598) irrespective of their primary sites. The highly deleted region did not show any significant association with any of the clinical parameters. However, HPV infection was significantly associated (P < 0.05) with the differentiation grades and overall allelic alterations (LOH/MA) of the samples.

INTERPRETATION & CONCLUSION

Our data indicate that the 13.12 Mb deleted region in the chromosomal 8p21.3-23 region could harbour candidate tumour suppressor gene(s) (TSGs) associated with the progression anti invasion of HNSCC tumours in Indian patients.

Cholangiocarcinoma presenting with recurrent venous thrombosis

A 38 years female presented with three episodes of venous thrombosis over one year--first in left femoral vein, next in splenic vein causing haematemesis and malena and lastly in inferior vena cava causing Budd-Chiari syndrome. During third episode, endoscopic cholangiopancreatography and guided biopsy established a diagnosis of cholangiocarcinoma at the mid portion of common bile duct. The disease was far advanced with cervical lymph node metastasis.

Sequential deletions in both arms of chromosome 9 are associated with the development of head and neck squamous cell carcinoma in Indian patients

In the deletion mapping of chromosome (chr) 9 in head and neck lesions of the Indian patient population by microsatellite markers, we have identified four discrete areas (D1-D4) with high loss of heterozygosities (LOHs) viz. 9p24-p23 (D1), 9p22-p21 (D2), 9q11-q13 (D3) and 9q22.3 (D4) regions. The deletions in D2 and D4 regions were suggested to be essential for the development of dysplastic lesions of head and neck, whereas the deletions in D1 and D3 regions were responsible for progression of the dysplastic lesions to early invasive head and neck squamous cell carcinoma (HNSCC). The microsatellite size alterations (MAs) were observed in the chromosomal 9pter-p23, 9p22-p21(D2), 9q13 and 9q21.1-q21.2 regions with gradual increase during progression of the tumor. Additional chromosomal alterations like loss of normal copy of chr.9 and biallelic alterations were also seen in our samples. There is a correlation between HPV infection with TNM stages, histopathological grades and LOHs at D1 and D4 regions. Whereas tobacco habit is associated with the occurrence of LOHs at D1 and LOHs / MAs at D2 region.

Investigation on Tc tuned nano particles of magnetic oxides for hyperthermia applications

Superparamagnetic as well as fine ferrimagnetic particles such as Fe3O4, have been extensively used in magnetic field induced localized hyperthermia for the treatment of cancer. The magnetic materials with Curie temperature (Tc) between 42 and 50 degrees C, with sufficient biocompatibility are the best candidates for effective treatment such that during therapy it acts as in vivo temperature control switch and thus over heating could be avoided. Ultrafine particles of substituted ferrite Co(1-a)Zn(a)Fe2O4 and substituted yttrium-iron garnet Y3Fe(5-x)Al(x)O12 have been prepared through microwave refluxing and citrate-gel route respectively. Single-phase compounds were obtained with particle size below 100 nm. In order to make these magnetic nano particles biocompatible, we have attempted to coat these above said composition by alumina. The coating of alumina was done by hydrolysis method. The coating of hydrous aluminium oxide has been done over the magnetic particles by aging the preformed solid particles in the solution of aluminium sulfate and formamide at elevated temperatures. In vitro study is carried out to verify the innocuousness of coated materials towards cells. In vitro biocompatibility study has been carried out by cell culture method for a period of three days using human WBC cell lines. Study of cell counts and SEM images indicates the cells viability/growth. The in vitro experiments show that the coated materials are biocompatible.