Percutaneous liver biopsy in adult haemophiliacs with hepatitis C virus: safety of outpatient procedure and impact of human immunodeficiency virus coinfection on the spectrum of liver disease

Both HCV and HIV are common in haemophiliacs previously treated with non-viral-inactivated clotting factor concentrates. Because of increased bleeding risks, little data are available on the safety of percutaneous outpatient liver biopsy (LBx) and impact of HIV coinfection in this population. This study aims at reporting our experience with percutaneous LBx in a cohort of haemophiliacs infected with HCV and describe the spectrum of disease and impact of HIV coinfection. A retrospective review of consecutive patients with haemophilia and HCV who underwent percutaneous LBx was performed. All patients were positive for HCV RNA by commercial assay and received factor concentrate prior to biopsy. A total of 29 male patients (mean age 36, 24 haemophilia A, five haemophilia B, and 44% coinfected with HIV) underwent successful outpatient percutaneous LBx without bleeding complication. Histologic activity index was 6.44 with advanced fibrosis (bridging fibrosis/cirrhosis) in 31%. When patients were stratified by HIV positive (n = 13) vs. HIV negative (n = 16), coinfected patients had higher fibrosis scores and higher proportion advanced fibrosis (54% vs. 12%; P = 0.0167) with no differences in age, demographic or other laboratory parameters. Multivariate logistic regression found that HIV positivity was independently associated with advanced fibrosis (OR = 3.7; 95% CI: 1.17-11.8; P = 0.026). Outpatient percutaneous LBx can be safely performed in patients with haemophilia. Despite similar age, HIV coinfection was an independent predictor of advanced fibrosis. These data support the hypothesis that HIV accelerates fibrosis progression in those coinfected with HCV and highlights the importance of liver histology in this population.

Developmental changes in the glycosylation of glycoprotein hormone free alpha subunit during pregnancy

Glycoprotein hormone alpha subunit, in its free form (free alpha), is a major placental product. Its glycosylation was found to change dramatically during the advancement of pregnancy. In this study, we have analyzed these glycosylation changes in five normal pregnancies. Binding to Lens culinaris lectin increased dramatically in all subjects between weeks 14 and 17 from the last menstrual period, indicating more core fucosylation as well as possible changes in branching of glycans. Studies using Datura stramonium agglutinin confirmed that the type of triantennary branching changed in this period of pregnancy. The precise structural nature of these changes was determined by high-pH anion-exchange chromatography and electrospray ionization mass spectrometry. Amounts of core fucosylation and of triantennary glycans increased substantially from early to late second trimester, and a shift was observed from 1-->4/1-->3- toward predominantly 1-->6/1-->6-branched triantennary structures. The glycosylation changes occurred in all five individuals at the same time period in gestation, suggesting developmental regulation of N-acetylglucosaminyltransferases IV and V and alpha6-fucosyltransferase during normal pregnancy. These enzymatic activities also appear to be affected in malignant transformation of the trophoblast. Our findings have important implications for the proposed use of specific forms of glycosylation as markers for cancer, as the relative amounts of these glycans in normal pregnancy will be determined by gestational age.

Human endometrial stromal cells generate uncombined alpha-subunit from human chorionic gonadotropin, which can synergize with progesterone to induce decidualization

During the secretory phase of the menstrual cycle, endometrial stromal cells differentiate into decidual cells, which play a crucial role in implantation and maintenance of pregnancy. In this and our previous study, we demonstrate that glycoprotein hormone free alpha-subunit potentiates progesterone-mediated decidualization of human endometrial stromal cells in vitro. Although addition of intact hCG to cultures resulted in stimulatory activity, its potency was 20-fold less than that of alpha-subunit. However, in the present study we show that decidualizing endometrial cells actively generate uncombined alpha-subunit by dissociating hCG. The amount of dissociated alpha-subunit could fully account for the stimulatory activity observed with hCG. Active dissociation of hCG was dependent on the presence of endometrial cells and did not occur in conditioned medium, excluding involvement of a stable secreted factor such as a protease. In addition to dissociated alpha- and beta-subunits, minor amounts of beta-core and alpha-fragments were detected as degradation products during active dissociation. We also observed an increase in beta-immunoreactivity that coeluted with hCG on size-exclusion gel chromatography, indicating that a portion of the still dimeric hCG may have been nicked in the dissociation process. However, using an assay with specificity for nicked hCG, we showed that dissociation of hCG was not produced from a pool of preexisting nicked hCG. These findings more firmly establish the concept that gonadotropin hormone free alpha-subunit plays a role in the regulation of human endometrial cell differentiation. In addition, identification of the various products formed by incubation of hCG with decidualizing cells yielded insight into the mechanism of hCG degradation, and may explain some activity previously ascribed to hCG.

Cardiovascular effects of nifedipine in the dog

This study was designed to measure certain cardiovascular effects of 2 or 11 micrograms nifedipine/kg body weight given intravenously to dogs anesthetized with fentanyl-droperidol-pentobarbital. Parameters measured were: cardiac output, stroke volume, stroke work, systemic arterial pressure and vascular resistance, splenic weight (a measure of venous capacitance), and fractionation of cardiac output to many tissues. In response to doses of nifedipine, systemic vascular resistance decreased, cardiac output and flows to most organs increased, and heart rate, stroke work, and splenic capacitance were unchanged. The flow to the diaphragm increased more than that to other organs.

Mechanisms and pathways of aniline elimination from aquatic environments

The fate of aniline, a representative of arylamine pollutants derived from the manufacture of dyes, coal liquefaction, and pesticide degradation, was comprehensively evaluated by use of unpolluted and polluted pond water as model environments. Evaporation plus autoxidation proved to be minor elimination mechanisms, removing ca. 1% of the added aniline per day. Instantaneous binding to humic components of a 0.1% sewage sludge inoculum removed 4%. Biodegradation of aniline in pond water was accelerated by the sewage sludge inoculum. A substantial portion of the degraded aniline carbon was mineralized to CO2 within a 1-week period, and microbial biomass was formed as a result of aniline utilization. Biodegradation was clearly the most significant removal mechanism of polluting aniline from pond water. A gas chromatographic-mass spectrometric analysis of biodegradation intermediates revealed that the major pathway of aniline biodegradation in pond water involved oxidative deamination to catechol, which was further metabolized through cis,cis-muconic, beta-ketoadipic, levulinic, and succinic acid intermediates to CO2. Minor biodegradation pathways involved reversible acylation to acetanilide and formanilide, whereas N-oxidation resulted in small amounts of oligomeric condensation products.

Purification of a pregnenolone-binding protein in the soluble fraction of the guinea-pig adrenal cortex: differentiation from pregnenolone sulfotransferase

A pregnenolone-binding protein has been purified from the 235,000 g soluble fraction of the guinea-pig adrenal cortex. The binding protein had an apparent molecular weight of 34,000 when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Since the functional status of the pregnenolone-binding protein is not known, a search for intrinsic catalytic activity was made. Because the binding protein is known to be a soluble protein consideration of a soluble enzyme activity was made which led to an investigation of the enzyme 3B-steroid sulfotransferase. Pregnenolone sulfotransferase activity, however, which was present in the soluble fraction, was found to be distinguishable from the pregnenolone-binding protein. Although the physicochemical distinction between these two factors was consistently noted with numerous experiments, it is speculated that there may exist a specific functional interaction between them. It was particularly interesting that both factors were concentrated in the inner cortical zone.

Functional differences between the outer and inner zones of the guinea pig adrenal cortex

The guinea pig adrenal cortex is grossly composed of two regions: an outer, yellow zone and an inner, brown zone. These zones, which represent 33% and 66% of the total adrenocortical volume, respectively, can be separated by blunt dissection. It has been previously reported that specific pregnenolone and pregnenolone sulfate binding proteins are present in the high speed supernatant fraction (cytosol) prepared from the whole adrenal cortex of the guinea pig. However, when cytosol was prepared from the separate outer and inner cortical zones, it was found that the steroid-binding proteins were concentrated in the inner zone. This correlated with the level of pregnenolone which was significantly greater in the cytosol of the inner zone where greater than 50% was found to be bound. In contrast, the concentration of cortisol was 30 times greater in the cytosol of the outer cortical zone and less than 4% was found to be bound. These data suggest that cortisol is produced primarily in the outer cortical zone, a region which comprises only one-third of the total cortical volume. On the other hand, the coexistence of pregnenolone and its binding protein in the inner cortical zone, a region which comprises two-thirds or the greatest cortical volume, indicates a different functional status for this zone. The exact hormonal control of these two vastly different regions (chromatically, morphologically, and functionally) remains to be determined. It is speculated that the inner cortical zone of the adult guinea pig adrenal is the counterpart of the fetal cortex which did not involute.