Serine protease inhibitor-6 differentially affects the survival of effector and memory alloreactive CD8-T cells

The clonal expansion of effector T cells and subsequent generation of memory T cells are critical in determining the outcome of transplantation. While cytotoxic T lymphocytes induce direct cytolysis of target cells through secretion of Granzyme-B (GrB), they also express cytoplasmic serine protease inhibitor-6 (Spi6) to protect themselves from GrB that has leaked from granules. Here, we studied the role of GrB/Spi6 axis in determining clonal expansion of alloreactive CD8-T cells and subsequent generation of memory CD8-T cells in transplantation. CD8-T cells from Spi6(-/-) mice underwent more GrB mediated apoptosis upon alloantigen stimulation in vitro and in vivo following adoptive transfer into an allogeneic host. Interestingly, while OT1.Spi6(-/-) CD8 T cells showed significantly lower clonal expansion following skin transplants from OVA mice, there was no difference in the size of the effector memory CD8-T cells long after transplantation. Furthermore, lack of Spi6 resulted in a decrease of short-lived-effector-CD8-cells but did not impact the pool of memory-precursor-effector-CD8-cells. Similar results were found in heart transplant models. Our findings suggest that the final alloreactive CD8-memory-pool-size is independent from the initial clonal-proliferation as memory precursors express low levels of GrB and therefore are independent of Spi6 for survival. These data advance our understanding of memory T cells generation in transplantation and provide basis for Spi6 based strategies to target effector T cells.

Detection of the common resistance genes in Gram-negative bacteria using gene chip technology

OBJECTIVE

To design a resistance gene detection chip that could, in parallel, detect common clinical drug resistance genes of Gram-negative bacteria.

MATERIALS AND METHODS

Seventy clinically significant Gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa, Acinetobacter baumannii) were collected. According to the known resistance gene sequences, we designed and synthesized primers and probes, which were used to prepare resistance gene detection chips, and finally we hybridized and scanned the gene detection chips.

RESULTS

The results between the gene chip and polymerase chain reaction (PCR) were compared. The rate was consistently 100% in the eight kinds of resistance genes tested (TEM, SHV, CTX-M, DHA, CIT, VIM, KPC, OXA-23). One strain of Pseudomonas aeruginosa had the IMP, but it was not found by gene chip.

CONCLUSION

The design of Gram-negative bacteria-resistant gene detection chip had better application value.

Split-dose administration of thiopurine drugs: a novel and effective strategy for managing preferential 6-MMP metabolism

BACKGROUND

Mercaptopurine and azathioprine (AZA) are efficacious in treating IBD. 6-tioguanine (6-TGN) levels correlate with therapeutic efficacy, whereas high 6-methylmercaptopurine (6-MMP) levels are associated with hepatotoxicity and myelotoxicity. Some IBD patients exhibit dose-limiting preferential 6-MMP production, which may lead to undesired side effects and impact efficacy.

AIM

To review the outcomes of thiopurine split-dosing in patients with preferential 6-MMP metabolism.

METHODS

A retrospective chart review of 179 IBD patients treated at the Cedars-Sinai IBD Center with AZA or mercaptopurine was performed. Preferential 6-MMP metabolisers with 6-MMP levels greater than 7000 pmol/8 × 10(8) erythrocytes who underwent split-dosing were identified and assessed for biochemical and clinical responses to these dose modifications.

RESULTS

A total of 20 of 179 patients met the criteria for preferential 6-MMP metabolism and underwent thiopurine split-dosing. Dividing the total daily thiopurine dose led to a reduction in 6-MMP levels (11785 vs. 5324 pmol/8 × 10(8) erythrocytes; P < 0.0001) without negatively affecting clinical disease activity or 6-TGN levels (239 vs. 216 pmol/8 × 10(8) erythrocytes; P = N.S.) and led to resolution of 6-MMP associated side effects (elevated transaminases, leucopenia and flu-like symptoms) in all but two patients. After mean follow-up of 36 months, 12 patients remained in clinical remission on split-dose mercaptopurine. Five of the remaining eight patients escalated to anti-TNF therapy, two progressed to surgery, and one switched to tioguanine therapy.

CONCLUSION

Split-dose administration of mercaptopurine/AZA represents an alternative option in IBD patients with preferential 6-MMP metabolism who might otherwise require steroid exposure or escalation of therapy.

Genomic studies of GVHD-lessons learned thus far

GVHD remains the most significant complication of hematopoietic SCT, despite advances in HLA matching and the identification of risk various factors. To account for the variation in the incidence and severity of this disease, many genetic association studies have been performed in order to explore the role of immunoregulatory gene polymorphisms. These genes include those that encode cytokines, chemokines, and costimulatory molecules. Polymorphisms in other classes of genes such as those involved in drug metabolism, protein folding, and DNA replication have also been studied. In this review, we address the current knowledge of the role of genetic polymorphisms in GVHD. We also discuss the potential pitfalls inherent in genetic association testing and alternative strategies to address these problems.

Spectral broadening of sound scattered by advecting atmospheric turbulence

Scattering and spectral broadening of a monochromatic sound wave by atmospheric turbulence that is flowing with a uniform constant horizontal wind is considered. The acoustic source and a detector are at rest and at different positions in a ground-fixed frame. Analytic expressions are derived for the sound pressure scattered to the detector by a single eddy. Since distances and the scattering angle change with time as the eddy flows through the scattering volume, the detector signal has time-dependent amplitude and frequency, for which general formulas are derived. A computer code is developed that calculates the scattered signal and its Fourier transform from a single eddy, or from a steady-state collection of eddies of many different scale lengths that represents isotropic homogeneous turbulence flowing with the wind. The code utilizes a time-shift algorithm that reduces the calculation time substantially. Several numerical results from this code are presented, including simulations of a recent experiment. The predicted spectral shape, including peak width and jaggedness, are in good agreement with experiment.

In vitro and in vivo correlation of the effect of granulocytemacrophage colony-stimulating factor gene transfer on the tumorigenicity and immunogenicity of B16 melanoma

Transduction of murine B16 melanoma cells with a GM-CSF gene, the B16-MG tumor line, showed reduced tumorigenicity. In vitro studies demonstrated no remarkable difference between the parent and transduced tumor lines in their ability to induce secondary response to generate the anti-tumor killer cells (immunogenicity), or in their susceptibility to the killing by anti-tumor killer cells (immunosensitivity). Both CD4(+) and CD8(+) cells were required for the generation of the effecters. Nevertheless the effecters were determined to be Thy1.2(+), CD8(-), and NK1.1(-). At least two antigenic specificities could be defined in the cytolytic reactions. One was a broadly cross-reactive antigen shared by a variety of tumor cells, and the other apparently a tumor-specific antigen which was only present in B16 tumors. Cold target inhibition experiment confirmed these specificities. In the in vivo tumor transplantation study, the B16-MG cell line was not only more immunogenic but also was more immunosensitive than the parent line. More than 50% of the mice which were immunized with B16-MG remained tumor free after challenge with the parent tumor B16, indicating that GM-CSF gene transfer makes an effective tumor vaccine. The in vivo protective effect was specific for B16 tumor, thus only the tumor-specific antigen could function as transplantation antigen. Both CD4(+) and CD8(+) cells were required for providing the in vivo protection. Both the B16 and B16-MG tumor bearing hosts could generate anti-tumor killer cells, hence the development of progressive growth of B16 tumor was not due to the lack of anti-tumor immune response. It appears that the overall effect of in vivo tumor immunity is determined by a complex network of interactions among different compartments of host immune cells and different compartments of host immune cells and different immune-regulatory molecules derived from the host and from the tumor.

A theoretical analysis of a new drug delivery system: a cylindrical device with a vertical opening on its surface

A theoretical analysis of a proposed drug delivery device is presented. The device is of cylindrical shape with an opening on its side surface. Analytical expressions for the temporal variations in the amount of drug released and the size of the unreleased portion of the device are derived. The result of numerical simulation reveals that an approximately zero-order mechanism can be obtained, provided that the device is designed appropriately. The applicability of the analytical expressions derived is justified by examining the release of sodium salicylate embedded in polyethylene. The present work is a generalization of analyses suggested previously for some similar devices.

Evaluation of the quality of bedside monitoring of the blood glucose level in a teaching hospital

We evaluated the precision and accuracy of monitoring of the blood glucose level in the laboratory and at the bedside with one of four glucose meters by an experienced operator and by 39 nurses in a teaching hospital. For precision studies aqueous quality control materials were used. A total of 85 blood samples were tested. The precision of the glucose meters (expressed as the coefficient of variation [CV]) in the hands of the experienced operator ranged from 6.7% to 11.1%. The correlation between the values obtained by the experienced operator and the reference values obtained in the laboratory was high (0.95 to 0.98). The precision of the values obtained by the nurses using the meters ranged from 13.7% on medical wards to 45.7% in the intensive care unit (ICU). The correlation between these values and those obtained in the central laboratory ranged from 0.72 to 0.82. Twenty-four percent of the glucose values determined on medical wards and 62% of those determined in the ICU deviated from the reference value by at least 20%. Of the 85 patients 12 (14%) would have received different insulin dosages had the reference value been available at the same time as the glucose meter reading: in 3 of the patients the discrepancy was 6 units of insulin or greater. Continuous quality control of bedside monitoring of the blood glucose level is needed. In addition, personnel who use glucose meters should receive adequate training.

Inhibition of human monocyte antigen presentation, but not HLA-DR expression, by cyclosporine

The effects of cyclosporine (CsA) on antigen-dependent human T cell proliferation have been studied using tetanus toxoid as the antigen. CsA significantly inhibited antigen-dependent T cell proliferation at concentrations as low as 0.1 microgram/ml. In dissecting this system we found that preexposure of separated monocytes to CsA during the period of antigen processing led to a marked inhibition of proliferation of T cells added subsequently to the monocytes. We investigated whether this suppressive effect on monocyte antigen presentation was related to monocyte HLA-DR expression, interleukin 1 (IL-1) production, or prostaglandin (PG) secretion. None of these functions seemed to be affected by CsA. In particular, human monocyte HLA-DR expression was not inhibited by CsA, even at concentration of 10 micrograms/ml. The addition of exogenous IL-1 or indomethacin did not reverse the inhibitory effects of CsA. These experiments demonstrate that CsA inhibits antigen-dependent human T cell proliferation, at least in part by acting directly on human monocytes to inhibit antigen presentation. The mechanism of action seems to be independent of IL-1 production, PG secretion, and HLA-DR expression.