Changes of gene expression of iron regulatory proteins during turpentine oil-induced acute-phase response in the rat

In the present study, turpentine oil was injected in the hind limb muscle of the rat to stimulate an acute-phase response (APR). The changes in the gene expression of cytokines and proteins known to be involved in the iron regulatory pathway were then studied in the liver and in extra-hepatic tissue. In addition to the strong upregulation of interleukin-6 (IL-6) and IL-1 beta observed in the inflamed muscle, an upregulation of the genes for IL1-beta and tumor necrosis factor-alpha, but not IL-6, were detectable in the liver. Hepatic Hepc gene expression increased to a maximum at 6 h after the onset of APR. An upregulation of transferrin, transferrin receptor 1 (TfR1), TfR2, ferritin-H, iron responsive element binding protein-1 (IRP1), IRP2 and divalent metal transporter gene expression was also found. Hemojuvelin (Hjv)-, ferroportin 1-, Dcytb-, hemochromatosis-gene- and hephaestin gene expression was downregulated. Hepcidin (Hepc) gene expression was not only detectable in extra-hepatic tissues such as heart, small intestine, colon, spleen and kidney but it was also upregulated under acute-phase conditions, with the Hjv gene being regulated antagonistically. Fpn-1 gene expression was downregulated significantly in heart, colon and spleen. Most of the genes of the known proteins involved in iron metabolism are expressed not only in the liver but also in extra-hepatic tissues. Under acute-phase conditions, acute-phase cytokines (eg IL-6) may modulate the gene expression of such proteins not only in the liver but also in other organs.

x-Irradiation in Rat Liver: Consequent Upregulation of Hepcidin and Downregulation of Hemojuvelin and Ferroportin-1 Gene Expression

PURPOSE

To prospectively analyze hepcidin, hemojuvelin, and ferroportin-1 expression after x-irradiation of rat liver and isolated rat hepatocytes.

MATERIALS AND METHODS

The treatment of the rats and this study were approved by the local committee and the public authority on animal welfare. Rat livers in vivo and isolated rat hepatocytes in vitro were irradiated. The total number of rats in this study was 43. RNA extracted from livers (1, 3, 6, 12, 24, and 48 hours after irradiation) and from hepatocytes (1, 3, 6, 12, and 24 hours after irradiation) was analyzed with real-time polymerase chain reaction and Northern blot. Cytokines and prohepcidin in serum of irradiated rats were quantitatively detected with enzyme-linked immunosorbent assay. Sham-irradiated animals served as controls in all experiments. Differences between sham-irradiated and irradiated data groups were tested with analysis of variance and Dunnett post hoc test.

RESULTS

In vivo, a significant radiation-induced increase of hepcidin (P=.034), interleukin (IL) 1beta (P=.008), IL-6 (P<.011), and tumor necrosis factor alpha (TNF-alpha) (P=.047) expression could be detected within the first 48 hours after irradiation. Expression of hemojuvelin (P=.008) and ferroportin-1 (P=.002) was significantly decreased. Serum iron levels were decreased because of irradiation (P<.058); prohepcidin serum levels were increased (P=.05). In rat hepatocytes in vitro, hepcidin RNA levels were significantly downregulated after irradiation (P<.001). Incubation of irradiated hepatocytes with IL-1beta, IL-6, or TNF-alpha led to upregulation of hepcidin expression in vitro up to 6 hours after irradiation, with subsequent significant downregulation for incubation with IL-1beta (P<.001). Hemojuvelin expression behaved in a way opposite to that of hepcidin.

CONCLUSION

x-Irradiation of the liver induced changes of hepcidin gene expression that are probably induced by acute phase mediators produced within the liver itself.

Hepcidin and hemojuvelin gene expression in rat liver damage: in vivo and in vitro studies

In this work, we used two rat models, partial hepatectomy (PH) and CCl(4) administration, to study the changes in iron pathways in response to hepatic damage. Liver injury induced changes in the hepatic gene expression of hepcidin, hemojuvelin (Hjv), several other proteins of iron metabolism, and several cytokines such as IL-1beta, IL-6, TNF-alpha, and IFN-gamma. Hepcidin gene expression was upregulated between 4 and 8 h with a maximum up to 16 h after surgery. However, Hjv gene expression was downregulated at the same time. An early upregulation of hepcidin (3 h) and downregulation of Hjv gene expression was found after CCl(4) administration. Transferrin receptor 1 and ferritin H gene expression was upregulated, whereas ferroportin 1 gene expression was downregulated. Hepatic IL-6 gene expression was upregulated early after PH and reached maximum 8 h after the PH. In CCl(4)-induced liver injury, IL-6, IL-1beta, TNF-alpha, and IFN-gamma upregulation were found at the maximum 12 h after the administration of the toxin. Treatment of isolated rat hepatocytes with IL-6 and, to a lesser extent, with IL-1beta but not with TNF-alpha or IFN-gamma dose dependently upregulated hepcidin and downregulated Hjv gene expression. In hepatic damage, changes of the hepatic gene expression of the main proteins involved in iron metabolism may be induced by locally synthesized mediators.

Cytokine-induced neutrophil chemoattractant-1 is released by the noninjured liver in a rat acute-phase model

The source of serum cytokine-induced neutrophil chemoattractant (CINC-1) and consequences of its presence in the tissue of synthesis have not been clearly elucidated under acute-phase situation. To pursue this question, turpentine oil (TO) was intramuscularly injected into rats, and RNA and local protein levels of acute-phase cytokines and of CINC-1 were studied in the TO injected gluteal muscle, as well as in noninjured muscle, in the liver, kidney, lung and spleen. The serum levels of acute-phase mediators and of CINC-1 were measured together with total leukocyte subpopulations. Recruitment of inflammatory cells in muscle and in the other organs was investigated by quantitative immunohistochemical methods. The effect of acute-phase mediators, including interferon gamma (IFN-gamma) on the synthesis of CINC-1 in cultured hepatocytes was also investigated at the RNA and protein level. We found that the sera of the TO-treated rats contained elevated levels of IL-6, IL-1beta and CINC-1. Increased serum levels of IFN-gamma were also observed not only in the injured muscle but also and to a higher extent in the liver. However, while neutrophils and mononuclear phagocytes were found in the injured muscle, no inflammatory cells were detected at the non-'inflamed' site, namely, the liver or in the other organs. In vitro, treatment of cultured hepatocytes with IL-1beta led to elevated CINC-1 gene expression. This was true to a lesser extent upon IL-6 and tumor necrosis factor (TNF-alpha) exposure. Interestingly, IFN-gamma did not effect CINC-1 gene expression. These results indicate that CINC-1 behaves as an acute-phase protein and its expression is inducible in hepatocytes. However, CINC-1-production in the liver does not lead to recruitment of inflammatory cells into the organ.

Spontaneously arising superficial temporal artery aneurysms: a report of two cases and review of the literature

The majority of superficial temporal artery (STA) aneurysms are due to trauma and are, in reality, false aneurysms. However, true STA aneurysms are extremely rare. Here, we present two cases of spontaneous superficial temporal artery aneurysms arising without any previous history of trauma.

Peyronie's disease with erectile dysfunction: penile modeling over inflatable penile prostheses

OBJECTIVES

To evaluate, retrospectively, the impact of penile correction by modeling of the penis over an inflatable penile prosthesis and the subsequent improvement in erectile function. Advanced Peyronie's disease with severe penile curvature and poor quality erections presents a challenge to the urologist.

METHODS

In our series, 46 patients with advanced Peyronie's disease and associated erectile dysfunction underwent insertion of an inflatable penile prosthesis between 1998 and 2003. Of the 46 patients, 28 (61%) underwent a standard modeling procedure; the other 18 patients (39%) did not need additional modeling, because their curvature was corrected by inflation of the prosthesis alone. Patients were evaluated postoperatively in the clinic, as well as by a postal questionnaire.

RESULTS

Of the 46 patients, 44 were satisfied with the penile correction and 2 (4.4%) underwent removal of their prosthesis because of infection. These 2 patients underwent revision surgery; subsequently both prostheses had to be removed, one for severe pain and the other for urethral erosion. None of the patients underwent reoperation for additional straightening. Of the 44 patients with intact prostheses, erectile function significantly improved in 41 (93%).

CONCLUSIONS

The results of our study have indicated that patients with severe Peyronie's disease and erectile dysfunction should be offered the choice of penile modeling over an inflatable penile implant to correct the curvature, as well as improve erectile function.

Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

The purpose of the study was to determine the role of transurethral resection of the prostate (TURP) to detect prostate cancer in patients with consistently negative transrectal ultrasound-guided biopsies of the prostate. We retrospectively identified and analysed the patients who also had at least two sets of transrectal ultrasound guided sextant prostate biopsies before their TURP during the period between 1998 and 2002. A total of 14 such patients were identified and the outcome of TURP was analysed. Three patients were found to have cancer in the resected specimen (3/14 = 21%). All three cancers were significant (Gleason scores between 6 and 8) and required further treatment. In patients who have rising levels of prostate-specific antigen and who have had multiple negative peripheral zone biopsies, the presence of biologically important transition zone cancers needs to be considered. This can be detected by transurethral resection of the prostate that samples the transition zone of the prostate.

Perinatal transmission of SHIV-SF162P3 in Macaca nemestrina

We developed a SHIV/macaque model of transmission from infected dams to their infants. Ten pregnant dams were infected intravenously with 100 MID(50) of macaque-titered SHIV-SF162P3 during the second trimester. Nine infants were born; the seven surviving beyond day of birth suckled for 6 months. Four of nine infants were infected (transmission rate = 44.4%), with one infection in utero, and three intrapartum and/or immediately post-birth via suckling. Varying levels of binding and neutralizing antibodies were transplacentally transferred to infants. Passive antibodies were detected in plasma on the day of birth and persisted for 5 weeks. Infants infected at or after birth controlled acute and post-acute viremia. Exposure to maternal SHIV-SF162P3 during birth and suckling in the presence of autologous maternal neutralizing antibodies may have affected transmission or pathogenesis in the infants. This transmission model can allow investigation of key parameters involved in perinatal transmission of HIV.

Multigene DNA prime-boost vaccines for SHIV89.6P

We assessed four prime-boost vaccine regimens with a Gene Gun component for SHIV89.6P in Macaca nemestrina. A dosing experiment using beta-galactosidase plasmid showed that 30 or 45 shots per dose elicited higher titer antibody than smaller doses. For SHIV89.6P, we administered a six-plasmid vaccine capable of producing non-infectious virions in vivo in combination with either vaccinia recombinants or inactivated virus. DNA prime/vaccinia boost, or the reverse, elicited strong immune responses. The SHIV89.6P challenge virus was grown in M. nemestrina peripheral blood mononuclear cells and titered in vivo intrarectally. As has been observed for SHIV89.6P in M. mulatta, the infected M. nemestrina experienced rapid and severe loss of circulating CD4+ T cells. Vaccinated macaques were challenged three weeks after the last boost. DNA prime/vaccina boost or vaccina prime/DNA boost protected 11/12 animals from acute CD4+ T cell depletion and disease, while other regimens were not effective.

Technology evaluation: CC49 humanized radioimmunoconjugates, National Cancer Institute

The National Cancer Institute and the University of Alabama are developing radiolabeled humanized versions of the anticarcinoma monoclonal antibody CC49 devoid of the CH2 domain (designated HuCC49 delta CH2). The antibody is currently undergoing phase I trials for the potential treatment of various tumors.

Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies: preliminary experience and long-term follow-up

OBJECTIVE

To evaluate the feasibility, efficacy and complications of internal iliac artery embolization as a palliative measure in the control of intractable haemorrhage from advanced pelvic urological malignancies.

PATIENTS AND METHODS

Six patients (mean age 80 years, range 76-87) with advanced pelvic malignancies (three each with bladder carcinoma and prostate carcinoma) underwent embolization between September 1997 and July 2001, using permanent coils in the anterior division of internal iliac artery bilaterally.

RESULTS

All patients had undergone conservative treatment before embolization for a mean of 2 days. The mean requirement for transfusion before embolization was 3.2 units. All patients except one were successfully embolized in a single setting with no complications. Bleeding was successfully controlled in one patient at the second attempt of embolization. There were minor complications, e.g. nausea, vomiting or fever, for a mean of 2 days, responding well to conservative treatment. At a mean follow-up of 22 months, no patient had a recurrence of bleeding.

CONCLUSION

Internal iliac artery embolization is a feasible, effective and minimally invasive option in managing advanced pelvic urological malignancies presenting with intractable bleeding; it should be bilateral and permanent.

Neurofibromatosis type 1: report of two contrasting cases

We present two cases of neurofibromatosis type 1 (NF-1), one a 35 year old male who first recognised his problem at the age of fifteen years and at the time of assessment, satisfied the National Institute of Health (NIH) diagnostic criteria for NF-1 and had a nodular plexiform neurofibroma involving the left fifth dorsal nerve root and a diffuse plexiform neurofibroma involving the left lower limb. The second patient, a 45 year old female recognised her problem at the age of 39 years, did not quite satisfy the NIH diagnostic criteria for NF 1 and had diffuse plexiform neurofibroma involving both lower limbs and buttocks almost symmetrically, a finding which has not previously been described to the best of our knowledge. The scarcity of management options are briefly outlined.

Isocyanate-terminated urethane prepolymer as bioadhesive material: evaluation of bioadhesion and biocompatibility, in vitro and in vivo assays

Attempts have been made to evaluate the degree of bioadhesion and biocompatibility of a synthesized urethane prepolymer with specially tailored microstructure. Wetting behaviour and extent of interfacial adhesion of the prepared prepolymer towards biological substrates were examined by in vitro methods. The former was carried out by measuring the contact angle between drops of the prepolymer liquid and a biological surface, while the latter was determined from the force between the prepolymer and tissue model or mucus. The obtained results exhibited good tissue wettability and bioadhesion by the prepolymer. Preliminary evaluation of biocompatibility for the uncatalytically cured prepolymer films was performed by cytotoxicity and histotoxicity experiments. Results showed a significant growth for the adhered L929 fibroblast cells within a period of 5 days incubation. Also, no severe inflammatory tissue response towards the samples implanted in rabbit for 16 weeks was seen. These observations can support the potentiality of the designed urethane prepolymer to be applied as hemostatic agent.

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

OBJECTIVE

To investigate whether taking two transition zone (TZ) and four lateral peripheral zone (PZ) biopsies in addition to routine parasaggital sextant biopsies would improve detection rates in men with suspected prostate cancer.

PATIENTS AND METHODS

The study included 493 consecutive men (mean age 68.7 years, sd 8.2) with elevated serum prostate-specific antigen (PSA) levels and/or abnormal findings on a digital rectal examination who underwent transrectal ultrasonography-guided prostate biopsy. In addition to sextant biopsies, six further biopsies were obtained, two from the TZ (mid-gland) and four from the lateral PZ (base and mid-gland). Pathological findings for the additional biopsies were compared with those of the sextant regions.

RESULTS

Prostatic adenocarcinoma was diagnosed in 164 of the 493 (33%) men biopsied. Men with cancer were older, had smaller prostates and higher median PSA levels than men with negative biopsies. Sextant biopsies were positive for cancer in 133 of 164 (81%) men. All three sets of biopsies were positive in 53 (32%) cases. In 50 (30%) men both the sextant and lateral PZ biopsies were positive, while in six (4%) men, both sextant and TZ biopsies were positive. Thirty-one (19%) tumours were not detected by sextant biopsies, 10 (6%) where the lateral PZ biopsies alone were positive, 17 (10%) where the TZ biopsies alone were positive and four (3%) where both the TZ and lateral PZ together were positive. There were no differences in median PSA concentration, total prostate volume or TZ volume between men with an isolated TZ cancer and men with cancer elsewhere in the prostate. However, 77% of men with TZ cancer had a PSA of > 10 ng/mL, compared with 60% of men with cancer at other sites within the prostate (P = 0.015).

CONCLUSION

An extended-core biopsy protocol significantly improves the detection rate for prostate cancer when compared with the standard sextant biopsy protocol alone. Routine TZ biopsies should be considered for men with serum PSA levels of >10 ng/mL.

Anti-tumour activity against B16-F10 melanoma with a GM-CSF secreting allogeneic tumour cell vaccine

Genetic modification of tumour cells with the GM-CSF encoding gene renders these cells more potent, as autologous tumour cell vaccine, than their wild-type counterparts. However, autologous vaccines are impractical for wide-scale clinical use and we have therefore investigated the efficacy of the GM-CSF genetic modification approach with an allogeneic whole cell tumour vaccine. In this report, we show that the allogeneic K1735-M2 (H-2k) melanoma cell vaccine induces a specific protective anti-tumour response against the syngeneic B16-F10 (H-2b) melanoma tumour in C57BL/6J mice. In vitro T cell work demonstrated that vaccination of animals with the allogeneic cell vaccine generated cytotoxic T cells specific for the autologous tumour. In vivo T cell subset depletion experiments also illustrated that this anti-tumour effect was mediated by both CD4+ve and CD8+ve T cells, suggesting that the allogeneic vaccine may operate through the 'cross-priming' phenomenon whereby tumour antigens are processed and presented to T cells by the host's own antigen presenting cells (APC). Thus, we transduced K1735-M2 cells with a GM-CSF expressing retroviral vector and showed anti-tumour activity of the GM-CSF secreting K1735-M2 cells as a therapeutic vaccine against the syngeneic B16-F10 tumour. Our data imply that GM-CSF genetically modified allogeneic whole cell tumour vaccines could be successful in the clinic. In addition, more potent combination gene therapy strategies could be tested using this therapeutic allogeneic vaccine model.

Interferon-inducible protein-10 identified as a mediator of tumor necrosis in vivo

Human Burkitt lymphoma cell lines give rise to progressively growing subcutaneous tumors in athymic mice. These tumors are induced to regress by inoculation of Epstein-Barr virus-immortalized normal human lymphocytes. In the present study, analysis of profiles of murine cytokine/chemokine gene expression in Burkitt tumor tissues excised from the nude mice showed that expression of the murine alpha-chemokine interferon-inducible protein-10 (IP-10) was higher in the regressing than in the progressive Burkitt tumors. We tested the effects of IP-10 on Burkitt tumor growth in nude mice. Inoculation of established Burkitt tumors either with crude preparations of murine IP-10 or with purified human IP-10 caused visible tumor necrosis in a proportion of the animals, although no complete tumor regressions were observed. Constitutive expression of murine IP-10 in Burkitt cells reduced their ability to grow as subcutaneous tumors, and caused visible tumor necrosis in a proportion of the animals. Histologically, IP-10-treated and IP-10-expressing Burkitt tumors had widespread evidence of tumor tissue necrosis and of capillary damage, including intimal thickening and vascular thrombosis. Thus, IP-10 is an antitumor agent that promotes damage in established tumor vasculature and causes tissue necrosis in human Burkitt lymphomas established subcutaneously in athymic mice.

Regression of experimental human leukemias and solid tumors induced by Epstein-Barr virus-immortalized B cells

We previously have reported on an experimental athymic mouse model in which regression of human Burkitt's lymphoma is induced by either coinjection with or intratumor inoculation of Epstein-Barr virus (EBV)-immortalized human B cells. In the current study, we were interested in determining whether the powerful antitumor effects of EBV-immortalized B cells could be effective against a variety of human tumors grown in athymic mice, including acute lymphocytic leukemia, malignant melanoma, acute promyelocytic leukemia, neuroblastoma, lung carcinoma, colon adenocarcinoma, Wilms tumor, Hodgkin's lymphoma, rhabdomyosarcoma and breast adenocarcinoma. We report here the results of experiments in nude mice that demonstrated the potent antitumor effect of EBV-immortalized B cells against human tumors derived from a variety of different tissues.

Anaemia and resistance to malaria in transgenic mice expressing human tumour necrosis factor

Transgenic mice carrying a modified human tumour necrosis factor (huTNF)/beta-globin gene construct linked to the T-cell-specific locus control region of the human CD2 gene express huTNF in their T cells which is released into the circulation and causes the development of a wasting syndrome. We now report that the mice develop anaemia, probably through enhanced erythrophagocytosis rather than inhibition of reticulocyte production. Thus autologous erythrocytes, as well as sheep erythrocytes, were cleared more rapidly from the circulation of transgenic mice than from littermate controls. By contrast, peritoneal macrophages from transgenic mice were less phagocytic in vitro than cells from controls. They also secreted less murine (mu)TNF when stimulated by either bacterial lipopolysaccharide or toxic malarial antigens. The yields of muTNF approached normal levels, however, when these refractory cells from the transgenic mice were stimulated in the presence of a high concentration of indomethacin, suggesting that the production of muTNF was inhibited by enhanced synthesis of prostaglandins. The parasitaemia of transgenic mice infected with Plasmodium yoelii was about 10-fold less at its peak than in controls, although it followed the same time-course, and the multiplication of P. chabaudi was inhibited to an even greater degree. This control of parasitaemia may also be explained by enhancement of macrophage activity, mediated by huTNF acting on the murine p55 receptor, presumably by increasing the removal of parasites by phagocytosis or their killing by toxic products released by the activated macrophages. These observations suggest that a factor in the anaemia of human malaria may be macrophage activation caused by the secretion of TNF that occurs in this disease.

Protective effect of BCG in Ahmednagar, India

As part of a series of investigations to determine the effect of sensitisation by environmental mycobacteria on the efficacy of BCG vaccination in India, this study was carried out in Ahmednagar in Maharashtra. A preliminary skin test survey showed that the rate of sensitisation with age was much lower than in Agra, the site of a previous study, and BCG vaccination scars were associated with considerable enhancement in sensitisation to Tuberculin and other reagents. It was possible to set up prospective BCG vaccination studies in pre-school and primary and secondary school children. Follow up with skin tests were carried out 1 and 2 years later. By the second year, results were obtained almost identical with those 10 years after BCG administration in the UK. On this basis it is proposed that the vaccine is likely to provide a considerable level of protection in Ahmednagar. The results of this study also resemble those obtained in the very youngest age group studied in Agra. The marked differences between Indian towns strongly suggest the influence of exposure to mycobacteria in the environment.