Clinical study of recombinant adenovirus-p53 (Adp53) combined with hyperthermia in advanced cancer (a report of 15 cases)

The study was to evaluate the efficacy of the Adp53 combined with hyperthermia on advanced cancer. Fifteen patients with advanced cancer were enrolled in this clinical trial. Thirteen patients with recurrent tumours failed in conventional treatments and the two other patients with primary tumour received no treatment before they were enrolled. Recombinant adenovirus-p53 (Adp53) is a E1 substituted replication-incompetent recombinant adenovirus encoding the human wild-type p53 (wtp53) gene. The 15 patients were intra-tumourally injected with Adp53, 1x10(12)vp (virus particle) once a week, with a total of 4-8 times was given. The temperature being set hyperthermia every week 3 days after the injection of Adp53 at 43-44 degrees C using 915 MHz microwave machine for superficial tumour for 1 h or at 42-43 degrees C using 41 MHz radiofrequency machine for deep-seated tumour for 1 h. Among the 15 patients, five concurrently were added with radiotherapy and three were added with cisplatin-based chemotherapy. The treatment achieved CR in two cases, PR in four cases, SD in eight cases and PD in one case and, after the treatment, tumours of two cases disappeared and seven of the other 13 cases (54%) had low-density area (LDA) of more than 50% on CT images in tumours. In the 15 patients, no dose-limiting toxicity and adverse events were noted, except transient fever after Adp53 administration. In conclusion, Adp53 combined with hyperthermia was safe and effective in patients with advanced cancer and p53 gene therapy was potential to thermosensitize in advanced cancer.

Detection of porcine circovirus type 2, porcine parvovirus and porcine pseudorabies virus from pigs with postweaning multisystemic wasting syndrome by multiplex PCR

Multiplex PCR was established to detect porcine circovirus type 2 (PCV-2), porcine parvovirus (PPV) and porcine pseudorabies virus (PRV) and applied to samples from 137 piglets exhibiting clinical signs of postweaning multisystemic wasting syndrome (PMWS). PCV-2 DNA was detected from all samples. Moreover, 43 samples were positive for PPV but negative for PRV; 11 samples were positive for PRV but negative for PPV; and 35 samples were positive both for PPV and PRV. These results suggests that PCV-2 co-infection with PRV and PPV may play an important role in PMWS. Also, multiplex PCR is an appropriate candidate method for diagnosis of PCV-2, PRV and PPV simultaneously in field cases.

Analysis of lectin receptors in normal nasal mucosa, nasal polyp, inverted papilloma and papillary adenocarcinoma

In order to investigate the changes in glycoprotein structure in the process of cellular differentiation of the nasal mucosa, formalin-fixed, paraffin-embedded biopsy specimens of normal nasal mucosae, nasal polyps, inverted papillomas and papillary adenocarcinomas were analysed by the Avidin Biotin-Peroxidase Complex technique for the demonstration of peanut agglutinin (PNA) receptors, concanavalin ensifomis agglutinin (ConA) receptors, ulex europeaus agglutinin (UEA-I) receptors, wheat germ agglutinin (WGA) receptors, carcino-embryonic antigen (CEA) and keratin. The quantity and distribution of PNA receptors, ConA receptors, UEA-I receptors and CEA were different, in relation to the varying pathological changes. The results suggest that the glycoprotein structure in the cells of the nasal mucosa will change following their differentiation and malignant transformation, which may be helpful in establishing the diagnosis.

[Effect of artemether on nucleoside uptake and nucleic acid content in Schistosoma japonicum]

AIM

To observe the effect of artemether (Art) on nucleoside uptake and nucleic acid content in Schistosoma japonicum.

METHODS

RNA and DNA contents of both male and female worms harbored in mice treated intragastrically (i.g.) with Art 300 mg/kg for 24 h or 48 h were determined, respectively. After in vivo drug treatment, the schistosomes recovered were in vitro maintained in drug-free medium containing [3H]adenosine, [5-(3)H] uridine or [methyl-3H]thymidine at a final concentration of 37 MBq/L or 74 MBq/L for 2 h or 4 h, the tritiated nucleoside uptake and incorporation into nucleic acid of schistosomes were measured.

RESULTS

The RNA and DNA contents of female worms recovered from the host 48 h after dosing were markedly decreased by 51.6% and 23.5%, respectively, while the RNA content of male worms showed 42.4% reduction. When the above-mentioned schistosomes were in vitro exposed to the tritiated nucleoside for 2 h or 4 h, apparent decrease in tritiated nucleoside uptake with reduction rates of 35.2%-50.1% was seen in female worms. The incorporation of [methyl-3H]thymidine into the female worm DNA 2 h after incubation was reduced by 71.4% while the incorporation of [3H]adenosine into the female worm RNA and DNA 4 h after incubation was reduced by 65.2% and 50.0%, respectively.

CONCLUSION

Art exhibited an apparent effect on the nucleic acid metabolism in schistosomes, especially in female worms.

[Sequencing of cytochrome C oxidase 1 gene of Ancylostoma duodenale and Necator americanus]

AIM

To identify the genetic diversity between Ancylostoma duodenale and Necator americanus.

METHODS

Mitochondrial cytochrome C oxidase subunit 1 (CO1) gene was amplified from genomic DNA of human hookworms collected from infected patients in Hejiang County, Sichuan Province, and the purified PCR products were directly sequenced by using Licor auto-sequencer.

RESULTS

The PCR products were about 700 bp. Alignment of CO1 gene fragment sequences showed 89.7% similarity between Ancylostoma duodenale and Necator americanus, but still certain nucleotide variations (10.3%) existed.

CONCLUSION

CO1 gene sequence can be used as a marker to identify the two species of human hookworms.

In vitro and in vivo effect of levopraziquantel, dextropraziquantel versus racemic praziquantel on different developmental stages of Schistosoma japonicum

AIM

To compare the antischistosomal effect of racemic praziquantel (Pra) and its enantiomers, levopraziquantel (L-Pra) and dextropraziquantel (D-Pra), on different developmental stages of Schistosoma japonicum.

METHODS

The in vitro effects of the drugs were determined in different stages of schistosomes maintained in RPMI 1640 supplemented with 20% calf serum. In vivo study mice infected with schistosome cercariae were treated intragastrically (ig) with Pra, L-Pra or D-Pra at different intervals after infection. The efficacy of the drugs was evaluated by residual mean worm number.

RESULTS

Based on the degree of tegument damage induced by L-Pra, d28 and d35 schistosomes were most susceptible to L-Pra, while d14 schistosomules being least susceptible. At comparable concentrations of 0.1-1 g/ml, L-Pra was more active than Pra even when the concentration of L-Pra was reduced to one-half of the minimum effective concentration of Pra. At above-mentioned concentrations D-Pra exhibited no apparent in vitro effect on different stages of schistosomes. When infected mice were treated ig with L-Pra, Pra or D-Pra at a single dose of 300 mg/kg or 500 mg/kg, only the former two drugs showed apparent effect on d0, d21, d28 and d35 schistosomes and less or much less effect on d3, d7 and d14 schistosomules. D-Pra only exhibited a negligible effect on d35 adult schistosomes as compared with L-Pra and Pra. When mice infected with d35 adult schistosmes were treated ig with L-Pra 150 mg/kg, the efficacy was similar to that of mice treated with Pra 300 mg/kg.

CONCLUSION

L-Pra is the principal active component against schistosomes in racemic Pra.

The potential of artemether for the control of schistosomiasis

Schistosomiasis continues to rank--following malaria--at the second position of the world's parasitic diseases in terms of the extent of endemic areas and the number of infected people. There is yet no vaccine available and the current mainstay of control is chemotherapy with praziquantel used as the drug of choice. In view of concern about the development of tolerance and/or resistance to praziquantel, there is a need for research and development of novel drugs for the prevention and cure of schistosomiasis. Interestingly, derivatives of artemisinin, which are already effectively used in the treatment of malaria, also exhibit antischistosomal properties. Significant advances have been made with artemether, the methyl ether derivative of artemisinin. We review the discovery of the antischistosomal activity of artemether by Chinese scientists two decades ago; the detailed laboratory studies of the susceptibility of, and effect on, the different developmental stages of Schistosoma japonicum, Schistosoma mansoni and Schistosoma haematobium to artemether; the possible mechanism of action and the potential long-term toxicity. Finally, we look at the effect of combined treatment with artemether and praziquantel; and clinical findings thus far obtained from randomised controlled trials with oral artemether for the prevention of patent infections and morbidity. The review intends to create a forum for strategic discussion of how these laboratory and clinical findings could be translated into public health actions. We conclude that artemether--as part of integrated current control measures and adapted to specific socio-ecological and epidemiological settings--has considerable potential to significantly reduce the current burden of schistosomiasis in many parts of the world.

Current progress in the development and use of artemether for chemoprophylaxis of major human schistosome parasites

Human schistosomiasis, a chronic and debilitating parasitic disease of the tropics, is ranked second after malaria in terms of public health importance. At present, there is no vaccine available, and chemotherapy is the cornerstone of schistosomiasis control. Praziquantel is the drug of choice. Oxamniquine has become difficult to obtain and metrifonate has recently been withdrawn from the market. Rapid re-infection following treatment and concern about praziquantel resistance called for the search of novel drugs for prevention and cure of schistosomiasis. Significant progress has been made with artemether, the methyl ether of dihydroartemisinin, already widely used for the treatment of malaria. The present article reviews the literature that led to the development of artemether for chemoprophylaxis in schistosomiasis, and it summarises the experiences so far obtained with its use to control schistosomiasis in different endemic settings. Topics covered include an overview of the global burden of schistosomiasis and approaches for its control; the nature and features of artemisinin and related derivatives, initially discovered as antimalarials, other bioactivities, and their recent discovery of antischistosomal properties; a historic account disclosing the antischistosomal activity of artemether; in vivo assessment of drug susceptibility of different developmental stages of schistosome parasites; artemether-induced pathology evidenced by scanning and transmission electron microscopy; the possible mechanism of action; in vivo studies with combination therapy of artemether and praziquantel; results of randomised controlled clinical trials of oral artemether for the prevention of patent infection and morbidity; and, ultimately the translation of this knowledge into public health action in different endemic settings towards a more integrated approach of schistosomiasis control.

A model of the muscle action potential for describing the leading edge, terminal wave, and slow afterwave

The leading edge, terminal wave, and slow afterwave of the motor-unit action potential (MUAP) are produced by changes in the strength of electrical sources in the muscle fibers rather than by movement of sources. The latencies and shapes of these features are, therefore, determined primarily by the motor-unit (MU) architecture and the intracellular action potential (IAP), rather than by the volume-conduction characteristics of the limb. We present a simple model to explain these relationships. The MUAP is modeled as the convolution of a source function related to the IAP and a weighting function related to the MU architecture. The IAP waveform is modeled as the sum of a spike and a slow repolarization phase. The MU architecture is modeled by assuming that the individual fibers lie along a single equivalent axis but that their action potentials have dispersed initiation and termination times. The model is illustrated by simulating experimentally recorded MUAPs and compound muscle action potentials.

KIT activation is a ubiquitous feature of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and they are generally resistant to chemotherapy and radiation therapy. Most GISTs express the KIT receptor tyrosine kinase protein, and a subset of GISTs contain activating mutations within the KIT juxtamembrane region. We evaluated 48 GISTs, including 10 benign, 10 borderline, and 28 malignant cases, to determine whether KIT expression and activation are general properties of these tumors. Immunohistochemical KIT expression was demonstrated in each case. Somatic KIT mutations were found in 44 tumors (92%), of which 34 (71%) had juxtamembrane region mutations. Other GISTs had KIT mutations in the extracellular region (n = 6) and in two different regions in the tyrosine kinase domain (n = 4). Contrary to previous reports, KIT mutations were not identified preferentially in higher-grade tumors: indeed, they were found in each of 10 histologically benign GISTs. Notably, mutations in all KIT domains were associated with high-level KIT activation/phosphorylation, and KIT activation was also demonstrated in the four GISTs that lacked detectable KIT genomic and cDNA mutations. These studies underscore the role of KIT activation in GIST pathogenesis, and they suggest that activated KIT might represent a universal therapeutic target in GISTs.

Sp1 is the major fasl gene activator in abnormal CD4(-)CD8(-)B220(+) T cells of lpr and gld mice

The abnormal CD4(-)CD8(-)TCRalpha beta(+)B220(+) double-negative (DN) T cells that accumulate in lpr and gld mice are refractory to TCR cross-linking and IL-2 stimulation, yet they have an activated phenotype and express a high level of fasl mRNA. Specific binding sites for Sp1, NFAT, Egr, and NF-kappaB have been identified in the promoter region of the fasl gene. To determine the critical factor for fasl gene activation, fasl promoter reporter and mutant constructs were transiently transfected into the abnormal DN T cells. The data demonstrate that the Sp1 binding site is the major response element that regulates fasl promoter activity. Moreover, the abnormal DN T cells contain in their nuclei a high level of Sp1, a low level of NFAT and NF-kappaB, and a very low level of Egr. Ectopic expression of Egr-3 but not Sp1 protein in the abnormal DN T cells enhanced fasl promoter activity, suggesting that the Egr but not Sp1 was limiting for fasl gene activation. Comparison between the abnormal DN T cells and the Sertoli TM4 cells showed a strong correlation between Sp1 expression and fasl mRNA level and FasL function. Our study has identified Sp1 as the major transcription factor responsible for fasl gene activation in the abnormal DN T cells that are defective in signal transduction through TCR and IL-2R, thereby, implicating a novel regulatory pathway for fasl gene activation during the physiological development and elimination of the abnormal DN T cells.

Apoptosis-inducing membrane vesicles. A novel agent with unique properties

The CD95 ligand (FasL) transmembrane protein is found on activated T cells and cells outside the immune system. A well-known turnover process of membrane FasL is mediated by matrix metalloproteinase, which generates soluble FasL (sFasL). Here, we demonstrate that membrane FasL turnover occurs effectively through the release of membrane vesicles. Quantitative analysis indicates that this process is as effective as sFasL release for FasL-3T3 cells but somewhat less effective for FasL-expressing T cells. The apoptosis-inducing membrane vesicles display unique properties not found in FasL-expressing cells and sFasL. Unlike sFasL, vesicle-associated FasL remained bioactive, killing the same panel of targets that are susceptible to FasL-expressing cells. In contrast to FasL-expressing T cells, FasL-mediated killing by vesicles do not involve LFA-1/ICAM interaction and do not depend on de novo protein synthesis. These observations indicate that the release of FasL-bearing vesicles contributes to the turnover of cell-associated FasL, but the impact of the bioactive FasL-expressing vesicles on the function of cell-associated FasL is different from that of sFasL.

Species-specific identification of human hookworms by PCR of the mitochondrial cytochrome oxidase I gene

Significant differences in the life histories of the human hookworms Ancylostoma duodenale and Necator americanus necessitate their differentiation for epidemiological studies and the design of control programs. Current methods of identification require time-consuming, labor-intensive techniques. A polymerase chain reaction (PCR)-based method that enables rapid species identification is described. The mitochondrial cytochrome oxidase I genes of both species were sequenced, and species-specific primer sets were designed. The primers were used in PCR to amplify 585-bp fragments of the cytochrome oxidase gene from individual hookworm eggs, larvae, and adults. The technique was also able to identify mixed infections containing equal amounts of eggs from each species. The technique is rapid, technically simple, and sensitive and will permit the accurate identification of human hookworms in epidemiological field studies.

C1q-bearing immune complexes induce IL-8 secretion in human umbilical vein endothelial cells (HUVEC) through protein tyrosine kinase- and mitogen-activated protein kinase-dependent mechanisms: evidence that the 126 kD phagocytic C1q receptor mediates immune complex activation of HUVEC

Endothelial cells play a pivotal role in the initiation and perpetuation of inflammation. C1q, the first component of the classical pathway of complement, is a potent stimulus leading to endothelial cell activation and cytokine production. The specific cellular mechanisms through which endothelial cells are stimulated by C1q are not known. We stimulated human umbilical vein endothelial cells (HUVEC) with either monomeric C1q or C1q-bearing immune complexes (C1q-IC) in the presence or absence of inhibitors of protein tyrosine kinases (PTK) or mitogen-activated protein kinases (MAPK). C1q-IC, but not monomeric C1q, induced IL-8 production in dose- and time-dependent fashion. R3, a cross-linking monoclonal IgM antibody against the 126 kD phagocytic C1q receptor (C1qR), also stimulated IL-8 production. IL-8 mRNA accumulation was detected by Northern blot analysis within 2 h of stimulation by the immune complexes and was enhanced by the addition of cycloheximide. Secretion of IL-8 by C1q-IC stimulated HUVEC was completely blocked by the PTK inhibitor, genistein or the MAPK inhibitor, UO126. These experiments demonstrate that C1q-IC-induced production of IL-8 in HUVEC is dependent upon the activation of PTK and MAPK. These findings also support a role for the phagocytic C1qR as an important activator of HUVEC by immune complexes.

Tegumental alterations in juvenile Schistosoma haematobium harboured in hamsters following artemether treatment

We report the findings of a detailed temporal study on tegumental alterations in juvenile Schistosoma haematobium, induced by artemether, using scanning electron microscopy. Hamsters infected with S. haematobium cercariae for 28 days were treated intragastrically with a single dose of 300 mg/kg artemether. Groups of two hamsters were killed 24 h, 72 h and 7 days after treatment, and schistosomula were recovered from livers by perfusion and subsequent systematic examination of the tissue, before routinely processing for scanning electron microscopic examination. Most schistosomula collected 24 h after artemether administration showed severe tegumental damage, usually including swelling, fusion, vesiculation, peeling and collapse of enlarged sensory structures. After 72 h, tegumental damage had increased and schistosomula generally showed contraction with extensive swelling, erosion and peeling of the tegument. Seven days post-treatment, severe tegumental damage was only seen in a single male specimen with swelling of the worm body and destruction of the oral sucker. The other schistosomula showed only light to moderate damage, suggesting that schistosomula surviving the treatment began to recover. Our findings of tegumental damage following artemether treatment correlate with the efficacy of this novel antischistosomal drug in killing the juvenile stages of S. haematobium and complement recent findings with S. japonicum and S. mansoni.

Effect of combined treatment with praziquantel and artemether on Schistosoma japonicum and Schistosoma mansoni in experimentally infected animals

Praziquantel and artemether are safe and efficacious antischistosomal drugs that act against different developmental stages of the parasite: praziquantel against adult worms and artemether against schistosomula. A combined treatment has been suggested as a strategy for transmission control. Recent laboratory experiments with rabbits with a mixed infection of Schistosoma japonicum parasites of different ages confirmed the effectiveness of a combination therapy. In the present work, we assessed the effect of a combined treatment on adult worms of S. japonicum and found significantly higher worm reduction rates than with a single dose of praziquantel. In a next step, we extended the study of the combined treatment to Schistosoma mansoni. A combined treatment with 75 mg/kg praziquantel and 150 mg/kg artemether was administered to hamsters infected with juvenile and adult S. mansoni. The two drugs, administered simultaneously or spaced by 6 h, 1, 3 or 7 days, resulted in significantly higher worm reduction rates than a single treatment with praziquantel. A combination therapy with increased doses of 100 mg/kg praziquantel and 300 mg/kg artemether showed very high worm reduction rates of 90% and above, however, some hamsters died in five different combined treatment experiments, suggesting that these drug concentrations were too high. We conclude that a combined treatment with praziquantel and artemether at the lower doses is safe and more effective than praziquantel alone, which forms a foundation for designing respective clinical trials in humans.

[Bioactivity and test grafting of acellular dermal matrix containing fibroblasts]

OBJECTIVE

To investigate the bioactivity of acellular dermal matrix with fibroblasts and its role as dermal skeleton.

METHODS

Human fibroblasts (HFs) were planted onto the surface of acellular dermal matrix (ADM) to form living dermal substitute. The IL -- 6, IL -- 8 and TGF contents in the supernatant of the culture of HF -- ADM were determined with ELISA method, and the secretion of hyaluronic acid and laminin from extracellular matrix was measured with RIA method. The speed of vascularization and the wound contracture rate were observed after the dermal substitute was grafted on the full skin loss wound of Balb/c-nu mice (nude mice).

RESULTS

HFs grew very well after being planted onto ADM so as to form a single layer of cellular membrane. Many kinds of cytokines and extra cellular matrix components were secreted. Compared with simple acellular dermal grafting, the vascularization was accelerated, and the wound contracture rate decreased, after the living dermal substitute being grafted on the wound.

CONCLUSION

The ADM seeded with HFs exhibited excellent bioactivity and might be an optimal dermal substitute.

Uremic levels of BUN do not cause nitric oxide deficiency in rats with normal renal function

In vitro, 7 days of high blood urea nitrogen (BUN) inhibits endothelial L-arginine transport and nitric oxide synthase (NOS) activity. The present study investigates whether 7 days of high BUN in vivo influences renal hemodynamics, blood pressure (BP), and/or the nitric oxide (NO) system. Normal rats were fed low-nitrate food containing 30% urea for 7 days, which increased BUN (15 +/- 1 to 69 +/- 4 mg/100 ml, P < 0.001). High BUN did not reduce 24-hour urinary nitrite/nitrate excretion (a measure of total NO production). Baseline BP and renal hemodynamics were unaffected by high BUN as were the pressor and renal vasoconstrictor responses to acute NOS inhibition with N(G)-nitro-L-arginine-methyl ester. In addition, high BUN had no impact on renal cortical L-arginine concentration, density of either endothelial NOS or neuronal NOS protein, or renal cortical NOS activity. NOS activity in the brain cerebellum was also unaffected. In conclusion, high BUN did not lead to vasoconstriction or NO deficiency in rats with normal renal function. Further studies are needed to evaluate the effect of high BUN on the NO system in rats with progressive renal functional insufficiency.

[Postlaryngectomy peristomal recurrence]

OBJECTIVE

To study the etiopathology, diagnosis and management of peristomal recurrence after laryngectomy, and the prevention of peristomal recurrence.

METHODS

Retrospective analysis of clinical management and outcomes of 16 cases of peristomal recurrence.

RESULTS

The subglottic extension of laryngeal cancer and peritracheal metastasis may result in peristomal recurrence. The stomal resection with mediastinal dissections and the use of the pectoralis major myocutaneous flap were done. The survival period of 11 cases surgically treated was longer than that of 5 cases irradiated or untreated.

CONCLUSION

Surgical management would improve the survival, but overall prognosis is dismal and attention should be focused on prevention. It is evident that early diagnosis of stomal recurrences will yield good results.

A new locus for hereditary gingival fibromatosis (GINGF2) maps to 5q13-q22

Gingival fibromatosis (GINGF) is an oral disorder characterized by enlargement of the gingiva. It occurs either as the sole phenotype or combined with other symptoms. Thus far, one GINGF locus has been mapped on chromosome 2, at 2p21, and a second possible locus has been mapped to 2p13. However, the genes responsible for this disorder have not been elucidated. We identified a four-generation Chinese GINGF family in which the disease manifests within 1 year after birth. After exclusion of the two known GINGF loci in this family, we performed a genome-wide search to map the chromosome location of the responsible gene. We identified a new locus, GINGF2, on chromosome 5q13-q22 with a maximum two-point lod score of 4.31 at D5S1721 (theta = 0.00). Haplotype analysis placed the critical region in the interval defined by D5S1491 and D5S1453. Within this region, calcium/calmodulin-dependent protein kinase IV (CAMK4) is a strong candidate.