Quantitative analysis of six gene products as candidate markers of early placental villi development in the human

Early placental development is critical for successful pregnancy. Recently, we have reported that -70 genes were differentially expressed in human placental villi between 6- and 8- weeks of gestation in cDNA-based expression arrays for -400 PCR products, of which six specific gene products (COL4A4, CXCR4, ERBB2, HDAC1, HPRT1, and TNFRSF1A) appeared intriguing. In the present study we have examined expressions of these six candidate genes in placental villi obtained from 6-weeks, 7-weeks and 8-weeks (n = 6 for each group) human placental samples using quantitative real time RTPCR. We observed that there was considerable concordance (>95% confidence) in pair-wise analysis of transcript profiles between the two methods, however, absolute quantitative values as measured by quantitative RTPCR differed from those obtained from cDNA-based array analysis for 2 gene products (CXCR4 and ERBB2) out of 6 genes. No significant change was observed in the steady state expression of COL4A4 and HPRT1 during the time period examined. However, there was significant decrease in CXCR4 for 7-weeks (P < 0.01) and 8-weeks (P < 0.05) samples, and significant (P < 0.05) increase was seen for ERBB2 in 7-weeks and 8-weeks as compared to 6-weeks samples with no change between 7-weeks and 8-weeks samples. Moreover, significant (P < 0.05) increase for HDAC1 and decrease for TNFRSF1A was observed in 8-weeks samples as compared to 6-weeks samples with no change observed between 6-weeks and 7-weeks samples. We infer that it is essential that cDNA array-based data are verified in terms of quantitative estimates preferably by quantitative PCR before their use for any exploratory purpose. Taking together our previous array based data and the present study we conclude that a categorical balance exists between the expression of ERBB2 and HDAC1 genes affecting cell proliferation and differentiation in one hand, and CXCR4 and TNFRSF1A affecting chemotaxis, inflammatory response and apoptosis on the other hand. The expression of these genes appear important for the early development of human placental villi.

Small scale transcript expression profile of Human first trimester placental villi analyzed by a custom-tailored cDNA array

Human placental trophoblastic mass grows rapidly between 4 and 8 weeks of gestation making it highly vulnerable to external and internal challenges, however, there has been no reported study exploring the developmental molecular characteristics in human first trimester placental villi. In the present study, transcript expressions of human placental villi of normal pregnancies during 6 (n=6), 7 (n=6) and 8 (n=6) weeks of gestation using custom-tailored cDNA-based expression arrays for -400 annotated human gene products were examined. Unsupervised and supervised analyses of expression data revealed that 386 (95%) genes were overtly involved in the first trimester placental villi, and these genes segregated into three clusters specifically corresponding to 6-, 7- and 8-weeks of gestation in principal component analysis. Bayesian prediction analysis based on relative expression levels of genes studied identified that expression patterns in 15 samples out of 18 samples showed concordance with high (0.8-1.0) confidence measures with the chronological age of the placenta, however, two samples collected during 7-weeks of gestation and one sample collected during 8-weeks of gestation were predicted to be 6-weeks sample with confidence measures between 0.6 and 0.5. Unsupervised hierarchical clustering analysis segregated the samples into two major branches; while one of them was composed of five 7-weeks samples only, the second major branch had three sub-branches: one of them was exclusively composed of three 8-week samples only, while other two sub-branches were mainly composed of 6-weeks samples. K-means clustering analysis identified four optimal clusters of genes depending on the similarity of their relative expression for the set of genes studied across all the samples. Gene ontology (GO) based functional classifications of genes in K-means clusters revealed that the overall putative functions of co-regulated gene clusters were mutually comparable, however, specific genes related to ion homeostasis, metabolism, and VEGF activity specifically clustered in 8-weeks samples. Analysis of relative gene expression during in 6-8 week placental villi revealed that a large number of gene products were over represented by their either up-regulation (70 genes: approximately 18%) or down regulation (53 genes; approximately 14%) between 6 and 8 weeks villi samples and these genes are reportedly involved in biological processes like regulation of cell growth and proliferation, anti-apoptosis, angiogenesis, immune and inflammatory responses, extracellular matrix remodeling and multicellular organismal development involving almost all cellular components and molecular functions like signal transduction activity, transcription factor activity, nucleotide and protein binding, ion (especially calcium and zinc) binding and growth receptor activities. Interestingly, four genes (oxytocin receptor, tenascin C, TNF-R1 and retinol binding protein 1) showed differential regulation in human placental villi during 6-8 weeks of gestation, suggestive of an underlying network of regulation involving these factors in the developing placenta. To our knowledge, this is the first report indicating that these genes are involved in the early stage development of human placenta.

Delayed growth of glioma by Scutellaria flavonoids involve inhibition of Akt, GSK-3 and NF-κB signaling

Plants of the genus Scutellaria constitute one of the common components of Eastern as well as traditional American medicine against various human diseases, including cancer. In this study, we examined the in vivo anti-glioma activity of a leaf extract of Scutellaria ocmulgee (SocL) while also exploring their potential molecular mechanisms of action. Oral administration of SocL extract delayed the growth of F98 glioma in F344 rats, both in intracranial and subcutaneous tumor models. Immunohistochemistry revealed inhibition of Akt, GSK-3α/β and NF-κB phosphorylation in the subcutaneous tumors following treatment with Scutellaria. The SocL extract as well as the constituent flavonoid wogonin also showed dose- and time-dependent inhibition of Akt, GSK-3α/β and NF-κB in F98 cell cultures in vitro, as determined by western blot analysis. Pharmacologic inhibitors of PI3K and NF-κB also significantly inhibited the in vitro proliferation of F98 glioma cells, indicating the key role of these signaling molecules in the growth of malignant gliomas. Transfection of F98 cells with constitutively active mutant of AKT (AKT/CA), however, did not significantly reverse Scutellaria-mediated inhibition of proliferation, indicating that Scutellaria flavonoids either directly inhibited Akt kinase activity or acted downstream of Akt. In vitro Akt kinase assay demonstrated that the SocL extract or wogonin could indeed bind to Akt and inhibit its kinase activity. This study provides the first in vivo evidence and mechanistic support for anti-glioma activity of Scutellaria flavonoids and has implications in potential usage of Scutellaria flavonoids in adjuvant therapy for malignant tumors, including gliomas.

Comet assay: a prognostic tool for DNA integrity assessment in infertile men opting for assisted reproduction

BACKGROUND & OBJECTIVES

The growing concern on transmission of genetic diseases in assisted reproduction technique (ART) and the lacunae in the conventional semen analysis to accurately predict the semen quality has led to the need for new techniques to identify the best quality sperm that can be used in assisted procreation techniques. This study analyzes the sperm parameters in the context of DNA damage in cytogenetically normal, AZF non deleted infertile men for DNA damage by comet assay.

METHODS

Seventy infertile men and 40 fertile controls were evaluated for the semen quality by conventional semen parameters and the sperms were also analyzed for DNA integrity by comet assay. The patients were classified into oligozoospermic (O), asthenozoospermic (A), teratozoospermic (T), oligoasthenoteratozoospermic (OAT) categories and infertile men with normal semen profile. The extent of DNA damage was assessed by visual scoring method of comets.

RESULTS

Idiopathic infertile men with normal semen profile (n=18) according to conventional method and patients with history of spontaneous abortions and normal semen profile (n=10) had high degree of DNA damage (29 and 47% respectively) as compared to fertile controls (7%). The O, A, T and OAT categories of patients had a variably higher DNA damage load as compared to fertile controls.

INTERPRETATION & CONCLUSION

The normal range and threshold for DNA damage as a predictor of male fertility potential and technique which could assess the sperm DNA damage are necessary to lower the trauma of couples experiencing recurrent spontaneous abortion or failure in ART.

Terlipressin therapy for reversal of type 1 hepatorenal syndrome: a meta-analysis of randomized controlled trials

BACKGROUND AND AIM

Hepatorenal syndrome (HRS) is a serious complication of advanced liver disease and carries a poor prognosis. Recent trials have indicated that terlipressin may be effective in reversing HRS. Our aim was to evaluate the efficacy of terlipressin therapy in reversing type 1 HRS defined as a serum creatinine <1.5 mg/dL during treatment.

METHODS

Randomized controlled trials in which patients with type 1 HRS received at least 3 days of terlipressin therapy and albumin in the intervention arm were included after a systematic search of the published English reports. Studies with other vasoconstrictor therapies in the control group were excluded.

RESULTS

A total of 223 patients with HRS type 1 in four different trials, were included in the final analysis. Alcohol-related cirrhosis was the most common underlying etiology. The risk ratio for reversal in type 1 HRS with terlipressin therapy was 3.66 (95% confidence interval 2.15-6.23). Recurrence of HRS was low (8%). Serious side-effects requiring discontinuation of therapy were seen only in 6.8% of patients on terlipressin therapy. There was a trend towards improved transplant-free survival at 90 days in the terlipressin group (relative risk 1.86 95% confidence interval 1.0-3.4, P = 0.05).

CONCLUSIONS

Terlipressin is effective in reversing HRS type 1. Recurrence of HRS is rare with at least 14 days of therapy. Serious side-effects requiring discontinuation of therapy are less common. There appears to be a survival benefit in patients with HRS treated with terlipressin.

Effects of air pollution on respiratory parameters during the wheat-residue burning in Patiala

Effects of pollution produced by wheat-residue burning on respiratory parameters of healthy inhabitants were investigated for two consecutive wheat cultivation periods (February-July in 2007 and 2008) at Patiala city of Punjab, India. A total of 51 selected subjects of the age group 13-53 were selected from five sites of Patiala for pulmonary function tests (PFTs), including force vital capacity (FVC), force expiratory volume in one second (FEV(1)), peak expiratory flow (PEF) and force expiratory flow between 25 to 75% of FVC (FEF(25-75%)) using a spirometer. High volume samplers (HVS) and an Andersen cascade impactor were also used to measure the concentration of suspended particulate matter (SPM) and particulate matter (PM) of size less than 10 mum. PFTs show significant decrease and particulate matter shows a significant increase during the burning period of wheat residue. Decrease in FVC and FEV(1) did not recover even after completion of the exhaustive burning period this is a more serious concern then PEF and FEF(25-75%). The results showed that the public exposure to relatively high levels of pollutants during the exhaustive burning period of wheat residue influences the PFTs of even healthy inhabitants.

Antioxidant levels in blood and seminal plasma and their impact on sperm parameters in infertile men

Excess reactive oxygen species (ROS) beyond the scavenging capacity of antioxidants leads to DNA damage and oxidation of lipoprotein components at the cellular and subcellular level. The oxidative stress (OS) adversely affects sperm function by altering membrane fluidity, permeability and impairs sperm functional competence. In the present study, the OS status in seminal plasma and blood serum in infertile men and its relationship with spermatozoa parameters have been investigated. Four groups of infertile men viz., oligozoospermic (n = 15), asthenozoospermic (n = 17), teratozoospermic (n = 19), and oligoasthenoteratozoospermic (n = 9), and healthy fertile controls (n = 40) have been analyzed for superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and malondialdehyde (MDA) in seminal plasma and blood serum. Significant correlation between blood serum SOD and sperm count has been observed in patients (p = 0.018) and controls (p = 0.021). Similarly, significant correlation between blood serum GSH and sperm progressive motility in patients (p = 0.036) and controls (p = 0.029) is observed. The low seminal MDA is associated with increase in sperm progressive motility in patients (p = 0.039) and controls (p = 0.028). Positive correlation is found between increased seminal MDA levels and abnormal sperm morphology in both patients and controls (r = 0.523, p = 0.029; r = 0.612, p = 0.034 respectively). Correlations between blood SOD and sperm count and between blood GSH levels and progressive motility suggest that these can be important biochemical markers in assaying the sperm count and motility. A negative correlation of motility with seminal MDA indicates that sperm membrane lipid peroxidation affects the fluidity and thus mobility of sperm axoneme. This affects functional competence of the sperm and acts like a biological safeguard. The results of the present study suggest the prospects of using the blood serum and seminal plasma antioxidants as a valuable tool to evaluate the sperm reproductive capacity and functional competence.

Management of infertility in low resource countries

Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub-Saharan Africa where infection-related tubal damage is the commonest cause. Most infections causing tubal damage are preventable and assisted conception can treat the infertility. However, assisted conception, despite being available for nearly three decades is either unavailable or inaccessible to most residents of resource poor countries. Infertility has social, economic and personal effects, which go beyond childlessness, and women bear the major brunt of the burden. There is urgent need for a comprehensive sexual and reproductive healthcare initiative involving maternal and child health, safe abortions, family planning and infertility prevention and management. The provision of low cost assisted reproduction for couples in poorly resourced countries also needs to be revisited.

Endovascular management of infective intracranial aneurysms with acrylic glue. A report of two cases

SUMMARY

Cerebral mycotic aneurysms (MAs) also called infective aneurysms, are uncommon and are usually encountered in patients with infective endocarditis. These aneurysms often present with intracranial hemorrhage. MAs may resolve on treatment with antibiotics alone. However prognosis with medical management alone is unpredictable. Good prognosis with surgery has been reported for single accessible ruptured MAs. However surgery is associated with significant morbidity. Endovascular treatment of MAs along with appropriate antibiotics is emerging as an acceptable option for these patients. We describe two cases of infective endocarditis complicated by ruptured MA treated successfully by liquid embolic glue material.

Medical termination of pregnancy and concurrent contraceptive adoption in a tertiary referral hospital in Delhi

This study was undertaken to review the demographic profile and assess the concurrent contraceptive acceptance in women seeking medical termination of pregnancy. A total of 15,726 women came for induced abortion in the years 1995 to 2007 at All India Institute of Medical Sciences, New Delhi. The mean age and parity of women was 27.6 +/- 5.3 years and 2.5 respectively with 63% between 25-29 years, 99.1% married and 72% with three or more living children. Majority of married (92.5%) and 12% unmarried women reported in the first trimester of pregnancy. Nearly 40% were not using any contraception at the time of conception and only 4.2% used oral pills or intrauterine contraceptive device. The main reasons for seeking abortion were enough children (56%), unplanned pregnancy (14%), contraceptive failure (10%), previous child very young (7.5%) and others (12.5%). The concurrent contraception accepted was 95.54% with 56.32% sterilization, 37.84% IUD, 0.75% and 0.5% oral pills and DMPA respectively. Quality counseling provided at time of abortion can help the couple make an informed choice.

Targeting of glioblastoma with activated T cells armed with anti-CD3xanti-HER2/neu (HER2Bi) and anti-CD3xanti-EGFR (EGFRBi) bispecific antibodies

3038

Background: Malignant gliomas are the most common primary brain tumors in adults. The prognosis for patients with glioblastoma remains poor despite aggressive multimodality treatment including surgery and chemoradiotherapy. The receptor tyrosine kinases EGFR, mutant EGFR (EGFRvIII), and HER2/neu are expressed on the majority of glioblastomas and are potential targets for activated T cells (ATCs) armed with bispecific antibodies (BiAbs). Methods: ATCs were generated from human peripheral blood mononuclear cells (PBMC) by culture for 14 days with monoclonal anti-CD3 and interleukin-2 and armed with HER2Bi and/or EGFRBi. HER2Bi- and/or EGFRBi-armed ATCs were examined for in vitro cytotoxicity (MTT and 51Cr release assays) against long-term malignant glioma lines (U87MG, U118MG, and U251MG) as well as primary glioblastoma lines derived from surgical specimens. Expression of EGFR and HER2/neu were evaluated by FACS. Anti-CD133 coated magnetic microbeads were used to separate CD133-positive and CD133-negative cell populations. Results: EGFRBi-armed ATCs killed up to 85% of U87, U118, and U251 targets. HER2Bi-armed ATCs exhibited comparable cytotoxicity against U118 and U251, but did not kill HER2-negative glioma U87. Cytotoxicity exhibited by either HER2Bi- or EGFRBi-armed ATCs against four primary glioblastoma cell lines was 50–80%. We found that both CD133-negative and CD133-positive cell populations were susceptible to killing by armed ATCs. When we armed ATCs simultaneously with HER2Bi and EGFRBi, killing by doubly armed ATCs was equal to or greater than that by EGFRBi-armed ATCs against the tested cell lines. Conclusions: BiAbs efficiently target ATCs to kill EGFR and/or HER2/neu expressing glioblastomas. Long-term malignant glioma cell lines and primary lines derived from surgical specimens are equally susceptible. Both CD133-negative and CD133-positive (the putative glioma stem cells) are killed. ATCs armed with BiAbs represent a potentially valuable adjuvant to current treatment.

No significant financial relationships to disclose.