Early diagnosis of polyomavirus type BK infection in tailoring immunosuppression for kidney transplant patients: screening with urine qualitative polymerase chain reaction assay

Polyomavirus type BK (BKV) nephropathy is increasingly a significant cause of graft dysfunction and even failure. Early diagnosis followed by reduction of immunosuppression has been associated with an improved prognosis. We screened 250 patients with the urine qualitative polymerase chain reaction (PCR) for BKV DNA. We followed with blood BKV PCR if the urine screen was positive and then reduced immunosuppression in viremic patients. One hundred ninety-nine patients (80%) had no viuria; 43 (17%) viuria; and 8 (3%) both viuria and viremia. Graft biopsy performed in three patients (1%) with viremia and impaired graft function all revealed BKV nephropathy. After 6 months of follow-up, seven out of eight viremic patients (88%) had negative repeat blood PCR and stabilized graft function. An early diagnosis of BKV infection with reduction of immunosuppression may reverse viremia and retard progression of BKV nephropathy. BKV screening by PCR assays should be considered in kidney transplant recipients, especially those with impaired graft function.

Alternations in quantities and activities of erythrocyte cytosolic carbonic anhydrase isoenzymes in glucose-6-phosphate dehydrogenase-deficient individuals

BACKGROUND

This study was designed to evaluate the quantitative and activity alterations of cytosolic carbonic anhydrase (CA) isoenzymes in the erythrocytes of glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals.

METHODS

Western Blot and CA esterase activity analysis were employed to measure cytosolic erythrocyte CA isoenzymes.

RESULTS

The total CA activities were analyzed from erythrocytes of 30 healthy and 30 G6PD-deficient individuals. The mean values with standard error (SE) were 22.9+/-1.69 U/gHb and 27.2+/-2.1 U/gHb (P<0.01), respectively. The ratio of CAI/CAII of G6PD-deficient individuals (1.28+/-0.06) was significantly lower than that of the normal subjects (3.79+/-0.18) (P<0.001). Furthermore, the concentration of CAIII in G6PD-deficient individuals was significantly lower than that of the normal subjects (P<0.001) and there were significant correlations between the concentration of CAI, CAII, CAIII, and ratio of CAI/CAII, and the activity concentration of G6PD.

CONCLUSIONS

Different carbonic anhydrase isoenzymes may serve different roles in the G6PD-deficient erythrocyte. CAI could be used as an indicator for hemolytic anemia. CAII is able to compensate for the functions of CAI and increased expression of CAII will promote oxidative damage. CAIII can provide the G6PD-deficient persons with some extent of protection against oxidative damage.

Establishment of a consistent L929 bioassay system for TNF-alpha quantitation to evaluate the effect of lipopolysaccharide, phytomitogens and cytodifferentiation agents on cytotoxicity of TNF-alpha secreted by adherent human mononuclear cells

TUMOR necrosis factor-alpha (TNF-alpha) plays an important role in the pathogenesis of rheumatoid arthritis. The present study was to evaluate the effects of lipopolysaccharide (LPS), phytomitogens and cytodifferentiation agents on cytotoxicity of TNF-alpha secreted by adherent human mononuclear cells (AMC). TNF-alpha cytotoxicity in LPS-treated, phytomitogen-treated, and cytodifferentiation agent-treated AMC supernatants were analyzed by the L929 bioassay system. Our results showed that LPS could induce homogeneous TNF-alpha production by AMC whereas, in addition to TNF-alpha, phytomitogens could also induce other TNF-like factors. Neither methotrexate, retinoic acid nor sodium butyrate can inhibit TNF-alpha cytotoxicity, while hexamethylene bisacetamide could not only inhibit TNF-alpha cytotoxicity but also TNF-alpha inducing ability of LPS to AMC.

The association of human papillomavirus 16/18 infection with lung cancer among nonsmoking Taiwanese women

Lung cancer is the leading cause of cancer death in Taiwanese women since 1982. High lung cancer mortality ratio of male:female in Taiwan (2:1) was observed, although less than 10% of female lung cancer patients are smokers. Until now, the etiological factor remains unknown. We hypothesize that high-risk human papillomavirus (HPV) 16/18 may be associated with lung cancer development based on high prevalence of p53 negative immunostainings in female lung tumors compared with that of male lung tumors. In this study, 141 lung cancer patients and 60 noncancer control subjects were enrolled to examine whether HPV 16/18 DNA existed in lung tumor and normal tissues by nested PCR and in situ hybridization (ISH), respectively. The concordant detection of HPV 16 and 18 DNA between nested PCR and ISH method was 73 and 85.5%, respectively. Our data showed that 77 (54.6%) of 141 lung tumors had HPV 16/18 DNA compared with 16 (26.7%; P = 0.0005) of 60 noncancer control subjects. In addition, ISH data showed that HPV 16/18 DNA was uniformly located in lung tumor cells, but not in the adjacent nontumor cells. When study subjects were stratified by gender, age, and smoking status, nonsmoking female lung cancer patients who were older than 60 years old had significantly high prevalence of HPV 16/18 infection. The odds ratio of HPV 16/18 infection of nonsmoking female lung cancer patients is much higher at 10.12 (95% confidence interval, 3.88-26.38) compared with 1.98 (95% confidence interval, 0.84-4.76) of nonsmoking male lung cancer patients. This result strongly suggests that HPV infection is associated with lung cancer development of nonsmoking female lung cancer patients. The high prevalence of HPV 16/18 infection may explain to a certain extent why Taiwanese women nonsmokers had a higher lung cancer mortality rate.

Altered antigenicity of 'a' determinant variants of hepatitis B virus

The 'a' determinant of hepatitis B virus (HBV) surface antigen (HBsAg) is the most important target for diagnosis and immunoprophylaxis. Several HBV variants with point mutations within the 'a' determinant have been identified among fully vaccinated children in Taiwan. We investigated the effect of each of these mutations on the antigenic nature of the S protein by cloning and expression of the mutant S antigens in Pichia pastoris. Four variants, Ser-126, His-129, Arg-129 and Arg-145, all exhibited various degrees of altered binding of HBsAg to several monoclonal antibodies. Arg-145, a well-characterized immune escape mutant, and Arg-129 had the lowest binding capacities to all monoclonal antibodies as compared with other variants. Similar to Arg-145, the Arg-129 variant could be isolated from both vaccinated children and unvaccinated adults, thus representing a naturally occurring mutant with an altered 'a' determinant. Whether these 'a' determinant variants with altered antigenicity might gradually become major circulating strains, as a consequence of the immune pressure against the wild-type HBV created by vaccination, remains to be monitored.

Insulin controlled-release microcapsules to prolong the hypoglycemic effect in diabetic rats

A solvent evaporation process was employed for preparing insulin microcapsules by using biodegradable polymers [polylactic acid (PLA), HP-55] and non-biodegradable polymers [ethylcellulose (EC), ethylenevinyl acetate (EVA)]. The release behavior of insulin microcapsules in pH 7.4 phosphate buffer solution was undertaken by a continuous flow column method. Seven types of insulin microcapsules were respectively injected into the flanks of fasting-diabetic SD rats induced by streptozotocin. The glucose levels and insulin concentrations in the blood were periodically sampled from the tail and assayed by a glucose analyzer and RIA method. Body weights were measured twice per week. The release rate was controllably dependent on the polymer used. The PLA microcapsules could maintain normoglycemia only for five days, whereas the (PLA + 1%EVA) microcapsules exhibited two times the hypoglycemic effect of PLA microcapsules, but (PLA + 1%EVA) microcapsules treated with 4% wax extended the duration of hypoglycemic effects for two weeks. There was no significant effect for insulin-HP-55 microcapsules. The EC microcapsules prolonged the hypoglycemic effect for 15 days, however, the (EC + 1%EVA) microcapsules could maintain the same effect for up to three weeks. The slower the release rate of insulin microcapsules in vitro the longer the hypoglycemic effect of insulin microcapsules in vivo. A close relationship between in vitro release behavior and in vivo hypoglycemic efficacy of insulin microcapsules was obtained.

Microencapsulation and controlled release of insulin from polylactic acid microcapsules

Insulin has been encapsulated in biodegradable polylactic acid microcapsules and non-biodegradable ethylcellulose microcapsules by using an emulsification-solvent evaporation process. Gelatin and polyvinylalcohol were used as protective colloids. The concentrations and types of protective colloids affecting the micromeritic properties and release behavior of insulin microcapsules were studied. The higher the concentration of protective colloids the smaller the particle size of microcapsules. The median diameter of microcapsules decreased with the increase of the viscosity of protective colloids. Scanning electron microscopic observations suggested that microcapsules prepared from higher concentrations of polyvinylalcohol solution resulted in a nonporous and compact surface on the microcapsules, compared to the porous microcapsules prepared from gelatin solution. The residual crystals and porous structure of microcapsules affected the release rate of microcapsules. After the initial burst effect the release rate of insulin from microcapsules was found to be constant, so that prolonged release was obtainable. Three percent of polyvinylalcohol was the best choice for the preparation of polylactic acid microcapsules.