Population pharmacokinetic analysis of amikacin and validation on neonates using Monte Carlo method

AIM

To make programs for population pharmacokinetic analysis and to assess the ability of this method in pharmacokinetic parameter estimation and in the prediction of serum concentrations.

METHODS

Data of amikacin as a model drug were collected from 42 neonates with 142 serum samples. A one-compartment open model was used to describe the kinetics of amikacin after the intravenous infusion. Following Sheiner's idea of population pharmacokinetics, we made the programs to evaluate population parameter and individual parameter. The target function minimality was obtained from Monte Carlo algorithm. The validation of the population analysis was performed using classic pharmacokinetic program 3p87 for antithesis. The predictability of the developed method was evaluated by computing precision and accuracy of serum concentration predicted using the parameter estimates.

RESULTS

The stability of our self-made program was good. The population parameters obtained from this approach were in conformity with those from 3p87, and the interindividual variability was relatively small. For the learning sample and the validation sample, predicted and observed concentrations were all close with correlation coefficient 0.995 and 0.990, respectively. Most of predicted errors were found < +/- 1 mg/L, and RMSD and BIAS were 0.58 and -0.07 for the validation sample, respectively. The choice of blood sampling time was an important factor for the predictive performance. An early sampling time after the infusion was observed to be the best sampling time.

CONCLUSION

The estimation program of population parameter and individual parameter made by us ran stably, and allowed us to use sparse data to estimate population pharmacokinetic parameters. It provided accurate estimates of these parameters and satisfactory ability of serum concentration prediction. Therefore, it can be used for the population pharmacokinetic analysis and individualization of dosage regimen.

Lower-dose (13)C-urea breath test to detect Helicobacter pylori infection-comparison between infrared spectrometer and mass spectrometry analysis

BACKGROUND

The expense of the (13)C-urea breath test (UBT) to detect Helicobacter pylori infection is mainly due to the cost of (13)C-urea and the analysis using isotope ratio mass spectrometry (IRMS).

AIM

To test whether a UBT, using a lower dose of urea and lower-priced isotope-selective nondispersive infrared spectrometry (INIS), can preserve diagnostic efficacy in clinical practice.

METHODS

A total of 177 dyspeptic patients received endoscopy for H. pylori culture and histology. All of them received a UBT in which the duplicate baseline, 10 min, and 15 min breath samples after ingestion of 50 mg (13)C-urea were collected to analyse the excess (13)CO(2)/(12)CO(2) ratio (ECR) by IRMS (ABCA, Europa Scientific, UK) and INIS (UBiT-IR200, Photal Otsuka Electronics, Japan), respectively.

RESULTS

Of the 177 patients, 84 were infected and 93 were uninfected with H. pylori. A close correlation of ECR was found between IRMS and INIS (r=0.9829 at 10 min; r=0.9918 at 15 min, P < 0.0001). Analysing the 15-min samples, UBT by both IRMS and INIS achieved the same sensitivity (96. 4%) and specificity (98.9%).

CONCLUSIONS

INIS is as effective as IRMS for UBT, and can use a lower dose of (13)C-urea. This can provide an economic UBT, using the lower-priced INIS and a low dose of (13)C-urea.

Impact of Helicobacter pylori antimicrobial resistance on the outcome of 1-week lansoprazole-based triple therapy

PURPOSE

To determine the effect of Helicobacter pylori antimicrobial resistance on the efficacy of different proton pump inhibitor (PPI)-based triple therapies.

METHODS

One-hundred and twelve dyspeptic patients with H. pylori infection, as demonstrated by positive histology and culture, were randomized to receive one of the three PPI-based triple therapies. The regimens included lansoprazole (L) plus any two of the following three antibiotics: amoxicillin (A), metronidazole (M), and clarithromycin (C); patients were allocated to ALC, MLC, and ALM subgroups. Six weeks after the start of triple therapy, the 13C-urea breath test (UBT) was performed to evaluate the success of H. pylori eradication. Patients with positive UBT results underwent endoscopy for H. pylori culture. The pre- and post-treatment H. pylori isolates were analyzed for initial and acquired resistance using the E-test.

RESULTS

One hundred patients completed the study. The H. pylori eradication rates were 70% (21/30) in the ALM subgroups, 79% (26/33) in the MLC subgroup, and 89% (33/37) in the ALC subgroup. The frequencies of pretreatment H. pylori antimicrobial resistance were 0% for amoxicillin resistance (AR), 32% for metronidazole resistance (MR), and 6% for clarithromycin resistance (CR). For H. pylori isolates with initial MR, the eradication rates in the ALM (40%) and MLC (67%) subgroups were apparently lower than that in the ALC (92%) subgroup. In the ALM and MLC subgroups (i.e., patients who received metronidazole), the eradication failure rate was significantly higher for patients with MR isolates than for patients with metronidazole-susceptible isolates (47% vs 16%, p < 0.05). In the ALC and MLC subgroups (i.e., patients who received clarithromycin), the eradication failure rate was significantly higher for patients with CR isolates than for those with clarithromycin-susceptible isolates (100% vs 11%, p < 0.05).

CONCLUSIONS

The results indicate that H. pylori antimicrobial resistance is relevant to the success of eradication. The high MR but low CR and AR prevalence among H. pylori isolates in this study suggests that PPI-based triple therapy including amoxicillin and clarithromycin may achieve the most favorable eradication rate.

Selection of lower cutoff point of [13C]urea breath test is helpful to monitor H. pylori eradication after proton pump inhibitor-based triple therapy

Our objectives were to test the efficacy of [13C] urea breath test (UBT) for H. pylori infection in patients before and after proton pump inhibitor (PPI) based triple therapy, and thus to trace the optimal cutoff value of UBT to monitor H. pylori eradication; and to analyze the histologic bacterial density and distribution of H. pylori in patients with equivocal UBT. A total of 441 dyspeptic cases patients enrolled and completed the study design, including 120 noninfected and 321 H. pylori-infected patients. All 441 cases had received the same protocol of UBT. in which the baseline and 15-min gas samples after ingestion of 100 mg 13C-labeled urea were analyzed for excess 13CO2/12CO2 ratio (ECR). In addition, a first endoscopy was performed in each patient to evaluate the initial status of H. pylori by culture and histology. Of the 321 H. pylori-infected patients, 286 received a second endoscopy and a second UBT six weeks after completing any one of four regimens of the PPI-based triple therapy to document the success of H. pylori eradication. During both sessions of endoscopy, topographic gastric biopsies for histology were sampled to evaluate the distribution and density of H. pylori. Based on the diagnostic standard by culture and histology, the sensitivity and specificity of the first UBT achieved most optimally was 97.5% and 96.7%, respectively, by setting the cutoff point of ECR at 4.0. In contrast, using the same cutoff point of 4.0, the sensitivity and specificity of the second UBT in patients after therapy achieved just 80% and 97.6%, respectively. By applying cutoff points downward of 4.0, 3.5, 3, and 2.5 for the second UBT, the sensitivity was elevated to 80%, 82.8%, 88.6%, and 94.3%, respectively, while the specificity was preserved at more than 95.2%. The overall eradication rate of H. pylori was 87.8% (251/286). Seven of 35 patients with failure of therapy had equivocal ECR at the second UBT (range 2-5), and this accounted for the false negative result. All seven patients had low bacterial densities, and three patients had bacteria distributed only in high body near the cardia. In conclusion, selection of a lower cutoff value of ECR at 2.5 is helpful to maintain the diagnostic accuracy of UBT for monitoring the H. pylori eradication. The equivocal ECR of UBT after therapy would be related to the low bacterial load and its distribution.

Differential role of beta(1C) and beta(1A) integrin cytoplasmic variants in modulating focal adhesion kinase, protein kinase B/AKT, and Ras/Mitogen-activated protein kinase pathways

The integrin cytoplasmic domain modulates cell proliferation, adhesion, migration, and intracellular signaling. The beta(1) integrin subunits, beta(1C) and beta(1A), that contain variant cytoplasmic domains differentially affect cell proliferation; beta(1C) inhibits proliferation, whereas beta(1A) promotes it. We investigated the ability of beta(1C) and beta(1A) to modulate integrin-mediated signaling events that affect cell proliferation and survival in Chinese hamster ovary stable cell lines expressing either human beta(1C) or human beta(1A). The different cytodomains of either beta(1C) or beta(1A) did not affect either association with the endogenous alpha(2), alpha(V), and alpha(5) subunits or cell adhesion to fibronectin or TS2/16, a mAb to human beta(1). Upon engagement of endogenous and exogenous integrins by fibronectin, cells expressing beta(1C) showed significantly inhibited extracellular signal-regulated kinase (ERK) 2 activation compared with beta(1A) stable cell lines. In contrast, focal adhesion kinase phosphorylation and Protein Kinase B/AKT activity were not affected. Selective engagement of the exogenously expressed beta(1C) by TS2/16 led to stimulation of Protein Kinase B/AKT phosphorylation but not of ERK2 activation; in contrast, beta(1A) engagement induced activation of both proteins. We show that Ras activation was strongly reduced in beta(1C) stable cell lines in response to fibronectin adhesion and that expression of constitutively active Ras, Ras 61 (L), rescued beta(1C)-mediated down-regulation of ERK2 activation. Inhibition of cell proliferation in beta(1C) stable cell lines was attributable to an inhibitory effect of beta(1C) on the Ras/MAP kinase pathway because expression of activated MAPK kinase rescued beta(1C) antiproliferative effect. These findings show that the beta(1C) variant, by means of a unique signaling mechanism, selectively inhibits the MAP kinase pathway by preventing Ras activation without affecting either survival signals stimulated by integrins or cellular interactions with the extracellular matrix. These findings highlight a role for beta(1)-specific cytodomain sequences in maintaining an intracellular balance of proliferation and survival signals.

Prevalence of polyclonal mefA-containing isolates among erythromycin-resistant group A streptococci in Southern Taiwan

A total of 204 nonrepetitive isolates of group A streptococci (GAS), including 107 randomly collected between 1992 and 1995 and 66 and 31 consecutively collected in 1997 and 1998, respectively, from a university hospital in southern Taiwan were examined to determine the prevalence and mechanisms of erythromycin resistance among these isolates. Resistance to erythromycin was detected in 129 isolates (63.2%) by the agar dilution test. Of these, 42 isolates (32.6%) were assigned to the constitutive macrolide, lincosamide, and streptogramin B resistance (cMLS) phenotype, and all carried the ermB gene; 4 (3.1%) were assigned to the inducible MLS resistance (iMLS) phenotype, and all harbored the ermTR gene; and 83 (64.3%) were erythromycin resistant but susceptible to clindamycin (M phenotype), and all possessed the mefA gene. Distributed by years, the rates of erythromycin resistance and different phenotypes were 61.7% (53.0% cMLS, 6.1% iMLS, and 40.9% M phenotype) between 1992 and 1995, 62.1% (12.2% cMLS and 87.8% M phenotype) in 1997, and 71. 0% (9.1% cMLS and 90.9% M phenotype) in 1998. Pulsed-field gel electrophoresis showed that all but 2 cMLS isolates were clonal in origin, and 17 clones were detected among the M-phenotype isolates. These results indicate that the high incidence and increasing rate of erythromycin-resistant GAS in southern Taiwan are due to the prevalence of multiple M-phenotype clones and that clindamycin may be the drug of choice for the treatment of infections with GAS in penicillin-hypersensitive patients in this area.

Protein tyrosine kinases: structure, substrate specificity, and drug discovery

Protein tyrosine kinases (PTKs) play a crucial role in many cell regulatory processes. It is therefore not surprising to see that functional perturbation of PTKs results in many diseases. Despite the diverse primary structure organization of various PTKs, the catalytic or kinase domains of various PTKs as well as that of Ser/Thr kinases are generally conserved. The high resolution crystal structure of a few PTKs has been solved in the last few years. In contrast to the well-defined linear peptide substrate motifs recognized by specific Ser/Thr kinases, the identification of specific substrate motifs for PTK has been slow. It is not until recently that through the use of combinatorial peptide library methods that specific recognition motifs for specific PTKs have begun to emerge. Efficient and specific peptide substrates for some PTKs with Km at the mid microM range have been identified. Based on these peptide substrates, relatively potent (IC50 at the low microM range) and highly selective pseudosubstrate-based peptide inhibitors have been developed. There has been enormous effort in the development of PTK inhibitors for diseases such as cancer, psoriasis, and osteoporosis. Several new high-throughput PTK assay technologies have recently been described. Small molecules against specific PTK have been developed. Most of them are competitive inhibitors at the ATP binding site. Some of these inhibitors have already been in clinical trial.

Prevalence of SHV-12 among clinical isolates of Klebsiella pneumoniae producing extended-spectrum beta-lactamases and identification of a novel AmpC enzyme (CMY-8) in Southern Taiwan

Twenty (8.5%) of 234 nonrepetitive clinical isolates of Klebsiella pneumoniae from southern Taiwan were found to produce extended-spectrum beta-lactamases (ESBLs): 10 strains produced SHV-12, 4 produced SHV-5, 2 produced a non-TEM non-SHV ESBL with a pI of 8.3, 3 produced a novel AmpC beta-lactamase designated CMY-8 with a pI of 8.25, and 1 produced SHV-12 and an unidentified AmpC enzyme with a pI of 8.2. The CMY-8 enzyme confers a resistance phenotype similar to CMY-1 and MOX-1, and sequence comparisons showed high homologies (>95%) of nucleotide and amino acid sequences among these three enzymes. Plasmid and pulse-field gel electrophoresis analyses revealed that all isolates harboring an SHV-derived ESBL were genetically unrelated, indicating that dissemination of resistance plasmids is responsible for the spread of SHV ESBLs among K. pneumoniae in this area. All three isolates carrying CMY-8 had identical genotypic patterns, suggesting the presence of an epidemic strain.

Two-dimensional peptide mapping of cross-linked type IX collagen in human cartilage

Type IX collagen is a quantitatively minor component of hyaline cartilage that is essential for the normal structural integrity of the tissue. Purification and analysis are difficult because the mature protein is insoluble as a cross-linked integral component of the fibrillar matrix. In order to view a peptide map of the total pool of type IX collagen in a cartilage sample, a selective method based on Western blot analysis was developed for displaying collagen IX peptides in a cyanogen bromide digest of tissue. Digests were partially resolved by reverse-phase HPLC, individual fractions were run on SDS-PAGE and then transblotted to membrane, and the collagen IX fragments were revealed using an anti-collagen IX rabbit antiserum. All major CB-peptides from alpha1(IX), alpha2(IX), and alpha3(IX) chains in the resulting two-dimensional display were identified by amino-terminal sequence analysis. Cross-linked peptides originating from sites of covalent interaction between collagen types IX and II and between IX and IX were also defined. By comparison with an analysis of soluble type IX collagen from chondrocyte culture medium, the results showed that the pool of type IX collagen molecules in fetal and adult human cartilage is extensively cross-linked intermolecularly at sites previously revealed by other methods using purified protein. This sensitive, direct method has the potential to screen for abnormalities in the content and properties of type IX collagen in tissue samples, for example, in the study of heritable chondrodysplasia syndromes and the pathogenesis of cartilage destruction in osteoarthritis.

Surgical treatment of full thickness rotator cuff tear in patients younger than 40 years

BACKGROUND

Full thickness tear of the rotator cuff is a well-known entity in the middle-aged and elderly population and the results of surgical repair are well documented. Rotator cuff tear in patients under the age of 40 years is unusual and the cause and treatment are not well established. The present study reports 12 young patients with full thickness tear of the rotator cuff treated surgically.

METHODS

Open anteroinferior acromioplasty and cuff repairs were performed on every patient after failure of nonsurgical treatment. The average follow-up was 59.5 months (range, 36-100 months).

RESULTS

The average patient age at the time of surgery was 30.2 years (range, 17-39 years). Symptoms included pain and dysfunction in all patients and weakness in eight patients. The duration of symptoms before surgery ranged from 6 to 60 months (average, 22.8 months). Ten patients were able to return to their preinjury status within an average of 4.5 months (range, 3-9 months) after surgery. Three athletes were able to return to previous levels of competition. Nine patients had excellent functional results with regard to pain, motion, strength, function and satisfaction. Eleven patients were satisfied with the operation and had significant pain reduction compared with their preoperative status.

CONCLUSIONS

An acute traumatic event was the etiology of the rotator cuff tears in this study. The results of surgical treatment in this younger group of patients were satisfactory and were comparable to the outcomes reported for surgical treatment of rotator cuff tears in older patients and athletes.

The gene cloning and sequencing of Bm-12, a chlorotoxin-like peptide from the scorpion Buthus martensi Karsch

According to the known amino acid sequence of Bm-12, a short chain insect neurotoxin from the venom of the scorpion Buthus martensi Karsch (BmK) with considerable primary sequence homology to chlorotoxin, the gene specific primers were designed and synthesized for 3' and 5'RACE (Rapid Amplification of cDNA Ends). The two partial cDNA fragments obtained by 3' and 5'RACE were cloned and sequenced, and the full length cDNA sequence of Bm-12 was then completed by overlapping these two partial cDNA sequences. The predicted amino acid sequence consists of 59 amino acid residues including a putative signal peptide of 24 residues and a mature toxin of 35 residues. The predicted amino acid sequence of Bm-12 was almost consistent with the determined, different only in one residue at position 27, Lys was replaced by Gly. Based on the determined cDNA sequence, and using the total DNA isolated from the scorpion venom glands as a template, the genomic DNA of Bm-12 was also amplified by PCR and sequenced. The genomic DNA sequence revealed an intron of 93 bp present within the signal peptide region.

Multicenter surveillance of antimicrobial resistance of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in Taiwan during the 1998-1999 respiratory season

A susceptibility surveillance study of 276 isolates of Streptococcus pneumoniae, 301 of Haemophilus influenzae, and 110 of Moraxella catarrhalis was carried out from November 1998 to May 1999 in Taiwan. High rates of nonsusceptibility to penicillin (76%), extended-spectrum cephalosporins (56%), azithromycin (94%), clarithromycin (95%), and trimethoprim-sulfamethoxazole (TMP-SMX) (65%) for S. pneumoniae isolates and high rates of nonsusceptibility to amoxicillin (58%) and TMP-SMX (52%) for H. influenzae isolates were found. Higher percentages of S. pneumoniae isolates nonsusceptible to aminopenicillins, extended-spectrum cephalosporins, macrolides, and TMP-SMX were observed among penicillin-intermediate and -resistant isolates. All quinolones tested were active in vitro against these three organisms.

Comparison of the MB/BacT and BACTEC MGIT 960 system for recovery of mycobacteria from clinical specimens

A total of 543 specimens were cultured in parallel with the MB/BacT and BACTEC MGIT 960 systems and on the conventional solid media. Mycobacteria were identified from 95 (17.5%) specimens, including 63 (66.3%) Mycobacterium tuberculosis and 32 (33.7%) nontuberculous mycobacteria. The recovery rates for the MB/BacT, MGIT 960, and solid media were 91.6, 87.4, and 54.7%, respectively, for all mycobacteria; the recovery rates were 93.6, 88.9, and 63.4%, respectively, for M. tuberculosis complex alone, and 87.5, 84.4, and 37.5%, respectively, for all nontuberculous mycobacteria. The mean times to detection of all mycobacteria by individual systems were 13. 9, 8.7, 31.7 days for the MB/BacT, MGIT 960 and solid media, respectively, 13.9, 9.3, 32.9 days for M. tuberculosis alone, and 14. 1, 8.1, 27.2 days for all nontuberculous mycobacteria. The contamination rates of the MB/BacT and MGIT 960 were 10.2 and 5.4%, respectively. With regard to detection times and recovery rates, both automated systems are superior to the conventional media (all p < 0.005). As compared to the MB/BacT, the MGIT 960 detected mycobacterial growth more rapidly (p < 0.001), and had a lower contamination rate (p = 0.003); however, there was no statistically significant difference in recovery rates between these two systems. These results indicate that both MGIT 960 and MB/BacT systems are rapid, sensitive, and efficient methods for the recovery of mycobacteria from clinical specimens.

Clinical features and therapeutic implications of 104 episodes of monomicrobial Aeromonas bacteraemia

OBJECTIVES

Aeromonas bacteraemia is not a common infectious disease, but can cause a grave outcome in infected cases. In this study, clinical presentations and prognostic factors of cases of monomicrobial Aeromonas bacteraemia were analysed. Also, the impact of beta-lactam and aminoglycoside in combination and of emerging cephalosporin-resistance during therapy was discussed.

METHODS

From 1989 to 1998 in a medical centre in southern Taiwan, those cases with monomicrobial Aeromonas bacteraemia were included for study.

RESULTS

A total of 104 episodes of monomicrobial Aeromonas bacteraemia, accounting for 74% of all Aeromonas bacteraemia, were encountered. The infections usually occurred in the patients with hepatic cirrhosis (54%) or malignancy (21%) and were community-acquired (74%). Cases of community-acquired bacteraemia were more likely to have cirrhosis, a high severity score at onset, and a worse prognosis than those of nosocomial bacteraemia did and nosocomial isolates were less susceptible to cefoxitin and cefotaxime. Forty-three percent of cases had a concomitant infection focus, such as primary peritonitis, invasive cellulitis or necrotizing fasciitis, biliary tract or burn wound infections. Crude fatality rate within 2 weeks after the onset was 30%. Secondary bacteraemia and a higher severity score ( > or = 4) for illness at the first presentation were independently associated with a fatal outcome. The therapeutic superiority of beta-lactam and aminoglycoside in combination cannot be demonstrated in patients with Aeromonas bacteraemia. Cefotaxime resistance emerged in 3.4% of 58 patients treated with a cephalosporin for at least 72 h. None of the community-acquired isolates, but one-quarter of the nosocomial isolates, were resistant to cefotaxime.

CONCLUSIONS

Aeromonas bacteraemia usually occurred in patients with liver cirrhosis or malignancy, and heralded a poor prognosis, especially while associated with a relevant infectious source or with a higher severity score at presentation. The superiority of aminoglycoside and beta-lactam in combination cannot be demonstrated while treating those patients, and the emergence of antimicrobial resistance to cephalosporin was a rare event during cephalosporin therapy. Thus, a broad-spectrum cephalosporin remains one of the antimicrobial alternatives for invasive community-acquired Aeromonas infections.

Autoreactivity against matrilin-1 in a patient with relapsing polychondritis

Relapsing polychondritis (RP) is a rare inflammatory disease of cartilage. Chondritis of the auricular, nasal, and tracheal cartilages predominates in this disease, suggesting a response to a tissue-specific antigen. One potential antigen is matrilin-1, a cartilage matrix protein found uniquely in the tracheal, auricular, and nasal cartilage of adults. We describe herein a patient with RP who had both a humoral and a cellular immune response directed toward the cartilage matrix protein matrilin-1.

Rapid dissemination of Staphylococcus aureus with classic oxacillin resistance phenotype at a new university hospital

To determine the prevalence rates of oxacillin-resistant Staphylococcus aureus (ORSA) at a new university hospital since its opening, the results of disk diffusion tests on all clinical isolates, recovered between 1990 and 1998 at the National Cheng Kung University Hospital, were reviewed. In order, to investigate the mechanisms of oxacillin resistance among strains of S. aureus in Taiwan, MICs were determined by an agar dilution method, and polymerase chain reaction and colony hybridization assays were performed on 288 isolates collected during November 1998 to detect the mecA gene. The prevalence rates of ORSA increased rapidly from 14.1% in 1990 to 61.0% in 1998. The increasing rates were most rapid in the first four-year period, ranging from 11.6 to 106.7% per year, and became steady after 1994, ranging from 1.8% to 11.6%. Of 288 clinical isolates collected in November 1998, 206 (71.5%) were resistant to oxacillin (MIC >/= 16 mg/L), and four were borderline resistant (MIC 2-8 mg/L). All 210 strains possessed the mec A gene (classic resistance). The present study demonstrated that ORSA could disseminate in a new hospital with great speed, and indicated that all ORSA strains in Taiwan revealed classic resistance phenotype.

Development of the interstitial cell of Cajal: origin, kit dependence and neuronal and nonneuronal sources of kit ligand

Kit is a marker for interstitial cells of Cajal (ICC). ICCs interact with enteric neurons and are essential for gastrointestinal motility. The roles of neural crest-derived cells, neurons, Kit, and Kit ligand (KL) in ICC development were analyzed. ICC development lagged behind that of neurons and smooth muscle. Although mRNA encoding Kit and KL was detected at E11, Kit-immunoreactive ICCs did not appear until E12 in foregut and E14 in terminal hindgut. Transcripts of Kit and KL and Kit-immunoreactive cells were found in aganglionic gut from ls/ls and c-ret -/- mice. ICCs also developed in crest-free cultures of ls/ls terminal colon. ICCs appeared in cultures of noncrest- but not those of crest-derived cells isolated from the fetal bowel by immunoselection with antibodies to p75(NTR). KL immunoreactivity was coincident in cells with neuronal or smooth muscle markers. The development of ICCs in cultures of mixed cells dissociated from the fetal gut was dependent on plating density. No ICCs appeared at </=80,000 cells/ml, but many cells, including filamentous ICCs, appeared at >/=200,000 cells/ml. Exogenous KL partially substituted for a high plating density. These data support the ideas that mammalian ICCs are neither derived from the neural crest nor developmentally dependent on neurons. ICC differentiation/survival requires KL, which can be provided by neurons or cells in a smooth muscle lineage. Neurons may be needed for development of myenteric ICCs and the mature ICC network.

Development of the interstitial cell of Cajal: origin, kit dependence and neuronal and nonneuronal sources of kit ligand

Kit is a marker for interstitial cells of Cajal (ICC). ICCs interact with enteric neurons and are essential for gastrointestinal motility. The roles of neural crest-derived cells, neurons, Kit, and Kit ligand (KL) in ICC development were analyzed. ICC development lagged behind that of neurons and smooth muscle. Although mRNA encoding Kit and KL was detected at E11, Kit-immunoreactive ICCs did not appear until E12 in foregut and E14 in terminal hindgut. Transcripts of Kit and KL and Kit-immunoreactive cells were found in aganglionic gut from ls/ls and c-ret -/- mice. ICCs also developed in crest-free cultures of ls/ls terminal colon. ICCs appeared in cultures of noncrest- but not those of crest-derived cells isolated from the fetal bowel by immunoselection with antibodies to p75(NTR). KL immunoreactivity was coincident in cells with neuronal or smooth muscle markers. The development of ICCs in cultures of mixed cells dissociated from the fetal gut was dependent on plating density. No ICCs appeared at </=80,000 cells/ml, but many cells, including filamentous ICCs, appeared at >/=200,000 cells/ml. Exogenous KL partially substituted for a high plating density. These data support the ideas that mammalian ICCs are neither derived from the neural crest nor developmentally dependent on neurons. ICC differentiation/survival requires KL, which can be provided by neurons or cells in a smooth muscle lineage. Neurons may be needed for development of myenteric ICCs and the mature ICC network.

Development of the interstitial cell of Cajal: origin, kit dependence and neuronal and nonneuronal sources of kit ligand

Kit is a marker for interstitial cells of Cajal (ICC). ICCs interact with enteric neurons and are essential for gastrointestinal motility. The roles of neural crest-derived cells, neurons, Kit, and Kit ligand (KL) in ICC development were analyzed. ICC development lagged behind that of neurons and smooth muscle. Although mRNA encoding Kit and KL was detected at E11, Kit-immunoreactive ICCs did not appear until E12 in foregut and E14 in terminal hindgut. Transcripts of Kit and KL and Kit-immunoreactive cells were found in aganglionic gut from ls/ls and c-ret -/- mice. ICCs also developed in crest-free cultures of ls/ls terminal colon. ICCs appeared in cultures of noncrest- but not those of crest-derived cells isolated from the fetal bowel by immunoselection with antibodies to p75(NTR). KL immunoreactivity was coincident in cells with neuronal or smooth muscle markers. The development of ICCs in cultures of mixed cells dissociated from the fetal gut was dependent on plating density. No ICCs appeared at </=80,000 cells/ml, but many cells, including filamentous ICCs, appeared at >/=200,000 cells/ml. Exogenous KL partially substituted for a high plating density. These data support the ideas that mammalian ICCs are neither derived from the neural crest nor developmentally dependent on neurons. ICC differentiation/survival requires KL, which can be provided by neurons or cells in a smooth muscle lineage. Neurons may be needed for development of myenteric ICCs and the mature ICC network.

Genomic organization of three novel toxins from the scorpion Buthus martensi Karsch that are active on potassium channels

The cDNA and genomic DNA of three novel toxins from the scorpion Buthus martensi Karsch that are active on K(+) channels, designated BmKTX (where KTX is kaliotoxin), BmTX1 and BmTX2, were cloned and sequenced. On the basis of their known amino acid sequences, gene-specific primers for 3' and 5' rapid amplification of cDNA ends (RACE) were designed and synthesized. By overlapping the two partial cDNA sequences obtained by 3' and 5' RACE, their full-length cDNA sequences were completed. BmKTX encodes a signal peptide of 22 amino acid residues and a mature toxin of 38 residues, whereas BmTX1 and BmTX2 encode signal peptides of 20 and 21 residues respectively and a mature toxin of 38 residues for each. Their cDNA-deduced amino acid sequences were totally consistent with those determined except that the C-terminus of BmKTX had an additional Gly residue, which was removed during post-translational processing and was indispensable for the amidation of its C-terminal Lys residue. In addition, the first deduced amino acid for both BmTX1 and BmTX2 is Gln instead of pyro-Glu in the reported toxins, which obviously also undergoes post-translational processing. The genomic DNA species of these three toxins were also amplified by PCR, then cloned and sequenced. They all consisted of two exons disrupted by a small single intron. All of these introns were inserted within the signal peptides at position -6 for BmKTX and at position -5 for both BmTX1 and BmTX2 upstream of the mature toxins, and consisted of 87, 87 and 80 bp respectively.

Development of the interstitial cell of Cajal: origin, kit dependence and neuronal and nonneuronal sources of kit ligand

Kit is a marker for interstitial cells of Cajal (ICC). ICCs interact with enteric neurons and are essential for gastrointestinal motility. The roles of neural crest-derived cells, neurons, Kit, and Kit ligand (KL) in ICC development were analyzed. ICC development lagged behind that of neurons and smooth muscle. Although mRNA encoding Kit and KL was detected at E11, Kit-immunoreactive ICCs did not appear until E12 in foregut and E14 in terminal hindgut. Transcripts of Kit and KL and Kit-immunoreactive cells were found in aganglionic gut from ls/ls and c-ret -/- mice. ICCs also developed in crest-free cultures of ls/ls terminal colon. ICCs appeared in cultures of noncrest- but not those of crest-derived cells isolated from the fetal bowel by immunoselection with antibodies to p75(NTR). KL immunoreactivity was coincident in cells with neuronal or smooth muscle markers. The development of ICCs in cultures of mixed cells dissociated from the fetal gut was dependent on plating density. No ICCs appeared at </=80,000 cells/ml, but many cells, including filamentous ICCs, appeared at >/=200,000 cells/ml. Exogenous KL partially substituted for a high plating density. These data support the ideas that mammalian ICCs are neither derived from the neural crest nor developmentally dependent on neurons. ICC differentiation/survival requires KL, which can be provided by neurons or cells in a smooth muscle lineage. Neurons may be needed for development of myenteric ICCs and the mature ICC network.

Identification of a high-affinity anti-phosphoserine antibody for the development of a homogeneous fluorescence polarization assay of protein kinase C

In the last few years, fluorescence polarization (FP) has been applied to the development of robust, homogeneous, high throughput assays in molecular recognition research, such as ligand-protein interactions. Recently, this technology has been applied to the development of homogeneous tyrosine kinase assays, since there are high-affinity anti-phosphotyrosine antibodies available. Unlike tyrosine kinases, application of FP to assay development for serine/threonine kinases has been impeded because of lack of high-affinity anti-phosphoserine/threonine antibodies. In the present study, we report the discovery of a high-affinity, monoclonal anti-phosphoserine antibody, 2B9, with a Kd of 250 +/- 34 pM for a phosphoserine-containing peptide tracer, fluorescein-RFARKGS(PO(4))LRQKNV. Our data suggest that 2B9 is selective for fluorescein-RFARKGS(PO(4))LRQKNV. The antibody and tracer have been used for the development of a competitive FP assay for protein kinase C (PKC) in 384-well plates. Phosphatidylserine, which enhances the kinase activity of PKC in a Ca(2+)-dependent manner and has a structure similar to that of phosphoserine, did not interfere with binding of the peptide tracer to the antibody in the FP assay. The data indicate that the FP assay is more sensitive and robust than the scintillation proximity assay for PKC. The FP assay developed here can be used for rapid screening of hundreds of thousands of compounds for discovery of therapeutic leads for PKC-related diseases.

Measurement of cdk4 kinase activity using an affinity peptide-tagging technology

Cyclin-dependent kinases such as Cdk4 are involved in the control of cell cycle progression, and misregulation of Cdk4 has been implicated in many types of cancers. In the present study, we report the development of a novel homogeneous assay using an affinity peptide-tagging technology for rapidly discovering Cdk4 inhibitors. The DNA sequence encoding a streptavidin recognition motif, or StrepTag (AWRHPQFGG), was cloned and expressed at the C-terminus of a fusion protein of a 152-amino acid hyperphosphorylation domain (Rb152) of the retinoblastoma protein (Rb) linked to GST at the N-terminus. This affinity peptide-tagged protein (GST-Rb152-StrepTag), which contains the two known phosphorylation sites of Rb, specifically phosphorylated by Cdk4 in vivo, was used as a substrate in the current in vitro kinase assay. After phosphorylation, scintillation proximity assay (SPA) scintillant beads coated with streptavidin were added. Radiolabeled GST-Rb152-StrepTag was brought in close proximity to the SPA scintillant beads through the interaction between StrepTag and streptavidin, resulting in the emission of light from beads. By applying the affinity peptide-tagging technology, we have eliminated the separation and wash steps which are normally required in a radioactive filtration assay. Therefore, this homogeneous method is simple, robust, and highly amenable to high-throughput screening of Cdk4-specific inhibitors. Furthermore, the affinity peptide tagging technique reported here is a simple, generic method that can be applied to many recombinant proteins for the development of kinase and protein-protein interaction assays.

A mutation in the alpha 3 chain of type IX collagen causes autosomal dominant multiple epiphyseal dysplasia with mild myopathy

Multiple epiphyseal dysplasia (MED) is a degenerative cartilage condition shown in some cases to be caused by mutations in genes encoding cartilage oligomeric matrix protein or type IX collagen. We studied a family with autosomal dominant MED affecting predominantly the knee joints and a mild proximal myopathy. Genetic linkage to the COL9A3 locus on chromosome 20q13.3 was established with a peak log(10) odds ratio for linkage score of 3.87 for markers D20S93 and D20S164. Reverse transcription-PCR performed on the muscle biopsy revealed aberrant mRNA lacking exon 3, which predicted a protein lacking 12 amino acids from the COL3 domain of alpha3(IX) collagen. Direct sequencing of genomic DNA confirmed the presence of a splice acceptor mutation in intron 2 of the COL9A3 gene (intervening sequence 2, G-A, -1) only in affected family members. By electron microscopy, chondrocytes from epiphyseal cartilage exhibited dilated rough endoplasmic reticulum containing linear lamellae of alternating electron-dense and electron-lucent material, reflecting abnormal processing of mutant protein. Type IX collagen chains appeared normal in size and quantity but showed defective cross-linking by Western blotting. The novel phenotype of MED and mild myopathy is likely caused by a dominant-negative effect of the exon 3-skipping mutation in the COL9A3 gene. Patients with MED and a waddling gait but minimal radiographic hip involvement should be evaluated for a primary myopathy and a mutation in type IX collagen.