Triaging of Bone Marrow for Esoteric Testing – Cost-effective and Patient-centric Approach Utilizing WHO Nomenclature for Hematolymphoid Malignancies

Introduction/Objective

Esoteric testing (ES) plays a major role in bone marrow (BM) evaluation. Providers usually order tests considering differential diagnoses based on clinical history. Hematopathologists (HP) while reviewing the BM consider modifying the standing orders. Knowledge and simple guidelines for triaging BM for ES are limited in the literature.

Methods/Case Report

Between 2015-2021, a total of 2560 BMs were selected. Initial tests that were ordered by providers were reviewed by HP considering clinical history, medical necessity, and preliminary BM morphology. Average Medicare fee schedule for 2022 was used for cost analysis. Types of ES were evaluated for Flow Cytometry (FC); Cytogenetics (CG); Fluorescence In-Situ Hybridization (FISH) and Molecular Genetics (MG). Immunostains were excluded in this study.

Results (if a Case Study enter NA)

Cases were evaluated and categorized as cytopenias, cytosis, staging, MPN, MDS, myelomas, treatment follow-up and miscellaneous indications. ES were modified based on medical necessity and blinded with insurance plans or payment status. Initial clinical orders were modified by HP as follows: FC-reduced 15%; CG-reduced 38%; FISH-modified 25%; MG-modified 40% (single assays or NGS). Overall healthcare savings by modifying tests were close to $1.2M.

Conclusion

Effective triaging of BM is a complex decision and can result in significant cost savings. Factors positively impacting these savings are: 1) expertise training in hematopathology, 2) personalized order of ES considering clinical indication, 3) peer-to- peer interaction with providers, and 4) the types of samples obtained. Collaborative efforts among pathologists and clinicians may lead to appropriate ordering of tests, cost- saving effective patient care with relevant diagnostic, therapeutic and prognostic information obtained as recommended by WHO nomenclature for hematolymphoid malignancies. In addition, established practice guidelines with personalized medicine will reduce the burden for pre-authorization when challenged with time sensitive samples obtained from cancer patients obtained thru invasive procedures.

Exploring the genetic makeup and population structure among Capsicum accessions for crop improvement and breeding curriculum insights

Background

Capsicum or chilli is an important crop in India which exhibits immense structural and genetic variations reflecting their intra- and inter-specific relationships. The aim of this study was to establish relationships amongst 54 Capsicum accessions through analysis of genetic and population structure using ISSR markers.

Results

Out of 19, successful DNA amplifications were shown by 7 ISSR primers and a total of 80 bands were identified ranging between 8 and 14 with an average of 11.43 bands/primer. A significant degree of polymorphic information content (PIC), discriminating power (DP), resolving power (RP), effective multiplex ratio (EMR), and marker index (MI) were identified as 0.39, 0.70, 6.40, 5.88, and 2.30, respectively, using ISSR markers in chillies. The cross-transferability ranged from 8.0 to 72.15% with an average of 52.63% among chillies. Amongst genetic information, grand mean values were 0.264, 0.180, 0.376, 0.296, and 0.180, which correspond to Shannon’s information index (I), expected heterozygosity (He), Nei’s gene diversity, total diversity among species (Ht), diversity within species (Hs), respectively. Further, the coefficients of gene differentiation (Gst) and gene flow (Nm) were 0.393 and 0.773, representing higher genetic variation among the population which was confirmed by analysis of molecular variance (AMOVA).

Conclusion

ISSR markers represented a potent system for the estimation of relationships or variation studies and generated information useful for planning crop management and improvement strategies in chilli breeding.

Zinc homeostasis in immunity and its association with preterm births

Preterm birth is among the most common adverse pregnancy outcomes and is the leading cause of neonatal mortality and morbidity. While trace elements are essential for humans, their specific roles in the prenatal period remain unexplored. Zinc, a ubiquitous element plays a pivotal role in protein synthesis, cell division, nucleic acid metabolism, apoptosis, ageing, reproduction, immunological as well as antioxidant defense mechanism. Although zinc quantities are very small in body tissue, it is involved in every conceivable biochemical pathway which is critical for the performance of various functions necessary to sustain life. Owing to the multifactorial role of zinc, it is not possible to attribute a certain zinc dependent mechanism in pre-term births. Although the effect of zinc deficiency on immunity, its impact on maternal function and health as well as its role in the developing foetus is well documented, much less attention has been given to the understanding of micronutrient zinc homeostasis in immunity and its association with preterm births. Despite extensive research, the pathway by which zinc regulates pregnancy outcomes as well as the function of immune cells in controlling the delivery status (term/ preterm) is still obscure. The present review aims to focus on the understanding of relationship of micronutrient zinc homeostasis in immunity and its association with preterm births.

Hsp40s play distinct roles during the initial stages of apolipoprotein B biogenesis

Apolipoprotein B (ApoB) is the primary component of atherogenic lipoproteins, which transport serum fats and cholesterol. Therefore, elevated levels of circulating ApoB are a primary risk factor for cardiovascular disease. During ApoB biosynthesis in the liver and small intestine under nutrient-rich conditions, ApoB cotranslationally translocates into the endoplasmic reticulum (ER) and is lipidated and ultimately secreted. Under lipid-poor conditions, ApoB is targeted for ER Associated Degradation (ERAD). Although prior work identified select chaperones that regulate ApoB biogenesis, the contributions of cytoplasmic Hsp40s are undefined. To this end, we screened ApoB-expressing yeast and determined that a class A ER-associated Hsp40, Ydj1, associates with and facilitates the ERAD of ApoB. Consistent with these results, a homologous Hsp40, DNAJA1, functioned similarly in rat hepatoma cells. DNAJA1 deficient cells also secreted hyperlipidated lipoproteins, in accordance with attenuated ERAD. In contrast to the role of DNAJA1 during ERAD, DNAJB1-a class B Hsp40-helped stabilize ApoB. Depletion of DNAJA1 and DNAJB1 also led to opposing effects on ApoB ubiquitination. These data represent the first example in which different Hsp40s exhibit disparate effects during regulated protein biogenesis in the ER, and highlight distinct roles that chaperones can play on a single ERAD substrate.

System for administering and monitoring hydroxychloroquine prophylaxis for COVID-19 in accordance with a national advisory: preliminary experience of a tertiary care institute in India

BACKGROUND

Hydroxychloroquine (HCQ) was one of the earliest drugs to be recommended for tackling the COVID-19 threat leading to its widespread usage. We provide preliminary findings of the system, established in a tertiary care academic center for the administration of HCQ prophylaxis to healthcare workers (HCW) based on Indian Council of Medical Research (ICMR) advisory.

METHODS

A dedicated clinical pharmacology and internal medicine team screened for contraindications, administered informed consent, maintained compliance and monitored for adverse events.

RESULTS

Among the 194 HCWs screened for ruling out contraindications for prophylaxis, 9 were excluded and 185 were initiated on HCQ. A total of 55 adverse events were seen in 38 (20.5%) HCWs out of which 70.9%, 29.1% were mild and moderate & none were severe. Before the completion of therapy, a total of 23 participants discontinued. Change in QTc interval on day 2 was 5 (IQR: -3.75, 11) ms and the end of week 1 was 15 ms (IQR: 2, 18). Out of the 5 HCW who turned positive for COVID-19, 2 were on HCQ.

CONCLUSION

HCQ prophylaxis was found to be safe and well tolerated in HCW when administered after appropriate screening and with monitoring for adverse events.

Impact of Asthma on the Quality of Sleep in Young People

Introduction

Asthma has a negative impact on the quality of life of patients and their families. One of the factors responsible for the low quality of life is poor sleep quality in asthmatic patients. Sleep disturbances, such as difficulty initiating and maintaining sleep, are common in asthma. In this study, we aim to determine the quality of sleep in young asthmatic patients in a local setting.

Method

This case-control study was conducted in the pulmonology and internal medicine unit of a tertiary care hospital, Pakistan from January 2021 to May 2021. After seeking informed consent, 200 patients with a previously confirmed diagnosis of asthma were enrolled in the study. The control group also included 200 participants. Pittsburgh Sleep Quality Index (PSQI) is an efficient measure of the quality and pattern of sleep. A global PSQI score of ≥5 signifies “poor sleep quality.”

Results

The mean PSQI score was significantly higher in the asthmatic group compared to the control group (6.26 ± 2.01 vs. 3.41 ± 0.50; p-value: <0.0001). The percentage of participants with a PSQI score of ≥5 was significantly higher in the asthmatic group compared to the control group (54.5% vs. 17.0%; p-value: <0.0001).

Conclusion

Sleep disturbance is very common in young patients with asthma. Poor sleep may interfere with their daily performance, which may further have a negative impact on the quality of life in asthmatic patients. Management of asthma should also include improving sleep quality.

Downregulation of Candidate Gene Expression and Neuroprotection by Piperine in Streptozotocin-Induced Hyperglycemia and Memory Impairment in Rats

There is accumulating evidence showing that hyperglycemia conditions like diabetes possess a greater risk of impairment to the neuronal system because high glucose levels exacerbate oxidative stress, accumulation of amyloid-beta peptides, and mitochondrial dysfunction, and impair cognitive functions and cause neurodegeneration conditions like Alzheimer’s diseases. Due to the extensive focus on pharmacological intervention to prevent neuronal cells’ impairment induced by hyperglycemia, the underlying molecular mechanism that links between Diabetes and Alzheimer’s is still lacking. Given this, the present study aimed to evaluate the protective effect of piperine on streptozotocin (STZ) induced hyperglycemia and candidate gene expression. In the present study, rats were divided into four groups: control (Vehicle only), diabetic control (STZ only), piperine treated (20 mg/kg day, i.p), and sitagliptin (Positive control) treated. The memory function was assessed by Morris water maze and probe test. After treatment, biochemical parameters such as HOMA index and lipid profile were estimated in the serum, whereas histopathology was evaluated in pancreatic and brain tissue samples. Gene expression studies were done by real-time PCR technique. Present data indicated that piperine caused significant memory improvement as compared to diabetic (STZ) control. The assessment of HOMA indices in serum samples showed that piperine and sitagliptin (positive control, PC) caused significant alterations of insulin resistance, β cell function, and insulin sensitivity. Assessment of brain and pancreas histopathology shows significant improvement in tissue architecture in piperine and sitagliptin treated groups compared to diabetic control. The gene expression profile in brain tissue shows significantly reduced BACE1, PSEN1, APAF1, CASPASE3, and CATALASE genes in the piperine and sitagliptin (PC) treated groups compared to Diabetic (STZ) control. The present study demonstrated that piperine not only improves memory in diabetic rats but also reduces the expression of specific AD-related genes that can help design a novel strategy for therapeutic intervention at the molecular level.

Variant biochemical responses: intrinsic and adaptive system for ecologically different rice varieties

India has a diverse range of agro-ecological conditions which support the cultivation of different rice varieties differing in the adaptation which is so important for sustainable development of rice crop. Specific ecotypes of rice adapted to diverse conditions have divergence in their morphology, physiology, biochemistry, molecular function, agronomy, and stress response. In the present study, 12 different rice varieties viz., PB-1, PB-1509, Pusa-RH-10, CSR-30, HKR-47, PR-126, Govind, Sharbati, ADT-37, ADT-39, ADT-45, White Ponni, were selected for the study of intrinsic biochemical behaviour and these varieties belong to different Agro-ecological zones and basmati or non-basmati rice varieties. Amongst intrinsic biochemicals activity, the differential response of radical scavenging, superoxide dismutase (SOD), catalase (CAT) and guaiacol peroxidase (POX) activities, were observed in the selected rice varieties at 14 days old seedling stage, developed under controlled growth conditions. Comparatively, North India region rice varieties displayed an enhanced intrinsic biochemical response than south India region rice varieties. Similarly, basmati rice varieties showed increased biochemical response compared to non-basmati rice varieties. Thus, the differential biochemical responses (radical scavenging, SOD, CAT, and POX activities) observed creates a significant difference between rice varieties and provides valuable information about rice ecotype-biochemical interaction for sustainable adaptive value under different ecological conditions.

Curry Leaf and its Antioxidant Potential: A Systematic Study to Enhance its Activity in Aqueous Medium

Background:

We have done a systematic study on the antioxidant activity of the methanol and petroleum ether (60-80°C) extracts (MEC and PEC respectively) of Curry leaves (Murraya koenigii Spreng. Family: Rutaceae) using various in-vitro chemical methods.

Methods:

Both of these two extracts were found to be highly efficient in the formation of Ag and Au nanoparticles. So, we have explored their ability to form the nanoparticles to study their antioxidant activity. In all the assay systems, MEC showed higher activity over PEC in aqueous medium. This may be due to the higher solubility of MEC and its active components, like polyphenols and flavonoids in the aqueous medium. PEC contains lesser amount of these water soluble active components but PEC was rich in carbazole types of alkaloids which are hydrophobic in nature. So, to enhance the antioxidant activity of PEC and its carbazole constituents, like 2-hydroxy carbazole and mahanimbine, we have encapsulated these in the biopolymeric matrix of the mucilage isolated from an edible vegetable, Abelmoschus esculentus L. (commonly known as Lady's finger, family: Malvaceae).

Results:

It was interesting to note that, PEC and its carbazole compounds showed better antioxidant activity (ferrous ion chelation and ferric reducing antioxidant activity) in aqueous medium after this encapsulation process.

Conclusion:

The protocols used in the present study were very simple and can be implemented in any lab set-up. In future, this work can be extended to evaluate antioxidant potentials of other plant based materials.

Characterization of heavy metal pollution in an anthropogenically and geologically influenced semi-arid region of east India and assessment of ecological and human health risks

The present study evaluated the heavy metal contamination in groundwater and associated ecological and human health risks of a geologically and anthropogenically diverse semi-arid region of Birbhum district, India. For a reliable evaluation, concentrations of nine heavy metals in 680 groundwater samples (N = 680) which were collected during premonsoon and postmonsoon seasons of consecutive two years from 170 wells were measured. The human health risk assessment using the USEPA model which is based on single value for each parameter may inherit certain inaccuracy and uncertainties in the evaluation. Unlike earlier studies, a higher degree of accuracy in carcinogenic and noncarcinogenic health risk assessments was achieved through Monte Carlo simulations, sensitivity analysis and uncertainty analysis. The study revealed the occurrence of the target heavy metals in groundwater with mean dominance order of Fe > Zn > Sr > Mn > Cr > Pb > Ni > Cu > Cd where mean concentrations of the carcinogens, Pb and Fe exceeded their maximum permissible limits. The water quality status evaluated using the modified heavy metal pollution index, Nemerow index and Heavy metal evaluation index methods resulted in medium to high heavy metal contamination in groundwater within a large portion of the study area which indicated its unsuitability for drinking purpose. The study suspects a moderate to very high risk for the groundwater dependent ecosystems in major part of the study area. The study further revealed cancer risks, ranging from high to very high within the residents due to accumulative exposure of the carcinogenic heavy metals in groundwater through ingestion and dermal contact. Minor populations of the study area were found to be more vulnerable to the carcinogenic and noncarcinogenic diseases than teenagers and adults, mainly through oral exposure. The study recommends the residents to consume treated groundwater since the primary route of heavy metal exposure was identified to be the ingestion route.

Health risk assessment of pesticide residues in fruits and vegetables from farms and markets of Western Indian Himalayan region

The extensive use of pesticides in agriculture has become a very common practice in developing countries like India. Consequently, the increased concentration of residues of these hazardous pesticides in fruits and vegetables is manifested. The study aimed to assess the health hazards associated with the presence of pesticide residues in fruits and vegetables sampled from farms and markets of Kinnaur district of Himachal Pradesh (India). Residues of predominant pesticides used in the region, belonging to the group of organophosphates, pyrethroid and phthalimide, were analysed using gas chromatograph quadrupole mass spectrometer (GC-MS/MS). The pesticide extraction from the matrix was done following the modified QuEChERS method. Results indicated varying concentrations of pesticide residue in market and farm samples with farm samples more contaminated than market samples. Chronic health hazards prediction indicated that organophosphorus groups (methyl parathion and triazophos) posed health risk to children in the study area.

Morphological changes in spleen after dietary zinc deficiency and supplementation in Wistar rats

BACKGROUND

Study was conducted to determine the effect of dietary zinc deficiency and supplementation on the spleen morphology.

METHODS

Pre-pubertal Wistar rats (40-50 g) were divided into two groups with 6 sub-groups each viz. zinc control (ZC, 100 μg/g zinc diet), pair fed (PF, 100 μg/g zinc diet), zinc deficient (ZD, <1 μg/g zinc diet, zinc supplementation control (ZCS), zinc supplementation pair-fed (PFS) and zinc supplementation deficient (ZDS, 100 μg/g zinc control diet). Experiments were set for 2- and 4-weeks followed by 4 weeks of zinc supplementation.

RESULTS

In the present study body weight and BMI decreased significantly along with incidence of splenomegaly as typified by the increased splenic index in deficient groups compared with that of respective control groups. Histopathological changes such as disorganization of red pulp, several infiltered lymphocytes, vacuolization, loss of cellularity, karyolysis, dissolution of matrix, indistinct differentiation between red and white pulp were evident in spleen of 2ZD and 4ZD group animals. Degeneration was more severe after 4 weeks of zinc deficiency as giant cells formation and hypertrophy were also evident.

CONCLUSION

The findings revealed that zinc deficiency causes growth retardation and splenomegaly. Degenerative and atrophic changes in rat spleen suggest reduced cellular defense potential which will have a direct effect on immunity. Zinc supplementation may prove to be beneficial as there were varying degrees of cellular recovery after cessation of zinc deficiency.

Efficacy and field applicability of Burmese grape leaf extract (BGLE) for cadmium removal: An implication of metal removal from natural water

Burmese Grape Leaf Extract (BGLE), a low cost adsorbent was studied for cadmium (Cd(II)) removal from metal solutions and natural water samples. Batch adsorption studies were carried out to examine the influence of contact time and initial metal concentration after characterization under scanning electron microscopy (SEM). Cd(II)adsorptiononto BGLE was best explained by pseudo-second order kinetics (R² = 0.99) and best fitted with Langmuir isotherm model (R² = 0.76). Beside the selective adsorption activity of BGLE towards Cd(II), only 0.1g of BGLE have shown effective adsorption of these ions with a maximum adsorption capacity (q_m) of 44.72mgg^-1. This study was a unique combination of laboratory experiments and field implication. Study indicates that same efficacy cannot be obtained in natural water samples as obtained in the case of laboratory due to the interference of major ions in water.

Protein carbonyl, 3β-, and 17β-hydroxysteroid dehydrogenases in testes and serum FSH, LH, and testosterone levels in zinc deficient Wistar rats

The present study evaluated protein oxidation, alteration in hydroxysteroid dehydrogenases (3β- and 17β HSD) in testes and serum hormonal profiles of dietary zinc deficient Wistar rats. Pre-pubertal rats were divided into three groups: zinc control (ZC), pairfed (PF), and zinc deficient (ZD) and fed 100 ppm (ZC and PF groups) and 1.0 ppm (ZD group) zinc diet for 2- and 4-weeks. The testes from zinc deficient groups exhibited significant increase in total protein (2 weeks) and protein carbonyl (2- and 4-weeks) concentration as well as 3β- and 17β-hydroxysteroid dehydrogenase activities (4 weeks), whereas a significant decrease was recorded in total protein (testes 4 weeks; serum 2- and 4-weeks), total zinc (testes and serum 2- and 4-weeks), 3β- and 17β-hydroxysteroid dehydrogenase activities (testes 2 weeks), and serum hormonal profiles (FSH and testosterone 2- and 4-weeks). However, LH was below the detectable limits. These results reflect that zinc deficiency during pre-pubertal period affected total protein and zinc status, elevates protein oxidation, and causes dysregulation of the hydroxysteroid dehydrogenases. Low level of zinc attenuated the gonadal physiology which indicates that the metabolic regulation of testes is mediated by combined effects of a specific response (caused by decreased zinc concentration) and a nonspecific response (inhibition of gonadotrophin secretion). All these contribute to testicular dysfunction.

Nutritional composition and antioxidant activities of 18 different wild Cantharellus mushrooms of northwestern Himalayas

A total of 18 wild edible mushrooms of Cantharellus species were collected from northwestern Himalayan region of India. The basic composition (moisture, total carbohydrates, dietary fiber, crude fat, ash, nitrogen and protein) and amino acid contents (by high-performance liquid chromatography) of these wild edible mushrooms were determined. The macronutrient profile in general revealed that the wild mushrooms were rich sources of protein and carbohydrates, and had low amounts of fat. Total phenolics and antioxidant activity from water and methanolic extracts of these mushrooms were also determined. These wild mushrooms also had significant amount of phenol content and antioxidant capacity. Studies also provide the precise antioxidant status of 18 indigenous species of mushrooms, which can serve as a useful database for the selection of mushrooms for the function of preparation of mushroom-based nutraceutics.

Effect of dietary zinc deficiency on testes of Wistar rats: Morphometric and cell quantification studies

The present study investigates the effect of dietary zinc deficiency on testes of Wistar rats. Pre-pubertal rats (40-50g) were divided into three groups of 10 each viz. zinc control (ZC) and pair fed (PF) [100ppm zinc diet] and zinc deficient (ZD) [1ppm zinc diet]. Experiments were set for 2- and 4-weeks. Pre-pubertal rats fed zinc deficient diet for 2- and 4-weeks exhibited significant (P<0.05) decrease in diet consumption when compared with their respective control groups. Parallel to the reduced diet consumption, a significant (P<0.05) decrease in body and testicular weight of ZD animals was also observed. These observations indicate that the zinc deficiency reduces diet consumption and growth of the animals. Histological studies revealed degeneration in testes of ZD rats as evident by decreased seminiferous tubular diameter and Leydig cell nuclear diameter. Decreased Leydig cell nuclear diameter is responsible for disruption of the biochemical function of Leydig cell. Testicular atrophy (viz. wavy tunica propria, karyolysis, pyknosis, karyorhexis, apoptotic bodies, multinucleated giant cells, few sperms in the lumen, atrophied Leydig cells and accumulation of oedematous fluid in the interstitium) accompanied by significant loss of germ/somatic cells (viz. Type A and Type B spermatogonia, leptotene, zygotene, pachytene spermatocytes, Golgi, cap and acrosome spermatids, Sertoli and Leydig cell) was evident in ZD groups. The degeneration was severe after 4-weeks of zinc deficiency. These observations provide evidence that the functional and morphological changes in testes are probably due to zinc deficiency. Further, the increased oedematous fluid in the interstitial region is due to the cellular death. Impairment of spermatogenesis can be attributed to the direct action of zinc on testes or indirectly from Leydig cell degeneration indicating that zinc is a critical component for maintenance of both mitotic and meiotic stages of spermatogenesis.

Effect on histological and sperm kinetics in DBP exposed Wistar rats

Di-n-butyl phthalate (DBP) is a ubiquitous environmental pollutant, extensively used as a softener for polyvinyl chloride resins. A study was conducted to evaluate its effect on reproductive function of Wistar rats. DBP was given orally at a dose of 500, 1000 and 1500 mg kg(-1) body weight for 7 days. Evaluating histological and fertility parameters assessed reproductive function. Significant reduction in seminiferous tubule diameter, Leydig cell nuclear diameter (except at dose 500 mg), number of primary spermatocytes, secondary spermatocytes and spermatids were observed. Caudal sperm density and viability reduced significantly. Decrease in serum testosterone was also observed. Evidence indicates that DBP exposure causes dose dependent testicular toxicity and has the potential to induce adverse effect.

Sensitization to blackgram in patients with bronchial asthma and rhinitis: clinical evaluation and characterization of allergens

BACKGROUND

Legumes are important causative agents of type I hypersensitivity in south Asia and Europe but such studies are lacking in Indian population. The present study investigates blackgram sensitization in asthma and rhinitis patients and identifies immunoglobulin E (IgE)-binding proteins.

METHODS

Respiratory allergy patients were evaluated using standard questionnaire and skin prick tests (SPT) with common foods and aeroallergens. Blackgram-specific IgE level was estimated by enzyme-linked immunosorbent assay (ELISA) and sensitization was established by a double-blind, placebo-controlled food challenge (DBPCFC). The cross-reactivity of blackgram with other legumes was studied by immunobiochemical methods.

RESULT

Of 816 patients, 35 gave history of blackgram hypersensitivity. From these, 16 patients were SPT positive and 14 showed elevated specific IgE (three times of negative control) to blackgram. DBPCFC established blackgram sensitivity in four of 14 patients. Immunoblotting with individual patient's sera recognized eight most prevalent allergens of 78, 56, 47, 43, 40, 30, 28 and 16 kDa. Roasted blackgram showed six major allergens whereas 47, 43 and 28 kDa proteins retained IgE reactivity upon boiling. Blackgram extract required 14 ng of self protein for 50% ELISA inhibition whereas roasted and boiled blackgram required 16 and 120 ng protein. ELISA and immunoblot inhibition show partial inhibition to blackgram proteins by lentil, limabean and pea.

CONCLUSION

Blackgram induces IgE-mediated reactions in 1.7% of asthma and rhinitis patients and contains eight major IgE-binding components, of which six retained IgE reactivity after roasting. Blackgram shares allergenicity with lentil and limabean.

Instability of the fragile X syndrome repeat in mice: the effect of age, diet and mutations in genes that affect DNA replication, recombination and repair proficiency

Repeat expansion diseases such as fragile X syndrome (FXS) result from increases in the size of a specific tandem repeat array. In addition to large expansions, small changes in repeat number and deletions are frequently seen in FXS pedigrees. No mouse model accurately recapitulates all aspects of this instability, particularly the occurrence of large expansions. This may be due to differences between mice and humans in CIS and/or TRANS-acting factors that affect repeat stability. The identification of such factors may help reveal the expansion mechanism and allow the development of suitable animal models for these disorders. We have examined the effect of age, dietary folate, and mutations in the Werner's syndrome helicase (WRN) and TRP53 genes on FXS repeat instability in mice. WRN facilitates replication of the FXS repeat and enhances Okazaki fragment processing, thereby reducing the incidence of processes that have been suggested to lead to expansion. p53 is a protein involved in DNA damage surveillance and repair. We find two types of repeat instability in these mice, small changes in repeat number that are seen at frequencies approaching 100%, and large deletions which occur at a frequency of about 10%. The frequency of these events was independent of WRN, p53, parental age, or folate levels. The large deletions occur at the same frequency in mice homozygous and heterozygous for the repeat suggesting that they are not the result of an interallelic recombination event. In addition, no evidence of large expansions was seen. Our data thus show that the absence of repeat expansions in mice is not due to a more efficient WRN protein or p53-mediated error correction mechanism, and suggest that these proteins, or the pathways in which they are active, may not be involved in expansion in humans either. Moreover, the fact that contractions occur in the absence of expansions suggests that these processes occur by different mechanisms.

Transcription defects induced by repeat expansion: fragile X syndrome, FRAXE mental retardation, progressive myoclonus epilepsy type 1, and Friedreich ataxia

Fragile X mental retardation syndrome, FRAXE mental retardation, Progressive myoclonus epilepsy Type I, and Friedreich ataxia are members of a larger group of genetic disorders known as the Repeat Expansion Diseases. Unlike other members of this group, these four disorders all result from a primary defect in the initiation or elongation of transcription. In this review, we discuss current models for the relationship between the expanded repeat and the disease symptoms.

Deletion analysis of the dystrophin gene in Duchenne and Becker muscular dystrophy patients: use in carrier diagnosis

The dystrophin gene was analyzed in 8 Duchenne muscular dystrophy (DMD) and 10 Becker muscular dystrophy (BMD) unrelated families (22 subjects: 18 index cases and 4 sibs) for the presence of deletions by multiplex polymerase chain reaction (mPCR; 27 exons) and Southern hybridization using 8 cDMD probes. Deletions were identified in 5 DMD and 7 BMD patients (6 index cases and 1 sib). The concordance between the clinical phenotype and "reading frame hypothesis" was observed in 11/12 patients (92%). The female relatives of DMD/BMD patients with identifiable deletions were examined by quantitative mPCR. Carriers were identified in 7 families. We also describe a variation in the HindIII pattern with cDNA probe 8 and 11-14. Molecular characterization of the dystrophin gene in this study has been helpful in advising the patients concerning the inheritance of the condition, and carrier diagnosis of female relatives, and should also prove useful for prenatal diagnosis.

Fragile X syndrome and Friedreich's ataxia: two different paradigms for repeat induced transcript insufficiency

DNA repeat expansion is the genetic basis for a growing number of neurological disorders. While the largest subset of these diseases results in an increase in the length of a polyglutamine tract in the protein encoded by the affected gene, the most common form of inherited mental retardation, fragile X syndrome, and the most common inherited ataxia, Friedreich's ataxia, are both caused by expansions that are transcribed but not translated. These expansions both decrease expression of the gene in which the expanded repeat is located, but they do so by quite different mechanisms. In fragile X syndrome, CGG. CCG expansion in the 5' untranslated region of the FMR1 gene leads to hypermethylation of the repeats and the adjacent CpG-rich promoter. Methylation prevents the binding of the transcription factor alpha-Pal/NRF-1, and may indirectly affect the binding of other factors via the formation of transcriptionally silent chromatin. In Friedreich's ataxia, GAA. TTC expansion in an intron of the FRDA gene reduces expression by interfering with transcription elongation. The model that best describes the available data is transcription-driven formation of a transient purine. purine. pyrimidine DNA triplex behind an advancing RNA polymerase. This structure lassoes the RNA polymerase that caused it, trapping the enzyme on the template.

Interaction of the transcription factors USF1, USF2, and alpha -Pal/Nrf-1 with the FMR1 promoter. Implications for Fragile X mental retardation syndrome

Hypermethylation of the FMR1 promoter reduces its transcriptional activity, resulting in the mental retardation and macroorchidism characteristic of Fragile X syndrome. How exactly methylation causes transcriptional silencing is not known but is relevant if current attempts to reactivate the gene are to be successful. Understanding the effect of methylation requires a better understanding of the factors responsible for FMR1 gene expression. To this end we have identified five evolutionarily conserved transcription factor binding sites in this promoter and shown that four of them are important for transcriptional activity in neuronally derived cells. We have also shown that USF1, USF2, and alpha-Pal/Nrf-1 are the major transcription factors that bind the promoter in brain and testis extracts and suggest that elevated levels of these factors account in part for elevated FMR1 expression in these organs. We also show that methylation abolishes alpha-Pal/Nrf-1 binding to the promoter and affects binding of USF1 and USF2 to a lesser degree. Methylation may therefore inhibit FMR1 transcription not only by recruiting histone deacetylases but also by blocking transcription factor binding. This suggests that for efficient reactivation of the FMR1 promoter, significant demethylation must occur and that current approaches to gene reactivation using histone deacetylase inhibitors alone may therefore have limited effect.

Detection of deletion in the dystrophin gene of a patient with quadriceps myopathy

A 43 year old male presented with slowly progressive weakness of limbs and hypertrophy of triceps, brachioradialis and calf muscles for four years. There was thinning of quadriceps muscles in both thighs. Histological study was compatible with Becker muscular dystrophy (BMD). Genomic DNA analysis showed a deletion of the Hind III fragments, spanning exons 45-47. A junction fragment of 11.0 kb was observed along with a deletion of a 3.4 kb PstI fragment containing exon 51 in the patient, and in one of his two sisters. The clinical and laboratory characteristics in this patient are in keeping with what has been described 'quadriceps myopathy' and fall within the phenotypic variants of BMD as has been shown by others.

Molecular characterisation of Duchenne muscular dystrophy and phenotypic correlation

Dystrophin gene was analysed in 32 unrelated DMD families (46 subjects: 32 index cases and 14 sibs) for the presence of deletions by mPCR for 27 exons and cDNA probes for the entire gene. Deletions were identified in 32 patients (25 index cases and seven sibs) from 25 families. The concordance between the clinical phenotype and 'reading frame' hypothesis was observed in 24 (75%) cases. Of these, nine patients were wheelchair bound between 8-12 years of age, nine (age range 5-10 years) showed progressive difficulty in walking and six (age range 1.6-4 years) had onset of muscle weakness. One patient (CH), who was wheelchair bound at 12 years, the effect of mutation on the ORF could not be ascertained due to the presence of a junction fragment. Seven patients had inframe deletions of which four were wheelchair bound by the age of 13 years, and three (age range 5-7 years) although, ambulatory had difficulty in walking. There were eight patients who showed no deletion, of which four became wheelchair bound by the age of 12 years, four, though still ambulatory, were unable to run and tired easily. Correlation between phenotype and genotype of these DMD patients demonstrates that genetic studies of lymphocyte DNA may not always reflect the situation in the tissue involved in dystrophin, i.e. muscle. We describe a common dystrophin gene polymorphism in the Indian population with cDNA 11-14 that alters the Hind III restriction sites. Novel RFLPs were observed in 26 patients and their family members. Whether this is a polymorphism or, related to the diseased phenotype needs confirmation.

Effect of retinol on ochratoxin-produced genotoxicity in mice

Ochratoxin (1 microgram/kg body weight/day), when administered orally daily to albino Swiss mice for 14 continuous days, increased the incidence of abnormalities in mitotic and meiotic metaphase chromosomes, and the gross morphology of the sperm head; the sperm count per unit volume of caput epididymal suspension also decreased. These genotoxic effects were substantially reduced by concurrent oral administration of retinol at double the clinically therapeutic dose. It is possible that the electrophilic metabolites of ochratoxin form adducts with DNA or produce replacement-type mutations. Retinol may achieve its antigenotoxic effect by means of blocks and shunts in the ochratoxin metabolic pathway. Vitamin A-mediated cellular repair and scavenging of the mutagenic radicals can also take place. The vitamin itself has some genotoxic potential.