The β-Cell in Type 1 Diabetes Pathogenesis: A Victim of Circumstances or an Instigator of Tragic Events?

Recent reports have revived interest in the active role that β-cells may play in type 1 diabetes pathogenesis at different stages of disease. In some studies, investigators suggested an initiating role and proposed that type 1 diabetes may be primarily a disease of β-cells and only secondarily a disease of autoimmunity. This scenario is possible and invites the search for environmental triggers damaging β-cells. Another major contribution of β-cells may be to amplify autoimmune vulnerability and to eventually drive it into an intrinsic, self-detrimental state that turns the T cell-mediated homicide into a β-cell suicide. On the other hand, protective mechanisms are also mounted by β-cells and may provide novel therapeutic targets to combine immunomodulatory and β-cell protective agents. This integrated view of autoimmunity as a disease of T-cell/β-cell cross talk will ultimately advance our understanding of type 1 diabetes pathogenesis and improve our chances of preventing or reversing disease progression.

[Progress in research of 2019-nCoV infection in children and adolescents]

As 2019-nCoV vaccine is widely used in the adult population, children and adolescents have gradually become an important susceptible population to 2019-nCoV due to their low coverage of the vaccine and high contact degree. Understanding the characteristics of 2019-nCoV infection in minors is vital. This paper summarized the progress in the research of 2019-nCoV in minors by using the data from the retrieval of recently published literature. Furthermore, the key characteristics of 2019-nCoV infection in minors, including the susceptibility, transmissibility, prognosis and immune response were analyzed and the progress in child and adolescent vaccine development was introduced.

Tet2 Controls the Responses of β cells to Inflammation in Autoimmune Diabetes

β cells may participate and contribute to their own demise during Type 1 diabetes (T1D). Here we report a role of their expression of Tet2 in regulating immune killing. Tet2 is induced in murine and human β cells with inflammation but its expression is reduced in surviving β cells. Tet2-KO mice that receive WT bone marrow transplants develop insulitis but not diabetes and islet infiltrates do not eliminate β cells even though immune cells from the mice can transfer diabetes to NOD/scid recipients. Tet2-KO recipients are protected from transfer of disease by diabetogenic immune cells.Tet2-KO β cells show reduced expression of IFNγ-induced inflammatory genes that are needed to activate diabetogenic T cells. Here we show that Tet2 regulates pathologic interactions between β cells and immune cells and controls damaging inflammatory pathways. Our data suggests that eliminating TET2 in β cells may reduce activating pathologic immune cells and killing of β cells.

Adjuvant chemoradiotherapy vs. radiotherapy alone in early-stage high-risk endometrial cancer: a systematic review and meta-analysis

OBJECTIVE

The benefits of adjuvant chemoradiotherapy (CRT) in patients with International Federation of Gynecology and Obstetrics (FIGO) stages I-II high-risk endometrial cancer remain controversial. We undertook a systematic review and meta-analysis to assess the efficacy of CRT over radiotherapy (RT) in patients with early-stage high-risk endometrial cancer.

PATIENTS AND METHODS

We searched MEDLINE (from 1946 to May 2018), EMBASE (from 1966 to May 2018), and the Cochrane Library database for randomized controlled trials (RCTs) conducted for endometrial cancer comparing CRT to RT alone. The outcomes were overall survival (OS), failure-free survival (FFS), local recurrence rates (LRR) and the distant metastasis rate (DMR).

RESULTS

Three eligible studies with 1120 participants were included in the meta-analysis. All studies were published from 1990 to 2018. The OS rates were 82.5% for the patients in the CRT group and 84.4% for patients in the RT group. The included three RCTs showed no significant difference of OS between the CRT and RT groups (odd ratio 0.98, 95% CI 0.93 to 1.02, p=0.35) with no heterogeneity (I2=0%, p=0.47). Two studies reported 382 FFS events in 469 patients with CRT treatment (81.4%) and 376 events of the 470 patients with RT treatment (80.0%). Overall, CRT group didn't provide any benefit over RT alone (1.02, 0.95 to 1.08, p=0.62; I2 = 0%, p=0.55) in FFS. 39 patients in CRT group (10.2%) vs. 16 patients in RT group (4.3%) were diagnosed with local recurrence. LRR was significantly more common in patients receiving adjuvant chemoradiotherapy compared with adjuvant radiotherapy (2.29, 1.31 to 3.98, p=0.004; I²=0%, p=0.33). The distant metastasis occurred in 20 patients (5.2%) treated with CRT and 26 patients (7.0%) treated with RT. The effect of reducing DMR was equivocal between the CRT group and the RT group, with an OR of 0.74 (0.43-1.27, p=0.28; I²=0%, p=0.87).

CONCLUSIONS

This study demonstrates that adjuvant chemoradiotherapy has no advantage over radiotherapy alone for overall survival and failure-free survival in high-risk patients with FIGO stages I-II endometrial cancer. In addition, CRT is associated with a high risk of local recurrences.

β cell responses to inflammation

Background

The extended and clinically silent progression of Type 1 diabetes (T1D) creates a challenge for clinical interventions and for understanding the mechanisms that underlie its pathogenesis. Over the course of the development of Type 1 diabetes, studies in animal models and of human tissues have identified adaptive changes in β cells that may affect their immunogenicity and susceptibility to killing. Loss of β cells has traditionally been identified by impairment in function but environmental factors may affect these measurements.

Scope of Review

In this review we will highlight features of β cell responses to cell death, particularly in the setting of inflammation, and focus on methods of detecting β cell death in vivo.

Major conclusions

We developed an assay to measure β cell death in vivo by detecting cell free DNA with epigenetic modifications of the INS gene that are found in β cells. This assay has robust technical performance and identifies killing in individuals at very high risk for disease, but its ability to identify β cell killing in at-risk relatives is limited by the short half-life of the cell free DNA and the need for repeated sampling over an extended course. We present results from the Diabetes Prevention Trial-1 using this assay. In addition, recent studies have identified cellular adaptations in some β cells that may avoid killing but impair metabolic function. Cells with these characteristics may aggravate the autoimmune response but also may represent a potentially recoverable source of functional β cells.

Have we pushed the needle for treatment of Type 1 diabetes?

Studies with immunologics have shown that the natural history of Type 1 diabetes can be modified. These studies have targeted key mediators of the disease and recent analyses, together with studies in preclinical models have identified mechanisms that may be involved in the clinical effects. Several issues remain including specificity of the interventions, adverse effects of the treatments, and duration of their effects. Future studies are likely to include more specific approaches with agents such as cell therapies with selected immune regulatory subsets, antigen specific therapies, and combinations of agents with complementary mechanisms of activity.

β Cells that Resist Immunological Attack Develop during Progression of Autoimmune Diabetes in NOD Mice

Type 1 diabetes (T1D) is a chronic autoimmune disease that involves immune-mediated destruction of β cells. How β cells respond to immune attack is unknown. We identified a population of β cells during the progression of T1D in non-obese diabetic (NOD) mice that survives immune attack. This population develops from normal β cells confronted with islet infiltrates. Pathways involving cell movement, growth and proliferation, immune responses, and cell death and survival are activated in these cells. There is reduced expression of β cell identity genes and diabetes antigens and increased immune inhibitory markers and stemness genes. This new subpopulation is resistant to killing when diabetes is precipitated with cyclophosphamide. Human β cells show similar changes when cultured with immune cells. These changes may account for the chronicity of the disease and the long-term survival of β cells in some patients.

Methylation of insulin DNA in response to proinflammatory cytokines during the progression of autoimmune diabetes in NOD mice

AIMS/HYPOTHESIS

Type 1 diabetes is caused by the immunological destruction of pancreatic beta cells. Preclinical and clinical data indicate that there are changes in beta cell function at different stages of the disease, but the fate of beta cells has not been closely studied. We studied how immune factors affect the function and epigenetics of beta cells during disease progression and identified possible triggers of these changes.

METHODS

We studied FACS sorted beta cells and infiltrating lymphocytes from NOD mouse and human islets. Gene expression was measured by quantitative real-time RT-PCR (qRT-PCR) and methylation of the insulin genes was investigated by high-throughput and Sanger sequencing. To understand the role of DNA methyltransferases, Dnmt3a was knocked down with small interfering RNA (siRNA). The effects of cytokines on methylation and expression of the insulin gene were studied in humans and mice.

RESULTS

During disease progression in NOD mice, there was an inverse relationship between the proportion of infiltrating lymphocytes and the beta cell mass. In beta cells, methylation marks in the Ins1 and Ins2 genes changed over time. Insulin gene expression appears to be most closely regulated by the methylation of Ins1 exon 2 and Ins2 exon 1. Cytokine transcription increased with age in NOD mice, and these cytokines could induce methylation marks in the insulin DNA by inducing methyltransferases. Similar changes were induced by cytokines in human beta cells in vitro.

CONCLUSIONS/INTERPRETATION

Epigenetic modification of DNA by methylation in response to immunological stressors may be a mechanism that affects insulin gene expression during the progression of type 1 diabetes.

Characterization of Diabetogenic CD8+ T Cells: IMMUNE THERAPY WITH METABOLIC BLOCKADE

Type 1 diabetes mellitus is caused by the killing of insulin-producing β cells by CD8+T cells. The disease progression, which is chronic, does not follow a course like responses to conventional antigens such as viruses, but accelerates as glucose tolerance deteriorates. To identify the unique features of the autoimmune effectors that may explain this behavior, we analyzed diabetogenic CD8+ T cells that recognize a peptide from the diabetes antigen IGRP (NRP-V7-reactive) in prediabetic NOD mice and compared them to others that shared their phenotype (CD44(+)CD62L(lo)PD-1(+)CXCR3(+)) but negative for diabetes antigen tetramers and to LCMV (lymphocytic choriomeningitis)-reactive CD8+ T cells. There was an increase in the frequency of the NRP-V7-reactive cells coinciding with the time of glucose intolerance. The T cells persisted in hyperglycemic NOD mice maintained with an insulin pellet despite destruction of β cells. We compared gene expression in the three groups of cells compared with the other two subsets of cells, and the NRP-V7-reactive cells exhibited gene expression of memory precursor effector cells. They had reduced cellular proliferation and were less dependent on oxidative phosphorylation. When prediabetic NOD mice were treated with 2-deoxyglucose to block aerobic glycolysis, there was a reduction in the diabetes antigen versus other cells of similar phenotype and loss of lymphoid cells infiltrating the islets. In addition, treatment of NOD mice with 2-deoxyglucose resulted in improved β cell granularity. These findings identify a link between metabolic disturbances and autoreactive T cells that promotes development of autoimmune diabetes.

Reconstituted Thymus Organ Culture

Reconstituted thymus organ culture is based on fetal thymus organ culture (FTOC). Purified thymocyte populations, from genetically modified mice or even from other species, are cultured in vitro with thymic lobes depleted of their endogenous thymocytes (by 2'-deoxyguanosine treatment) to form a new thymus. This potent and timesaving method is distinct from FTOC, which assesses development of unmodified thymic lobes, and reaggregate thymic organ culture, in which epithelial cells are separately purified before being aggregated with thymocytes.

Posterior approach for accessory-suprascapular nerve transfer: an electrophysiological outcomes study

The aim of this study was to retrospectively investigate the electrophysiological results obtained after employing the posterior approach for spinal accessory nerve-suprascapular nerve (SAN-SSN) transfer, and to compare this with the traditional anterior approach. SAN-SSN transfer was performed in 74 patients with brachial plexus injury. The posterior approach was used in 35 patients and the anterior approach was used in 39 patients. Electrophysiological examination was conducted and analyzed postoperatively. There was no significant difference between approaches in the time it took for the infraspinatus to show low-incidence motor unit action potentials (MUAPs) and an incomplete interference pattern. In addition, the final ratio of patients that showed regeneration potential of the infraspinatus was not significantly different between the approaches. Furthermore, latency and wave amplitude showed a linear regression with post-operative time in the posterior approach group. In the posterior approach group, the final abduction of the shoulder was positively correlated with the amplitude. The posterior approach for SAN-SSN is an effective potential alternative technique that may be appropriate for some clinical situations.

Pharmacokinetics and bioequivalence study of two indapamide formulations after single-dose administration in healthy Chinese male volunteers

The pharmacokinetics and relative bioavailability/bioequivalence of 2 formulations of indapamide were assessed in this paper. The study was conducted in 20 healthy Chinese male volunteers according to an open, randomized, single-blind, 2-way crossover study design with a wash-out phase of 7 days. Blood samples for pharmacokinetic profiling were taken up to 84 h post-dose, and indapamide concentrations in plasma were determined by a validated liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS) method. Based on the plasma concentration-time data of each individual in each period, pharmacokinetic parameters, Cmax, AUC0-τ, AUC0-∞ and t1/2, were calculated by non-compartmental analysis. Pharmacokinetic parameters for test and reference formulations were analyzed statistically to assess bioequivalence of the 2 formulations. The values of Cmax, Tmax, t1/2, AUC0-τ, AUC0-∞ for test and reference formulations were 49.53±5.53 and 47.79±4.68 ng/mL, 1.9±0.6 and 2.0±0.5 h, 22.49±5.93 and 23.23±4.48 h, 859.51±160.92 and 840.90±170.62 ng · h/mL, 934.35±190.60 and 919.52±179.74 ng · h/mL, respectively. The 90% confidence intervals of the T/R-ratios of logarithmically transformed data were within the accepted range of 80-125%. It showed that the 2 formulations of indapamide were bioequivalent. Both preparations were well tolerated and no adverse reactions were found throughout the study.

p300-mediated acetylation stabilizes the Th-inducing POK factor

The lineage-specifying factor Th-inducing POK (ThPOK) directs the intrathymic differentiation of CD4 T cells. Although the regulation of ThPOK at the transcription level has been extensively studied, specific posttranslational modifications regulating the activity of ThPOK have not been addressed. In this paper, we show that ThPOK is an unstable protein that is more readily degraded in CD8 T cells compared with CD4 T cells. Among the various proteins that bind ThPOK, acetyltransferase p300 specifically promotes the acetylation of ThPOK at K210, K216, and K339, outcompeting ubiquitination, thereby stabilizing the protein. In CD4 T cells, attenuation of p300-mediated acetylation promotes the degradation of ThPOK. In contrast, mutation of lysines 210, 216, and 339 to arginines stabilizes ThPOK and enhances its ability to suppress the expression of CD8 molecule and cytotoxic effectors in CD8 T cells. Our results reveal an essential role of p300-mediated acetylation in regulating the stability of ThPOK and suggest that such regulation may play a part in CD4/CD8 lineage differentiation.

[Effect of acupuncture combined behavior intervention on children with autism]

OBJECTIVE

To investigate the effect of acupuncture combined behavior intervention on children with autism.

METHODS

Patients were treated by "Jin's three-needling" as the main measure with the assistance of behavior intervention, and the changes were compared among the three groups (29 cases in combination group, 15 cases in acupuncture group and 10 cases in intervention group) before and after treatment of various factors and scores estimated by the autism behavior checklist (ABC) and autism development checklist (ADC).

RESULTS

In the combination group, the total scores of ABC and most factors of ABC including body movement, social communication and language factor were improved significantly after treatment (P < 0.01), but there was no significant changes in sense factor and daily life self-caring factor (P > 0.05). Comparison of most items of ADC before and after treatment also showed significant difference (P < 0.01).

CONCLUSION

Acupuncture combined behavior intervention has better therapeutic efficacy in the treatment of children with autism.

[Hepatic trisegmentectomy for 29 patients with huge neoplasms of liver]

OBJECTIVE

To evaluate the feasibility and effect of hepatic trisegmentectomy for patients with huge neoplasms of liver.

METHODS

From July 1993 to October 1999, 29 patients with huge hepatic neoplasms underwent hepatic trisegmentectomy, (23 patients with primary liver cancer, 1 patient with hepatic infiltration of gallbladder cancer, 1 patient with metastasis of colon cancer, 1 patient with hepatic angiosarcoma, 1 patient with hepatic neurofibroma, and 2 patients with huge liver cyst). Of these patients, 26 underwent right trisegmentectomies and the rest 3 accepted left trisegmentectomies. All trisegmentectomies were performed under normothermic interruption of the porta hepatis at single time and these interruptions lasted 15 to 40 minutes.

RESULTS

The relatively good effect was seen in our series of trisegmentectomies. The 1-, 3-, 5-year survival rates for patients with primary liver cancer were 63.6%, 36.4% and 27.3%, respectively. The survival time for patients with hepatic infiltration of gallbladder cancer and metastasis of colon cancer in the liver was 6 months. The patients with hepatic angiosarcoma, hepatic neurofibroma and 2 huge liver cysts survived 35, 26, 25, 40 months and 1 till to the latest follow-up, respectively. Main complications were present in 5 patients. Mortality within 1 month was 3.4% (1/ 29).

CONCLUSION

Hepatic trisegmentectomy is safe and effective in treatment of huge hepatic neoplasms if its indications and operative techniques are mastered properly.

[A surgery oriented serial treatments of 191 patients with large primary liver cancer]

OBJECTIVE

To discuss the methods and effects of a series of surgery oriented therapies in the treatment of large primary liver cancers.

METHODS

From January 1993 to June 1999, 191 patients with large liver cancer were treated chiefly by operation. The size of the primary cancer varied from 5.2 to 19.7 cm (median 9.4 cm). Various kinds of liver resections were performed in 121 patients and, as a supplement, deep cryosurgery was carried for out the rest 70 patients. Importable drug delivery system (IDDS) was instituted intraoperatively. Transcatheter arterial chemo-embolization (TACE, THP 30-60 mg, E-ADM 20-40 mg, CDDP 40-80 mg, MMC 10-20 mg, iodine oil 5-30 ml), percutaneous ethanol injection (PEI), bioimmunotherapy and the traditional Chinese medicine were used pre- and post-operatively. CT angiography (CTA) and CT during arterial portography (CTAP) were used to find satellite nodules. Early recurrence was diagnosed by AFPmRNA monitor in peripheral blood. Child's classification plus branch chain amino acid/aromatic amino acid (BCAA/AAA) were adopted in evaluating the pre-operative liver functions.

RESULTS

Remarkable results were observed after this surgery oriented serial treatment. The 1-, 3- and 5-year survival rates in the resection group were 75.8%, 45.6% and 30.4%, respectively. The 1- and 3-year survival rates in the cryosurgery group were 63.2% and 37.0%. The operative mortality was 1.6%. Recurrence rates were 69.2% in AFPmRNA positive group and 33.3% in AFPmRNA negative group. Comparing this two groups, significant difference was observed (P < 0.05). BCAA/AAA were lower than 1.5 in two patients died after resection.

CONCLUSION

A serial treatment with surgery as the chief modality gives satisfactory results in large primary liver cancers. This regimen should be adhered to as a main strategy in dealing with large liver cancers. AFPmRNA in the peripheral blood, signifying a recurrence, may become a hope of a new clinical parameter. BCAA/AAA plus Child's classification is able to evaluate more accurately the hepatic functional reserve before surgery.

Dammarane derivatives from the dried fruits of Forsythia suspensa

Anti-inflammatory activity guided fractionation of the n-hexane soluble fraction of a 70% aqueous methanolic extract of the dried fruits of Forsythia suspensa afforded two new triterpenes. The structures of these compounds were elucidated as 3beta-acetyl-20,25-epoxydammarane-24alpha-ol (1) and 3beta-acetyl-20,25-epoxydammarane-24beta-ol (2) on the basis of spectral data interpretation as well as by comparison with those of structurally similar compounds.

Expression of the MAGE-1 gene in human hepatocellular carcinomas

OBJECTIVE

To further investigate the expression of MAGE-1 gene in hepatocellular carcinoma (HCC).

METHODS

The tumors and adjacent liver tissue from 45 HCC patients and liver tissue from 28 non-HCC patients (16 with liver cirrhosis and 12 with normal liver) were characterized by RT-PCR. A 421 bp PCR product from a cDNA fragment spanning exons 1, 2 and 3 was sequenced. The HLA type was assayed by standard ELISA in 43 HCC patients.

RESULTS

Thirty-two of 45 tumor tissues from HCC patients expressed MAGE-1 mRNA (71.1%). In contrast, MAGE-1 mRNA was not detected in adjacent tissues. Three were found to have point mutations at 3 identical sites resulting in the substitution of two amino acid residues. The most frequent HLA types in 43 HCC patients were: HLA-A2, 53.5%; A11, 25.6%; A24, 20.9%; A33, 20.9%; HLA-B13, 28.3% and B35, 23.2%. Expression of HLA-A33 (20.9%) was higher in HCC patients than that predicted in the normal Chinese population (8.8%). There was no discemable correlation between MAGE-1 expression and alpha-FP level, tumor size and hepatitis B or C virus infection. The identification of peptides which are restricted by haploptypes other than A1 should increase the opportunity for peptide based immunotherapy.

CONCLUSIONS

This study shows that MAGE-1 mRNA is highly expressed in HCC tumor tissue in Chinese patients. Previously unreported point mutations in the MAGE-1 gene are described and may also provide additional opportunities for immunotherapy.

Biological function of a novel gene overexpressed in human hepatocellular carcinoma

OBJECTIVE

To clone the full-length of a differentially expressed cDNA fragment, LC27, and study its biological function tentatively.

METHODS

Northern blot was used to analyze the expression pattern of LC27 in hepatocellular carcinoma, matched nontumor liver tissues, fetal liver and normal adult liver tissues, as well as BEL-7402 hepatocellular carcinoma cell line ESTs splicing and 5' rapid amplification of cDNA ends (5' RACE) were used to clone the full-length of LC27 cDNA. An antisense oligodeoxynucleotide approach was used to investigate the biological role of the gene in the proliferation of BEL-7402 cells.

RESULTS

A 2186 bp novel cDNA with an open reading frame encoding a 283 amino acid protein was cloned. Analysis of the deduced amino acid sequence indicated that it is 38% (88/229) identical to human Golgi 4-transmembrane spanning transporter MTP. The gene and the encoded protein was termed hepatocellular carcinoma overexpressed transmembrane protein (hotp) and HOTP, respectively. Hotp mRNA was almost undetectable in normal adult liver and fetal liver tissues. However, it was significantly up-regulated in hepatocellular carcinoma and some matched nontumor liver tissues, as well as BEL-7402 cells. The proliferation of BEL-7402 cells was suppressed by an antisense oligodeoxynucleotide against hotp mRNA at a concentration of 50 micrograms/ml.

CONCLUSION

HOTP may be an integral membrane transporter protein. The overexpression of the gene in hepatocellular carcinoma may play an important role in hepatocarcinogenesis and disease progression.

[Melanoma antigen-3 expression in human hepatocellular carcinoma]

OBJECTIVE

To investigate the expression of melanoma antigen-3 (MAGE-3) mRNA in human hepatocellular carcinoma (HCC) and probe into the theoretical feasibility that MAGE-3 antigens can be developed as a new peptide vaccine for immunotherapy in HCC patients.

METHODS

The expression of MAGE-3 mRNA in HCC tissues and the adjacent non-HCC liver tissues was studied using RT-PCR in 45 HCC patients. The results were compared with those of 16 cirrhotic patients and 12 patients whose liver tissues were pathologically normal. MAGE-3 mRNA positive PCR products were DNA sequenced in 3 HCC patients. The sequenced fragments of MAGE-3 cDNA were used as template by which a [alpha(32)P] labeled probe was synthesized and employed for Southern blot analysis. HLA class I-A and -B typing of 43 HCC patients were assayed by ELISA.

RESULTS

Of the 45 HCC samples, 35 (78%) expressed MAGE-3 mRNA and six HCC adjacent tissues were also positive in MAGE-3 expression. Pathological examination showed cellular heteromorphism in these adjacent tissues. The non-HCC liver tissues from cirrhosis and normal liver samples were not MAGE-3 mRNA detectable. The DNA sequence confirmed that the target gene fragment in all of the 3 samples of PCR products was MAGE-3 cDNA. Southern blotting result confirmed that of RT-PCR assay. In HCC patients, the predominant types of HLA were A(2) (53.5%), A(11) (25.6%), A(24) (20.9%), A(33) (20.9%), B(13) (28.3%), and B(35) (23.2%). MAGE-3 mRNA expression in HCC showed no correlation with the level of serum AFP and the size of the tumor.

CONCLUSIONS

MAGE-3 mRNA is expressed at a high percentage of HCC samples. This tumor rejection antigen may be used as peptide vaccine for immunotherapy of HCC patients. The phenomena that some non-HCC adjacent tissues with heteromorphism can express MAGE-3 like their paired HCC tissues indicate that the expression of MAGE-3 may be an indicator in the early stage of carcinogenesis of liver tissues.

Expression of urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor, and plasminogen activator inhibitor-1 and -2 in hepatocellular carcinoma

It has become more and more clear in recent decades that the plasminogen activation system, which includes urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAR), plasminogen activator inhibitor (PAI)-1 and PAI-2, plays a very important role in the aggressiveness of cancer. Using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), the expression of these four components of the uPA system was analyzed in 19 cases of hepatocellular carcinoma (HCC) and 18 cases of the adjacent non-cancer tissues which all had chronic active hepatitis with liver fibrosis or liver cirrhosis. Four cases of normal liver tissues, as controls for immunohistochemical stains, were obtained from the hepatectomized liver of patients with metastatic cancer in the liver. The positive rates of uPA, uPAR, PAI-1 and PAI-2 for immunohistochemical stains in cancer tissues were 78.9, 68.4, 57.9 and 31.6%, respectively. Positive signals were mainly distributed in the cytoplasm of the cancer and in stromal cells. Moreover, the strong stains were chiefly located in the invasive front of the cancer cells. No specific stain was detected in four cases of normal liver tissues. In ELISA, there were significant differences between cancer and non-cancer tissues in concentration of uPA, uPAR and PAI-1 (P < 0.0003, 0.0024 and 0.01, respectively), but there was no significant difference in that of PAI-2 (P = 0.37). These results suggest that uPA, uPAR and PAI-1 are related to invasion of HCC.

Antiinflammatory effect of Forsythia suspensa V(AHL) and its active principle

This study was carried out to elucidate the antiinflammatory active principles obtained from 70% methanol extract of the dried fruit of Forsythia suspensa V(AHL) (F. suspensa). The methanol extract was then partitioned between n-hexane and water, and then the n-hexane fraction was evaporated to dryness under vacuum. The n-hexane fraction was chromatographed (Frs. I--V), Fr. IV was rechromatographed (Frs. VI--VIII), and then Fr. VII was rechromatographed (Frs. IX--XI) by silica gel column chromatography. The antiinflammatory activity of these fractions was investigated on acetic acid-induced vascular permeability in rats. The n-hexane fraction showed an antiinflammatory effect and these activities shifted successively to Fr. IV, Fr. VII and Fr. X. The chemical structure of the active principle obtained from Fr. X was identified as 3beta-acetoxy-20,25-epoxydammarane-24-ol. These results suggest that the antiinflammatory and an analgesic effect of 70% methanol extract of F. suspensa may be the result of the compound that it contains.

[The value of serum alpha-L-fucosidase activity in the diagnosis of primary liver cancer]

OBJECTIVE

To analyse the value of serum alpha-L-fucosidase (AFU) in the diagnosis of primary liver cancer (PLC).

METHODS

Serum AFU was studied in 141 patients with PLC, 17 patients with secondary liver cancer, 16 patients with cirrhosis, and 30 controls. Rank correlation analysis was used to assess the relation between value of AFU activity and TNM staging. The results were compared to those of serum AFP determination.

RESULTS

AFU was increased in 108 of 141 (76.6%) patients. The positive rate was statistically different from that in patients with secondary liver cancer, cirrhosis, and that in normal individual. The AFU level was correlated with TNM stage. In 25 PLC patients with AFU > 500 nmol.L-1.S-1, the average survival time was only 71 days. In 36 PLC patients who had received effective treatment, the serum AFU decreased to a significantly lower level than that examined before treatment. The positive rate of AFP in PLC patients was 64.5%. It rose to 86.2% if both parameters were used.

CONCLUSION

AFU is a useful marker of PLC for diagnosis and posttreatment monitoring.

Effect of thermal variables on human breast cancer in cryosurgery

There is a growing interest in the use of cryosurgery to treat breast cancer, following recent breakthroughs in noninvasive imaging and in cryotechnology, as well as the recent success of cryosurgery in treating various types of cancer. However, since haphazard freezing does not guarantee tissue destruction, in order to apply this technique effectively it is essential to determine the thermal parameters that produce complete destruction of malignant tissue. This study seeks to quantitatively identify the relationship between thermal variables and the degree of freezing damage to human breast cancer cells. In order to do this, human breast cancer and normal cells were frozen with controlled thermal parameters using a directional solidification apparatus. Cell viability was determined after thawing using trypan blue, and correlated to the thermal variables used during freezing. Cellular damage is observed to increase with increasing cooling rates, due to the higher probability of intracellular ice formation. A double freeze thaw cycle significantly increases the extent of cell damage, and is sufficient to ensure complete cell destruction at final freezing temperatures of -40 degrees C for a 25 degrees C/min cooling rate, and -20 degrees C for a 50 degrees C/min cooling rate. The correlations between cell death and thermal parameters are qualitatively identical for all the cell types in this study, although there is some variation from one cell type to another in the overall susceptibility to freezing damage. The correlations established in this study can be used to design systematic and optimal breast cryosurgery protocols.

[Infection of GBV-C virus among hepatitis and HCC patients]

To study the infection status of GBV-C virus among HBV, HCV, nonA-E and HCC patients, serum of clinical hepatitis patients and HCC patients before operation, and the composition in/beside HCC were collected to examine HGV RNA of the samples, using HGV RT-PCR method. Results showed that among the clinical patients with HBV, HCV, nonA-E and HCC, HGV infection rates were 9% (12/130), 10% (3/30), 17% (4/24), 0% (0/24) respectively, suggesting that HGV is a hepatitis virus with pervasive existence and has high superimposition infection rate with HBV and HCV but with little connection with HCC.

[Simultaneous determination of the enantiomers of verapamil and norverapamil in plasma by high performance capillary electrophoresis]

An analytical method has been developed to determine simultaneously plasma concentration of the enantiomers of verapamil and its major metabolite, norverapamil, using capillary zone electrophoresis. Trimethyl-beta-cyclodextrin was selected as chiral selector. Good separation was achieved under the conditions as below: Running electrolyte was pH 2.5, 60 mmol.L-1 phosphate buffer containing 60 mmol.L-1 trimethyl-beta-cyclodextrin; capillary: 30 cm x 75 microns (ID), coated; setpoint of capillary temperature: 20 degrees C; detector: UV 200 nm; injection: electromigration at 12 kV for 7 s; running voltage: 14 kV. Solvent of sample was doubly deionized water. The migration times of enantiomers were less than 12 min. The good linear range was from 300.0 ng.ml-1 to 2.50 ng.ml-1. Relative standard deviations of assay accuracy and precision were less than 12%. It fits for routine therapeutic monitoring as it is highly efficient, rapid, sensitive, with less solvent and sample consumption and automation.

Antiinflammatory effect of Forsythia suspensa Vahl and its active fraction

This study was carried out to elucidate the antiinflammatory effect of 70% methanol extract obtained from the dried fruit of Forsythia suspensa Vahl and its active principles. F. suspensa was extracted with 70% methanol and freeze-dried to give a powdered extract. The methanol extract was then dissolved in water and extracted with n-hexane, and the n-hexane fraction was evaporated to dryness under vacuum; the water fraction was freeze-dried to give a powdered extract. The antiinflammatory activity of the extract and fractions was investigated on acetic acid-induced vascular permeability and writhing symptoms in mice, as well as on carrageenin-induced edema and cotton pellet-induced granuloma formation in rats. The methanol extract and the n-hexane fraction (p.o.) showed the antiinflammatory effect and analgesic effect, but the water fraction did not. These results suggested that the antiinflammatory and analgesic activity induced by the methanol extract shifted to the n-hexane fraction and the active principles may be lipophilic compounds.

Immunological properties of TtT/M-87 cell line established from murine pituitary tumor-associated macrophages

TtT/M-87 cell is a macrophage cell line established from thyrotropic pituitary tumor tissues in mouse. In this paper, we report the immunological properties of M-87 cells as a model of tumor-associated macrophage. Contrasting with resident peritoneal macrophages, M-87 cells constitutively secreted small but significant amounts of TNF-alpha and IL-1 alpha, which were detectable in both biological assays (cytotoxic activity for L929 and co-mitogenic activity for Con A-induced T cell proliferation, respectively) and ELISA, and produced larger amounts of these cytokines upon stimulation with LPS. They expressed MHC class II molecules on their cell surface without stimulation by IFN-gamma. The accessory or antigen-presenting cell activity in antibody-producing response of spleen lymphocytes to sheep red blood cells was shown to be much higher in M-87 cells than normal peritoneal macrophages. In addition, when normal spleen lymphocytes were cultured with allogeneic tumor cells, such as EL-4 and S-180, in the presence of M-87 cells, lymphocytes reactive to stimulator cells were activated to manifest inhibitory effect on the tumor cell growth and also to manifest specific cytotoxic effect on the allogeneic tumor cells. These results show that M-87 cells derived from tumor-associated tissue are activated macrophages and that they are inhibitory to tumor cell growth and augmentative in the induction of T-cell-mediated immune responses.