Measurement of the polarization of the upsilon(1S) and upsilon(2S) states in pp collisions at square root[s]=1.96 TeV

We present a study of the polarization of the Upsilon(1S) and Upsilon(2S) states using a 1.3 fb;{-1} data sample collected by the D0 experiment in 2002-2006 during run II of the Fermilab Tevatron Collider. We measure the polarization parameter alpha=(sigma_{T}-2sigma_{L})/(sigma_{T}+2sigma_{L}), where sigma_{T} and sigma_{L} are the transversely and longitudinally polarized components of the production cross section, as a function of the transverse momentum (p_{T};{Upsilon}) for the Upsilon(1S) and Upsilon(2S). Significant p_{T};{Upsilon}-dependent longitudinal polarization is observed for the Upsilon(1S). A comparison with theoretical models is presented.

Precise measurement of the top-quark mass from lepton + jets events

We measure the mass of the top quark using top-quark pair candidate events in the lepton+jets channel from data corresponding to 1 fb;{-1} of integrated luminosity collected by the D0 experiment at the Fermilab Tevatron collider. We use a likelihood technique that reduces the jet energy scale uncertainty by combining an in situ jet energy calibration with the independent constraint on the jet energy scale (JES) from the calibration derived using photon+jets and dijet samples. We find the mass of the top quark to be 171.5+/-1.8(stat.+JES)+/-1.1(syst.) GeV.

Observation of ZZ production in p-p collisions at sqrt s=1.96 TeV

We present an observation for ZZ-->l+l-l'+l'- (l, l'=e or mu) production in p[over]p collisions at a center-of-mass energy of sqrt[s]=1.96 TeV. Using 1.7 fb(-1) of data collected by the D0 experiment at the Fermilab Tevatron Collider, we observe three candidate events with an expected background of 0.14(+0.03)_(-0.02) events. The significance of this observation is 5.3 standard deviations. The combination of D0 results in this channel, as well as in ZZ-->l+l- nu[over]nu, yields a significance of 5.7 standard deviations and a combined cross section of sigma(ZZ)=1.60+/-0.63(stat)+0.16_-0.17(syst) pb.

Reduced antigenicity of formaldehyde-fixed arterial allografts and their potential clinical application

This study was performed to examine the antigenicity of formaldehyde-fixed arterial allografts and their potential clinical application for hemodialysis access. Human femoral arteries were fixed with formaldehyde. New Zealand white rabbits were immunized with antigens prepared from fixed or unfixed grafts followed by anti-serum collection. The antigenicity of fixed grafts was evaluated using double-diffusion in two dimensions. Seventy-six fixed allografts were transplanted into 50 patients with end-stage renal diseases as hemodialysis access and monitored for acute rejection, blood flow, and patency rates. Anti-HLA antibody was evaluated using a panel-reactive antibody (PRA) assay in 6 patients. Formaldehyde-fixed grafts demonstrated reduced antigenicity as determined using double-diffusion in two dimensions when compared with unfixed grafts. Histological evaluation of allografts demonstrated absence of cell-mediated acute rejection after transplantation. Allografts demonstrated satisfactory blood flow with primary and secondary patency rates at 1, 2, and 3 years after allotransplantation. Serum collected from 6 patients after transplantation (mean, 3.3 +/- 3.2 years) did not demonstrate increased anti-HLA antibody levels. The allograft intimal hyperplasia was characterized by proliferation of actin-expressing smooth muscle cells. This study demonstrated that formaldehyde fixation reduced the antigenicity of arterial allografts. Acute rejection was absent after allotransplantation. The lack of increased PRA levels after allotransplantation suggested that allo-sensitization is not induced by fixed allografts. The use of formaldehyde-fixed allografts as hemodialysis access demonstrated blood flow and patency rates. Intimal hyperplasia of allografts is characterized by proliferation of actin-expressing cells. Our results supported the clinical use of formaldehyde-fixed arterial allografts for hemodialysis access.

CD4+ T-cell and monocyte interdependence during discordant xenoimmune responses

This study was designed to examine our hypothesis that human monocytes provide missing constimulatory signals to host CD4+ cells during interactions with porcine endothelial cells (PECs). PECs were isolated from the aorta. Human CD4+ T cells and monocytes were purified from peripheral blood mononuclear cells (PBMCs). A xenogeneic mixed lymphocyte-PEC reaction (xMLER) was performed to determine the proliferation of PBMCs or CD4+ cells in response to PEC. Monocyte-PEC cocultures with or without CD4+ cells were followed by analysis using fluorescence-activated cell scanning (FACS). We evaluated the CD4+ cells proliferation induced by PEC-conditioned monocytes with or without costimulation blockade. xMLER demonstrated strong lymphocyte proliferation in response to PECs. However, purified CD4+ cells showed reduced proliferative responses to PECs when compared with PBMCs. FACS analysis found that CD14+ monocytes up-regulated CD40 and CD80 expressions in the presence of CD4+ cells. PEC-activated but not resting monocytes induced CD4+-cell proliferation, which was inhibited by anti-CD154, anti-CD80, or anti-CD86 antibodies. In summary, human monocytes exposed to PECs are conditioned to up-regulate costimulatory molecules upon exposure to T cells. PEC-conditioned monocytes induced T-cell proliferation by indirect presentation. Costimulation blockade inhibited T-cell proliferation induced by PEC-conditioned monocytes. Our findings suggested that monocytes play an important role in indirect xenoantigen presentation, providing costimulation to T cells. This interaction can occur distant from the initial site of xenoantigen, but monocytes remaide void of costimulatory signals until their interaction with T cells.

Prosaposin is an AR-target gene and its neurotrophic domain upregulates AR expression and activity in prostate stromal cells

Recent studies have introduced prosaposin (PSAP) as a pleiotrophic growth factor for prostate cancer (PCa). We have previously reported that PSAP or one of its known active molecular derivatives, saposin C functions as an androgen-agonist and androgen-regulated gene (ARG) for androgen-sensitive (AS) PCa cell lines. Due to the potential significance of androgen receptor (AR)-expressing stroma in PCa, we evaluated a possible bi-directional paracrine regulatory interactions between DHT and PSAP in AR-positive prostate stromal (PrSt) cells. We report that saposin C in a ligand-independent manner increased AR expression, its nuclear content, and tyrosine phosphorylation. DHT treatment of PrSt cells increased PSAP expression. We also demonstrated both serum- and androgen-inducibility of a previously characterized hormone-responsive element (HRE) located in the proximal region of PSAP promoter. In addition, conditioned-media derived from PrSt cells and bone fibroblasts (i.e., MSF) differentially increased PSAP-promoter activity in androgen-independent (AI) PC-3 and AS LNCaP cells. Our data for the first time demonstrate that not only saposin C or PSAP regulates AR expression/activity, but also function as an ARG in PrSt. Ligand-independent activation of AR by PSAP or saposin C in PCa and stromal cells may contribute not only to prostate carcinogenesis at an early stage, but also in AI progression of the disease in an androgen-deprived tumor microenvironment.

luxS-based quorum-sensing signaling affects Biofilm formation in Streptococcus mutans

BACKGROUND

Quorum sensing (QS) is a process by which bacteria communicate with diffusible chemical signaling molecules called autoinducers (AIs). The autoinducer-2 signal (AI-2) produced by the LuxS protein mediates interspecies communication among Gram-positive and Gram-negative bacteria. In this study, we report that luxS-dependent QS is involved in the formation of Streptococcus mutans biofilms.

METHODS

An S. mutans luxS mutant was constructed, and the differences in growth and biofilm formation were compared between the wild-type strain and the mutant strain. To quantificationally analyze the kinetic biofilm formation of the mutant strain, an assay of BioFilm Ring Test(R) was applied.

RESULTS

There is a small increase in the growth of the luxS mutant strain after the stationary phase, compared with the parent strain. However during the exponential period, there were no significant differences. Using the BioFilm Ring Test(R), it was demonstrated that this luxS mutation was able to accelerate biofilm formation on a polystyrene surface during the mid-exponential growth phase. With 1% glucose treatment, even greater differences were observed between the mutant strain and its parental strain.

CONCLUSION

These data suggest that a luxS-dependent signal may play an important role in the biofilm formation of S. mutans.

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in children under the age of 12 years

OBJECTIVES

To assess the clinical and cost-effectiveness of inhaled corticosteroids (ICS) alone and ICS used in combination with a long-acting beta2 agonist (LABA) in the treatment of chronic asthma in children aged under 12 years.

DATA SOURCES

Major electronic bibliographic databases, e.g. MEDLINE and EMBASE, were searched up to February/March 2006 (and updated again in October 2006).

REVIEW METHODS

A systematic review of clinical and cost-effectiveness studies and economic analyses were carried out. A flexible framework was used to allow different types of economic analyses as appropriate, with either a cost comparison or cost-consequence comparison conducted.

RESULTS

Of 5175 records identified through systematic literature searching, 34 records describing 25 studies were included (16 were fully published randomised controlled trials, six were systematic reviews, and three were post-2004 conference abstracts). The most frequently reported relevant outcomes in the 16 RCTs were peak expiratory flow rate (13 trials), FEV1 (13 trials), symptoms (13 trials), adverse events or exacerbations (13 trials), use of rescue medication (12 trials), markers of adrenal function (e.g. blood or urine cortisol concentrations) (13 trials), height and/or growth rate (seven trials) and markers of bone metabolism (two trials). In the trials that compared low-dose ICS versus ICS and high-dose ICS versus ICS, no consistent significant differences or patterns in differential treatment effect among the outcomes were evident. Where differences were statistically significant at high doses, such as for lung function and growth, they favoured formoterol fumarate (FF), but this was generally in studies that did not compare the ICS at the accepted clinically equivalent doses. Differences between the drugs in impact on adrenal suppression were only significant in two studies. At doses of 200, 400 and 800 microg/day, beclometasone dipropionate (BDP) appears to be the current cheapest ICS product both with the inclusion and exclusion of chlorofluorocarbon (CFC)-propelled products. In the trials comparing ICS at a higher dose with ICS and LABA in combination, most outcomes favoured the combined inhaler. Only the combination inhaler, Seretide Evohaler, is slightly cheaper than the weighted mean cost of all types of ICS at increased dose except BDP 400 microg/day (including CFC-propelled products). Both the combination inhalers, Seretide Accuhaler and Symbicort Turbohaler, are more expensive than the weighted mean cost for all types of ICS at a two-fold increased dose. Compared with the lowest cost preparation for each ICS drug, all the combination inhalers are always more expensive than the ICS products at increased dose.

CONCLUSIONS

The limited evidence available indicates that there are no consistent significant differences in effectiveness between the three ICS licensed for use in children at either low or high dose. BDP CFC-propelled products are often the cheapest ICS currently available at both low and high dose, and may remain so even when CFC-propelled products are excluded. Exclusion of CFC-propelled products increases the mean annual cost of all budesonide (BUD) and BDP, while the overall cost differences between the comparators diminish. There is very limited evidence available for the efficacy and safety of ICS and LABAs in children. From this limited evidence, there appear to be no significant clinical differences in effects between the use of a combination inhaler versus the same drugs in separate inhalers. There is a lack of evidence comparing ICS at a higher dose with ICS and LABA in combination and comparing the combination products with each other. In the absence of any evidence concerning the effectiveness of ICS at higher dose with ICS and LABA, a cost-consequence analysis gives mixed results. There are potential cost savings with the use of combination inhalers compared to separate inhalers. At present prices, the BUD/FF combination is more expensive than those containing FP/SAL, but it is not known whether there are clinically significant differences between them. A scoping review is required to assess the requirements for additional primary research on the clinical effectiveness of treatment for asthma in children under 5 years old. Such a review could also usefully include all treatment options, pharmacological and non-pharmacological, for asthma. A direct head-to-head trial that compares the two combination therapies of FP/SAL and BUD/FF is warranted, and it is important to assess whether the addition of a LABA to a lower dose of ICS could potentially be as effective as an increased dose of ICS alone, but also be steroid sparing. There is also a need for the long-term adverse events associated with ICS use to be assessed systematically. Future trials of treatment for chronic asthma in children should aim to standardise further the way in which outcome measures are defined. There should be a greater focus on patient-centred outcomes to provide a more meaningful estimation of the impact of treatment on asthma control. Methods of reporting also require standardisation.

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in adults and children aged 12 years and over

OBJECTIVES

To assess the clinical and cost-effectiveness of inhaled corticosteroids (ICS) alone and ICS used in combination with a long-acting beta2 agonist (LABA) in the treatment of chronic asthma in adults and children aged over 12 years.

DATA SOURCES

Major electronic bibliographic databases, e.g. MEDLINE and EMBASE, were searched up to February/March 2006 (and updated again in October 2006).

REVIEW METHODS

A systematic review of clinical and cost-effectiveness studies was conducted. Cost comparison and cost-consequence analyses were performed where appropriate.

RESULTS

The assessment of clinical effectiveness was based on the 67 randomised controlled trials selected from the 5175 reports identified through the systematic literature search. The most frequently reported relevant outcomes were lung function, symptoms, use of rescue medication and adverse events. The trials varied considerably. In the trials that compared low-dose ICS versus ICS and high-dose ICS versus ICS, there were few significant differences in clinical effectiveness, although a few of the trials had assessed non-inferiority between the comparators rather than superiority. At doses of 400, 800 and 'high-level' doses of 1500 or 1600 microg/day, beclometasone dipropionate (BDP) appears to be the current cheapest ICS product both with the inclusion and exclusion of chlorofluorocarbon (CFC)-propelled products. A significant treatment benefit for combination ICS/LABA therapy across a range of outcomes compared with ICS alone was identified [when the ICS was double the accepted clinically equivalent dose of the ICS in the combination inhaler, and dry powder inhalers (DPIS) were used to deliver the drugs]. When a formoterol fumarate (FF)/salmeterol (SAL) combination inhaler and a budesonide (BUD)/FF combination inhaler were each compared with their constituent drugs delivered in separate inhalers, there were very few statistically significant differences between the treatments across the various efficacy outcomes and the rate of adverse events. Combination inhalers were more often cheaper than doubling the dose of ICS alone. However, the costs were highly variable and dependent on both the dose required and the preparation used in the trials. The estimated mean annual cost of FP/SAL combination varied from being 94 pounds cheaper to 109 pounds more expensive than the alternative of BUD at a higher dose. The BUD/FF combination varied from being 163 pounds cheaper to 66 pounds more expensive than the higher dose of either BUD or FP. When the combination inhalers were compared to each other, the results were mixed, with the FP/SAL combination significantly superior on some outcomes and the BUD/FF combination superior on others; however, meta-analysis showed that there were no significant differences between the two treatments in the rate of adverse events. Taking an ICS with a LABA as either of the two currently available combination products, FP/SAL and BUD/FF, is usually cheaper than taking the relevant constituent drugs in separate inhalers. At very high doses of BUD (1600 microg/day), however, the BUD/FF combination inhaler can be up to 156 pounds more expensive than having the same drugs in separate inhalers. In terms of the relative costs associated with taking one of the combination inhalers, at low dose (400 microg BUD or 200 microg FP/day) the cheapest combination inhaler is FP/SAL as a pressurised metered dose inhaler (pMDI) (Seretide Evohaler). However, this is only slightly cheaper than using BUD/FF as a DPI (Symbicort Turbohaler). At higher dose levels (800 microg BUD or 500 microg FP/day) FP/SAL as either pMDI aerosol (Seretide Evohaler) or a DPI (Seretide Accuhaler) is the cheapest combination product available, but again only slightly cheaper than the DPI BUD/FF combination (Symbicort Turbohaler). It should be highlighted, however, that the three head-to-head trials that compared the effects of FP/SAL with BUD/FF used the FP/SAL DPI combination inhaler, Seretide Accuhaler.

CONCLUSIONS

The evidence indicates that there are few consistent significant differences in effects between the five ICS licensed for use in adults and adolescents over the age of 12 years, at either low or high dose. On average, BDP products currently tend to be the cheapest ICS available and tend to remain so as the daily ICS dose required increases. There is evidence that the addition of a LABA to an ICS is potentially more clinically effective than doubling the dose of ICS alone, although consistent significant differences between the two treatment strategies are not observed for all outcome measures. The cost differences between combination therapy compared with ICS monotherapy are highly variable and dependent on the dose required and the particular preparations used. For the combination therapies of ICS/LABA there are potential cost savings with the use of combination inhalers compared with separate inhalers, with few differences between the two treatment strategies in terms of effects. The only exception to this cost saving is with BUD/FF at doses higher than 1200 microg/day, where separate inhaler devices can become equivalent to or cheaper than combination inhalers. Neither of the two combination inhalers (FP/SAL or BUD/FF) is consistently superior in terms of treatment effect. A comparison of the costs associated with each combination therapy indicates that at low dose FP/SAL delivered via a pMDI is currently the cheapest combination inhaler but only marginally cheaper than BUD/FF delivered as a DPI. At higher doses, both the FP/SAL combination inhalers (PMDI and DPI) are marginally cheaper than BUD/FF (DPI). Future trials of treatment for chronic asthma should standardise the way in which outcome measures are defined and measured, with a greater focus on patient-centred outcomes. For informing future cost-utility and cost-effectiveness analyses from a UK NHS perspective, there is a need for longitudinal studies that comprehensively track the care pathways followed when people experience asthma exacerbations of different severity. Further research synthesis, quantifying the adverse effects of the different ICS, is required for treatment choices by patients and clinicians to be fully informed.

Conversion from mycophenolate mofetil to azathioprine in renal allograft [corrected] patients within the first month posttransplantation

This retrospective study evaluated the safety of conversion from mycophenolate mofetil (MMF) to azathioprine (Aza) within the first month posttransplantation in 117 renal allograft patients concomittantly treated with cyclosporine (CsA) and prednisone. In 52 Conversion from MMF to Aza was conducted at 2 to 4 weeks posttransplantation in 52 patients (conversion group). Thirty-six patients received MMF (MMF group) and 29 patients were treated with Aza (Aza group). Patients were monitored for allograft function, acute rejection episodes, and CsA levels. The demographics were comparable between groups with respect to age, as well as warm and cold ischemic times of allografts. The cumulative allograft survival rates at 1, 2, 3, and 5 years were 98% +/- 2%, 96% +/- 3%, 90% +/- 4%, 90% +/- 4% in the conversion (n = 52) group versus 79% +/- 7%, 79% +/- 7%, 79% +/- 7%, and 75% +/- 8% in the MMF group (n = 36) versus 93% +/- 5%, 93% +/- 5%, 82% +/- 7%, and 78% +/- 8% in the Aza group (n = 29). The CsA trough levels at 1 year posttransplantation were 208.39 +/- 93.79 ng/mL in the conversion group; 159.30 +/- 52.99 ng/mL in the MMF group; and 241.82 +/- 112.76 ng/mL in the Aza group. The acute rejection rates during a 5-year follow-up were 28.85% in the conversion group; 27.78% in the MMF group; and 24.14% in the Aza group. The rejection-free allograft survival between the conversion group and the MMF group was identical (P < .921). However, allograft survival in the conversion group with acute rejection was significantly higher than the MMF group (P < .024). In conclusion, early conversion from MMF to Aza among renal allograft patients was safe without increased acute allograft rejection during a 5-year follow-up. The overall allograft survival in the conversion group was comparable to patients treated with MMF or Aza therapies.

Molecular characterization of hypoxia-hypothermia-conditioned human endothelial cells and their interaction with human monocytes

This in vitro study was designed to characterize the molecular profiling of human endothelial cells (ECs) during the early phase of hypoxia-hypothermia (HH) conditioning and to evaluate their interactions with allogeneic monocytes. The HH-conditioned ECs were analyzed using real-time quantitative polymerase chain reaction (RT-PCR). A cell adhesion assay was performed to assess adhesion of purified allogeneic monocytes as well as CD4- and CD8-positive T cells to HH-conditioned ECs with or without blocking antibodies specific for CD15s and CD162. Uptake of EC membrane by monocytes with or without scavenger receptor blockade was examined using fluorescence-activated cell scanning. The RT-PCR revealed up-regulation of gene transcripts for inflammatory cytokines, monocyte-associated growth factors, costimulatory, and apoptosis-related molecules in HH-conditioned ECs. Analysis using fluorescence-activated cell scanning showed minimal CD54 up-regulation in HH-conditioned ECs. We noted low-level adhesion of CD4- or CD8-positive cells to resting and HH-conditioned ECs. High-level adhesion of monocytes to HH-conditioned ECs was observed when compared with resting ECs. Blockade of CD15s and CD162 dramatically reduced monocyte adhesion to normal and HH-conditioned ECs. Monocytes but not T cells showed uptake of EC membranes during their interactions with HH-conditioned ECs, which was inhibited by scavenger receptor blockade. These data characterized the molecular features of ECs during early HH-conditioning. The EC transcripts related to monocyte recruitment and interaction between monocytes and HH-conditioned ECs dominated the early post-HH condition. Blockade of CD15s and CD162 prevented monocyte adhesion to ECs. These findings suggest that the initial interaction between monocytes and HH-conditioned ECs has a central role during the early phase of reperfusion injury.

Foxp3+ T regulatory cells (Tregs) are increased in nasal polyps (NP) after treatment with intranasal steroid

The pathogenesis of chronic rhinosinusitis (CRS) with nasal polyps(NP) is still poorly understood. To evaluate the role of Foxp3+ T regulatory cells (Tregs) in the pathogenesis and management of NP, we investigated the location and expression of Foxp3 in NP before and after treatment with intranasal steroid. NP specimens were obtained from 14 patients with NP before and after intranasal administration of mometasone (50 microg/day for 4 weeks). Foxp3 was detected by double immunofluorescence stain, quantitative reverse transcriptase polymerase chain reaction (RT-PCR), flow cytometry and western blot. The concentration of interleukin(IL)-10 in supernatants of homogenized tissue was measured by enzyme-linked immunosorbent assay (ELISA). We found that Foxp3 and IL-10 were downregulated in NP compared to the control mucosa (P<0.05). Foxp3 and IL-10 expression were increased significantly after intranasal steroid treatment (P<0.05). And Foxp3 was tightly correlated with IL-10 in NP (P<0.05) after treatment. These data suggest that Foxp3 is downregulated in NP and intranasal steroid attenuates the chronic inflammatory response by enhancing the expression and function of Foxp3 in NP.

Search for long-lived particles decaying into electron or photon pairs with the D0 detector

In this Letter we report on a search for long-lived particles that decay into final states with two electrons or photons. Such long-lived particles arise in a variety of theoretical models, such as hidden valleys and supersymmetry with gauge-mediated breaking. By precisely reconstructing the direction of the electromagnetic shower we are able to probe much longer lifetimes than previously explored. We see no evidence of the existence of such long-lived particles and interpret this search as a quasi model-independent limit on their production cross section, as well as a limit on a long-lived fourth generation quark.

Controlled trials in hepatitis B virus-related decompensate liver cirrhosis: peripheral blood monocyte transplant versus granulocyte-colony-stimulating factor mobilization therapy

BACKGROUND

Liver cirrhosis represents the end stage of chronic liver injury. Currently, liver transplantation provides the only definite cure but it is beset with many problems, including lack of donors and risk of rejection. Stem cell therapy is very attractive in this setting because it has the potential to help tissue regeneration. In this study, we aimed to investigate the therapeutic effect of peripheral blood monocyte cell (PBMC) transplantation in decompensated liver cirrhosis.

METHODS

A total of 40 subjects (31 men and nine females, age range 21-71 years) was recruited to two groups. Group 1 received granulocyte-colony-stimulating factor (G-CSF) mobilization, PBMC collection by leukapheresis and PBMC transplant therapy. Group 2 received G-CSF mobilization for 4 days. At baseline and 6 months after treatment, liver function of the two groups was monitored by blood examination and ultrasonagraphy.

RESULTS

Both groups gained significant improvement in liver synthetic function, such as serum albumin and prothrombin time, from baseline to 6 months after treatment (P<0.01). However, there was no significant difference in alanine aminotransferase, aspartate aminotransferase and total bilirubin in both groups (P>0.05). Compared with group 2, a significantly improved liver function was observed in group 1, including elevated serum albumin level and a decreased CTP score (P<0.05). No major adverse effects were noted.

DISCUSSION

Autologous PBMC transplantation could be considered as a novel and alternative treatment for patients with decompensated liver cirrhosis.

Detection and differentiation of Theileria luwenshuni and T. uilenbergi infection in small ruminants by PCR

Theileria luwenshuni and T. uilenbergi are newly identified Theileria species highly pathogenic for sheep and goats in China. As they are morphologically indistinguishable and poorly characterized, there is no easily applicable method available to differentiate between these species. In the present study, PCR assays are described for the differentiation and detection of T. luwenshuni and T. uilenbergi using species-specific primers, which were designed based on the hypervariable region of the small subunit ribosomal RNA gene sequences. By testing 100 field blood samples of sheep collected from five geographically different regions where the Theileria species were described to be prevalent, the PCR assays not only detected infected samples but also identified mixed infection. This suggests that these PCR assays are useful tools for the detection of and differentiation between T. luwenshuni and T. uilenbergi.

Development and evaluation of a loop-mediated isothermal amplification method for diagnosis of tropical theileriosis

A loop-mediated isothermal amplification (LAMP) assay was developed and evaluated for diagnosis of tropical theileriosis. A set of six primers was designed based on the unique gene of Theileria annulata (Theileria annulata strain Ankara hypothetical protein (GeneDB TA04795). The protocol for the reaction was setup and the specificity and sensitivity of the assay were established. The specificity experiment showed that LAMP primers amplified T. annulata DNA successfully, while no amplification was seen for Theileria parva, Theileria mutans, Theileria sergenti, Theileria sinensis, Babesia bovis as well as bovine genomic DNA and water control. When the sensitivity of LAMP assay was compared with that of conventional PCR a 10-fold higher sensitivity was found, with a detection limit of 10 pg/microl of genomic DNA isolated from a T. annulata-infected cell line. The LAMP product was confirmed by restriction digestion and staining with SYBR Green I. Furthermore, the LAMP assay was applied for the diagnosis of T. annulata in field samples and compared with reverse line blot (RLB), demonstrating that results of the LAMP assay corresponded to those of RLB. These results indicate that the LAMP assay is rapid and simple to run, cost-effective, sensitive and specific and has potential usefulness for application in epidemiological studies on T. annulata infection of cattle.

Observation of efficacy and safety of converting the calcineurin inhibitor to sirolimus in renal transplant recipients with chronic allograft nephropathy

OBJECTIVE

The objective of this study was to evaluate the efficacy and safety of converting from a calcineurin inhibitor (CNI) to sirolimus among renal transplant recipients with chronic allograft nephropathy (CAN).

METHODS

In 16 patients with CAN, substituted sirolimus for CsA or FK506 and observed the incidence of acute rejection and changes in serum creatinine, triglycerides, cholesterol, blood uric acid, and peripheral blood leukocyte/platelet counts within 12 months. All recipients underwent an allograft biopsy before conversion. The targeted sirolimus level was 4-8 ug/L.

RESULTS

After conversion to sirolimus, the creatinine level of 7 cases decreased and the efficacy rate was (43.8%). No acute rejection occurred during the follow-up. The cases with hypercholesteremia increased from 3 to 7 after conversion; hypertriglyceridemia increased from 3 to 5; leukopenia occurred in 2; subnormal platelet counts increased from 2 to 3; and hyperuricemia increased from 6 to 7. Meanwhile, the average level of peripheral blood leukocytes obviously decreased in the first month, the average peripheral blood cholesterol increased over 12 months, but the average content of peripheral blood platelets, triglyceride and blood uric acid failed to display as statistic difference. Eight patients showed C4d deposition in peritubular capillary in graft tissue before conversion, 7 cases of whom showed no improvement in renal function. In 6 cases there was no C4d deposition in peritubular capillary in graft tissue. Only 2 of 6 cases showed no improvement in renal function. There were 6 patients whose creatinine level was <2.48 mg/dL before conversion, and renal function in 5 of them improved in a year after conversion. In contrast, among 10 patients whose blood creatinine level was >2.48 mg/dL, only 2 cases improved.

CONCLUSION

It is safe for patients with CAN to use substitute sirolimus for CNI; the incidence of acute rejection did not increase. In this study, 43.8% of patients showed improved renal function. The main adverse reactions after conversion to sirolimus were hypercholesteremia and decreased peripheral blood leukocytes. The serum creatinine level and the deposition of C4d in peritubular capillary were important factors influencing therapeutic efficacy.

Tailored regimen of interferon alpha for HBeAg-positive chronic hepatitis B: a prospective controlled study

The response to interferon-alpha treatment of patients with chronic hepatitis B under the current protocol is not satisfactory. The aim of this study was to try an alternative approach to improve treatment outcome. Of 374 HBeAg-positive patients, 127 of them received 5 million units of interferon-alpha thrice weekly for 6 months and constituted the control group, while 247 in the study group received the same dosage but the duration of treatment was tailored. The study protocol provided for continuation of treatment if HBV DNA levels were continuously decreasing. The treatment ended when viral, antigenic and biochemical endpoints were reached or when HBV DNA levels were no longer decreasing. The median length of tailored treatment was 10 (range 6-24) months. The end-of-treatment response rates were 39.3% and 23.6% (P = 0.002), and after 12-month, follow-up, the sustained response rates were 40.5% and 28.3% (P = 0.013) in the study and control groups, respectively. Excluding the patients who dropped out, 228 and 115 completed a median of 40- and 44-month-long follow-up; the long-term response was thus 45.3% and 33.1% (P = 0.014) in the respective groups. Interferon-alpha treatment tailored in length demonstrated significantly increased efficacy in patients with chronic hepatitis B.