Identification of a novel inflammation-protective locus in the Fischer rat

Inbred LEW/N rats are relatively susceptible, while histocompatible inbred F344/N rats are relatively resistant to development of a wide variety of inflammatory diseases in response to a range of pro-inflammatory stimuli. In a LEW/N vs. F344/N F2 intercross, we identified a quantitative trait locus (QTL) on Chr 10 that protects in a dominant fashion against the exudate volume component of innate inflammation in the F344/N rat, as well as a suggestive QTL on Chr 2 near the Fibrinogen cluster region. The exudate volume linkage region on Chr 10 may be similar to one of the multiple regions found to link to inflammatory arthritis phenotypes in other crosses. The suggestive linkage on Chr 2 has not been previously reported and does not seem to contribute to this phenotype in the same manner as the QTL on Chr 10. These findings are consistent with the hypothesis that the innate exudate volume trait is a sub-phenotype of more complex inflammatory phenotypes, such as arthritis, and genes within the Chr 10 linkage region could account for differences in this non-specific acute phase component of the inflammatory response. Since the rat Chr 10 exudate volume linkage region we have identified is syntenic with a region of human Chr 17 that has been shown to link to a variety of autoimmune/inflammatory diseases, including insulin-dependent diabetes mellitus, multiple sclerosis, and psoriasis, identification of genes within this linkage region will shed light on genes relevant to the earliest inflammatory component and to susceptibility and resistance to such human autoimmune/inflammatory diseases.

Feasibility of vermicomposting dairy biosolids using a modified system to avoid earthworm mortality

A laboratory study was conducted to examine the feasibility of vermicomposting dairy biosolids (dairy sludge), either alone or with either of the bulking agents-cereal straw or wood shavings, using the epigeic earthworm-Eisinea andrei. Earthworms added directly to these three substrates died within 48 hours. A system was developed to overcome the toxic effect of unprocessed dairy biosolids. The substrates were placed over a layer of vermicomposted sheep manure into which the earthworms were inoculated. Within two weeks, all earthworms were within the upper layer of substrate. Compared to sheep manure which is a favourable substrate for vermicomposting, the three substrates containing dairy biosolids were more effective in supporting earthworm growth and reproduction. The final products obtained after 63 days of vermicomposting had 39-53% less organic carbon than the initial substrates. Organic fractionation indicated that vermicomposting increased the stability of the materials to biological decomposition. The vermicomposts obtained from the three substrates with dairy biosolids had low heavy metal contents and electrical conductivities, and did not inhibit plant growth when compared with a commercial vermicompost in a bioassay.

Effects of simultaneous administration of desferrioxamine and tacrine in rats

Tacrine (1,2,3,4-tetrahydro-9-aminoacridine), a reversible cholinesterase inhibitor, was effective in the treatment of Alzheimer's disease (AD). In turn, desferrioxamine (DFO), a chelating agent with ability to chelate iron and aluminum (Al), produced a 50% decrease in the rate of cognitive decline in patients with AD. Since combined therapy with tacrine and DFO might be more effective than individual administration of these drugs for the treatment of AD patients, this study evaluated the toxic effects of concomitant administration of tacrine and DFO to rats. Three groups of 8 rats each received the following treatments for 8 w: 80 mg DFO/kg/d i.m., 7.5 mg tacrine/kg/d po, or 80 mg DFO/kg/d i.m. +7.5 mg tacrine/kg/d po. A control group received distilled water by gavage daily and a 0.9% saline injection i.m. The administration of DFO + tacrine for 8 w did not increase most of the side effects caused by the individual DFO or tacrine administrations. These results open the possibility of considering the effectiveness of simultaneous administration of DFO and tacrine as a palliative treatment for AD patients.

Rac-1 regulates nuclear factor of activated T cells (NFAT) C1 nuclear translocation in response to Fcepsilon receptor type 1 stimulation of mast cells

Transcription factors of the nuclear factor of activated T cells (NFAT) family play a key role in antigen receptor-mediated responses in lymphocytes by controlling induction of a wide variety of cytokine genes. The GTPases Ras and Rac-1 have essential functions in regulation of NFAT transcriptional activity in the mast cell system, where Fcepsilon receptor type 1 (FcepsilonR1) ligation results in induction of multiple NFAT target genes. This report examines the precise biochemical basis for the Rac-1 dependency of FcepsilonR1 activation of NFAT in mast cells. We are able to place Rac-1 in two positions in the signaling network that regulates the assembly and activation of NFAT transcriptional complexes in lymphocytes. First, we show that activity of Rac-1 is required for FcepsilonR1-mediated NFATC1 dephosphorylation and nuclear import. Regulation of NFAT localization by the FcepsilonR1 is a Rac-dependent but Ras-independent process. This novel signaling role for Rac-1 is distinct from its established regulation of the actin cytoskeleton. Our data also reveal a second GTPase signaling pathway regulating NFAT transcriptional activity, in which Rac-1 mediates a Ras signal. These data illustrate that the GTPase Rac-1 should now be considered as a component of the therapeutically important pathways controlling NFATC1 subcellular localization. They also reveal that GTPases may serve multiple functions in cellular responses to antigen receptor ligation.

sigA is an essential gene in Mycobacterium smegmatis

sigA encodes a sigma factor of the sigma70 family, sigmaA, that is found in all mycobacterial species. As sigmaA shows high similarity to the primary sigma factor in Streptomyces coelicolor, it was postulated that sigmaA has the same role in mycobacteria. However, a point mutation in sigA, resulting in the replacement of arginine 522 by histidine, was found responsible for the attenuated virulence of the Mycobacterium bovis strain ATCC 35721. This raised the possibility that sigmaA was an alternative sigma factor specifically required for virulence gene expression. In this work, we show that sigA can not be disrupted in Mycobacterium smegmatis unless an extra copy of the gene is provided at another chromosomal site, which demonstrates that sigA is essential. To characterize the pattern of sigA expression during exponential and stationary phase in M. smegmatis, we measured the beta-galactosidase activity in a strain carrying a sigA-lacZ transcriptional fusion and monitored sigmaA levels using Western blotting. Our results indicate that sigA is expressed throughout the growth of the culture. The essential character of sigA and its pattern of expression corroborate the hypothesis that sigA codes for the primary sigma factor in M. smegmatis and, most likely, in all mycobacteria.

Functional properties of the neuronal nicotinic acetylcholine receptor beta3 promoter in the developing central nervous system

Within the chick central nervous system, expression of the beta3 nicotinic acetylcholine receptor gene is restricted to a subset of retinal neurons, the majority of which are ganglion cells. Transient transfection in retinal neurons and in neural and non-neural cells from other regions of the chick embryo allowed the identification of the cis-regulatory domain of the beta3 gene. Within this domain, a 75-base pair fragment located immediately upstream of the transcription start site suffices to reproduce the neuron-specific expression pattern of beta3. This fragment encompasses an E-box and a CAAT box, both of which are shown to be key positive regulatory elements of the beta3 promoter. Co-transfection experiments into retinal, telencephalic, and tectal neurons with plasmid reporters of beta3 promoter activity and a number of vectors expressing different neuronal (ASH-1, NeuroM, NeuroD, CTF-4) and non-neuronal (MyoD) basic helix-loop-helix transcription factors indicate that the cis-regulatory domain of beta3 has the remarkable property of discriminating accurately between related members of the basic helix-loop-helix protein family. The sequence located immediately 3' of the E-box participates in this selection, and the E-box acts in concert with the nearby CAAT box.

Retrograde autologous priming for cardiopulmonary bypass: a safe and effective means of decreasing hemodilution and transfusion requirements

OBJECTIVES

The obligatory hemodilution resulting from crystalloid priming of the cardiopulmonary bypass circuit represents a major risk factor for blood transfusion in cardiac operations. We therefore examined whether retrograde autologous priming of the bypass circuit would result in decreased hemodilution and red cell transfusion.

METHODS

Sixty patients having first-time coronary bypass were prospectively randomized to cardiopulmonary bypass with or without retrograde autologous priming. Retrograde autologous priming was performed at the start of bypass by draining crystalloid prime from the arterial and venous lines into a recirculation bag (mean volume withdrawal: 880 +/- 150 ml). Perfusion and anesthetic techniques were otherwise identical for the two groups. The hematocrit value was maintained at a minimum of 16% and 23% during and after cardiopulmonary bypass, respectively, in all patients. Patients were well matched for all preoperative variables, including established transfusion risk factors. Subsequent hemodynamic parameters, pressor requirements, and fluid requirements were equivalent in the two groups.

RESULTS

The lowest hematocrit value during cardiopulmonary bypass was 22% +/- 3% versus 20% +/- 3% in patients subjected to retrograde autologous priming and in control patients, respectively (p = 0.002). One (3%) of 30 patients subjected to retrograde autologous priming had intraoperative transfusion, and seven (23%) of 30 control patients required transfusion during the operation (p = 0.03). The number of patients receiving any homologous red cell transfusions in the two groups during the entire hospitalization was eight of 30 (27%; retrograde autologous priming) versus 16 of 30 (53%; control) (p = 0.03).

CONCLUSIONS

These data suggest that retrograde autologous priming is a safe and effective means of significantly decreasing hemodilution and the number of patients requiring red cell transfusion during cardiac operations.

Comprehensive multimodality blood conservation: 100 consecutive CABG operations without transfusion

BACKGROUND

Despite the recent introduction of a number of technical and pharmacologic blood conservation measures, bleeding and allogeneic transfusion remain persistent problems in open heart surgical procedures. We hypothesized that a comprehensive multimodality blood conservation program applied algorithmically on the basis of bleeding and transfusion risk would provide a maximum, cost-effective, and safe reduction in postoperative bleeding and allogeneic blood transfusion.

METHODS

One hundred consecutive patients undergoing coronary artery bypass grafting were prospectively enrolled in a risk factor-based multimodality blood conservation program (MMD group). To evaluate the relative efficacy and safety of this comprehensive approach, comparison was made with a similar group of 90 patients undergoing coronary artery bypass grafting to whom the multimodality blood conservation program was not applied but in whom an identical set of transfusion guidelines was enforced (control group). To evaluate the cost effectiveness of the multimodality program, comparison was also made between patients in the MMD group and a consecutive series of contemporaneous, diagnostic-related group-matched patients.

RESULTS

One hundred consecutive patients in the MMD group underwent coronary artery bypass grafting without allogeneic transfusion. This compared favorably with the control population in whom a mean of 2.2 +/- 6.7 units of allogeneic blood was transfused per patient (34 patients [38%] received transfusion). In addition, the volume of postoperative blood loss at 12 hours in the control group was almost double that of the MMD group (660 +/- 270 mL versus 370 +/- 180 mL [p < 0.001]). Total costs for the MMD group in each of the three major diagnostic-related groups were equivalent to or significantly less than those in the consecutive series of diagnostic-related group-matched patients.

CONCLUSIONS

Comprehensive risk factor-based application of multiple blood conservation measures in an optimized, integrated, and algorithmic manner can significantly decrease bleeding and need of allogeneic transfusion in coronary artery bypass grafting in a safe and cost-effective manner.

Inhibition of endosome function in CHO cells bearing a temperature-sensitive defect in the coatomer (COPI) component epsilon-COP

Recent evidence has suggested that subunits of the coatomer protein (COPI) complexes are functionally associated with endosomes in mammalian cells. We now provide genetic evidence that COPI plays a role in endocytosis in intact cells. The ldlF mutant CHO cell line bears a temperature-sensitive defect in the COPI subunit epsilon-COP. In addition to exhibiting conditional defects in the secretory pathway, we find that the cells are also defective at mediating endosome-associated functions. As found for cells microinjected with anti-COPI antibodies, ldlF cells at the restrictive temperature could not be infected by vesicular stomatitis (VSV) or Semliki Forest virus (SFV) that require delivery to acidic endosomes to penetrate into the cytosol. Although there was no temperature-sensitive defect in the internalization of receptor-bound transferrin (Tfn), Tfn recycling and accumulation of HRP were markedly inhibited at the restrictive temperature. Sorting of receptor-bound markers such as EGF to lysosomes was also reduced, although delivery of fluid-phase markers was only partially inhibited. In addition, lysosomes redistributed from their typical perinuclear location to the tips of the ldlF cells. Mutant phenotypes began to emerge within 2 h of temperature shift, the time required for the loss of detectable epsilon-COP, suggesting that the endocytic defects were not secondary to a block in the secretory pathway. Importantly, the mutant phenotypes were also corrected by transfection of wild-type epsilon-COP cDNA demonstrating that they directly or indirectly reflected the epsilon-COP defect. Taken together, the results suggest that epsilon-COP acts early in the endocytic pathway, most likely inhibiting the normal sorting and recycling functions of early endosomes.

Long-term regulation of contractility and calcium current in smooth muscle

Longitudinal smooth muscle strips from guinea pig ileum were cultured in vitro for 5 days, and the relationship between extracellular Ca2+ and force in high-K+ medium was evaluated. In strips cultured with 10% fetal calf serum (FCS), this relationship was shifted to the right (50% effective concentration changed by 2-3 mM) compared with strips cultured without FCS. The shift was prevented by inclusion of verapamil (1 microM) during culture and mimicked by ionomycin in the absence of FCS. The intracellular Ca2+ concentration ([Ca2+]i) during stimulation with high-K+ solution or carbachol was reduced after culture with FCS, whereas the [Ca2+]i-force relationship was unaffected. Cells were isolated from cultured strips, and whole cell voltage-clamp experiments were performed. Maximum inward Ca2+ current (10 mM Ba2+), normalized to cell capacitance, was almost three times smaller in cells isolated from strips cultured with FCS. Culture with 1 microM verapamil prevented this reduction. These results suggest that increased [Ca2+]i during culture downregulates Ca2+ current density, with associated effects on contractility.

Intracerebroventricular transplantation of embryonic neuronal tissue from inflammatory resistant into inflammatory susceptible rats suppresses specific components of inflammation

To more directly define the role of central nervous system factors in susceptibility to peripheral inflammatory disease, we examined the effect of intracerebroventricular transplantation of neuronal tissue from inflammatory resistant into inflammatory susceptible rats on subcutaneous carrageenan-induced inflammation (a measure of innate immunity), and on the relative percentage of naive and memory T helper cells in peripheral blood (a measure of the anamnestic immune response). Female inflammatory disease susceptible Lewis (LEW/N) rats transplanted with hypothalamic tissue from inflammatory resistant Fischer (F344/N) rats exhibited > 85% decrease in carrageenan inflammation compared to naive LEW/N rats, LEW/N rats transplanted with F344/N spinal cord, or sham-operated animals. LEW/N rats transplanted with LEW/N hypothalamic tissue exhibited > 50% decrease in carrageenan inflammation. In contrast, intracerebroventricular transplantation of neuronal tissue did not affect the characteristically twofold higher percentage of naive versus memory T helper cells in LEW/N rats, suggesting that the central nervous system (CNS) and hypothalamus play a greater role in the innate inflammatory response than in the acquired immune processes. Grafted tissue survived well and did not show extensive gliosis or inflammation. Compared to naive LEW/N rats, LEW/N rats transplanted with F344/N or LEW/N hypothalamic tissue expressed significantly greater hypothalamic corticotropin releasing hormone mRNA. LEW/N rats transplanted with F344/N hypothalamic tissue also showed significant increases in plasma corticosterone responses to lipopolysaccharide. These data indicate that intracerebroventricular transplantation of fetal hypothalamic tissue from inflammatory resistant into inflammatory susceptible rats suppresses peripheral inflammation partially through hypothalamic factors. These findings have implications for understanding the contribution of specific neuronal tissue in regulation of components of the immune/inflammatory response and in susceptibility to inflammatory disease. Furthermore, this model could be used in the development of potential new treatments for inflammatory/autoimmune diseases aimed specifically at sites within the CNS.

Ectopic pituitary adenoma in the sphenoid causing Nelson's syndrome

An ectopic functioning pituitary in the sphenoid is an extremely rare occurrence, and even rarer is pituitary adenoma causing symptoms of Nelson's syndrome. A case is presented of a young female diagnosed and treated in our clinic. The only functioning hypophyseal tissue was detected inside the sphenoid, as the pituitary gland had been radiated because of Cushing's syndrome 10 years before and imaging studies revealed an empty sella.

Intravenous oxytocin in patients undergoing elective cesarean section

The objective of this study was to compare four different doses of oxytocin to determine its minimal effective dose during elective cesarean section. A prospective, double-blind, randomized study was undertaken in 40 healthy term parturients presenting for elective cesarean section under regional anesthesia. Subjects were assigned to one of four groups. Group I received 5 IU, Group II 10 IU, Group III 15 IU, and Group IV 20 IU of oxytocin after clamping of the umbilical cord. Uterine tone was assessed by palpation on a linear analog scale (LAS) of 0 to 10 (0 = completely atonic, 10 = fully contracted) at 5, 10, 15 and 20 min after the start of oxytocin infusion. Estimated blood loss (EBL) and the difference in pre- and postoperative hematocrit (delta Hct) were also recorded. At alpha = 0.05, the study design had a power of 95% to detect a 25% difference in the LAS between the four groups. There were no differences in the uterine tone in the four groups at any of the four intervals. EBL and delta Hct were similar in all four groups. There appears to be no benefit in terms of degree of uterine contraction and amount of blood loss to administering more than 5 IU of intravenous oxytocin to term parturients undergoing elective cesarean section with a neuraxial block.

Identification of a new sigmaB-controlled gene, csbX, in Bacillus subtilis

We have identified a new member, csbX, of the general stress regulon controlled by sigmaB in Bacillus subtilis. As with other members of the sigmaB regulon csbX is expressed during the stationary phase of cell growth and inactivation of this gene produces no obvious phenotype during cell growth or early development. csbX lies uspstream from the sporulation gene bofC which is co-transcribed during stationary phase.

Expression of the Bacillus subtilis spoIVB gene is under dual sigma F/sigma G control

The expression of the Bacillus subtilis spoIVB gene, which encodes a developmental cell-cell signalling molecule, has been characterized. In some conditions, this gene can be transcribed by RNA polymerase associated with either sigma F or sigma G, in contrast to previous studies implying exclusive control by sigma G. However, during sporulation, only sigma G directs significant levels of spoIVB expression.

A comparison of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Trauma-Injury Severity Score (TRISS) for outcome assessment in intensive care unit trauma patients

OBJECTIVE

To assess the ability of the Acute Physiology and Chronic Health Evaluation (APACHE II) system and Trauma-Injury Severity Scoring (TRISS) system in predicting group mortality in intensive care unit (ICU) trauma patients.

DESIGN

Prospective study.

SETTING

A Canadian adult trauma tertiary referral hospital.

PATIENTS

Consecutive trauma patients admitted to the medical-surgical ICU or the neurosurgical ICU.

INTERVENTION

None.

MEASUREMENTS AND MAIN RESULTS

For each patient, demographic data, mechanism of injury, and surgical status were collected. Revised Trauma Scores and Injury Severity Scores were calculated from emergency room and operative data. The APACHE II score was calculated based on the data from the first 24 hrs of ICU admission. The probability of death was calculated for each patient based on the APACHE II and TRISS equations. The ability to predict group mortality for APACHE II and TRISS was assessed by receiver operating characteristic curve analysis, two by two decision matrices, and calibration curve analysis. Four hundred seventy trauma patients were admitted to the ICU. Sixty-three (13%) patients died and 407 (87%) survived. There were significant differences between survivors and nonsurvivors in age, Glasgow Coma Scale, Revised Trauma Score, Injury Severity Score, and APACHE II score. By receiver operating characteristic curve analysis, the areas under the curves (+/- SEM) of APACHE II and TRISS were 0.92 +/- 0.02 and 0.89 +/- 0.02, respectively. Using two by two decision matrices with a decision criterion of 0.5, the sensitivities, specificities, and percentages correctly classified were 50.8%, 97.3%, and 91.1%, respectively, for APACHE II, and 50.8%, 97.1%, and 90.9%, respectively, for TRISS. From the calibration curves, the r2 value was .93 (p = .0001) for APACHE II and .67 (p = .004) for TRISS.

CONCLUSIONS

Both APACHE II and TRISS scores were shown to accurately predict group mortality in ICU trauma patients. APACHE II and TRISS may be utilized for quality assurance in ICU trauma patients. However, neither APACHE II nor TRISS provides sufficient confidence for prediction of outcome of individual patients.