Serum brain-derived neurotrophic factor remains elevated after long term follow-up of combat veterans with chronic post-traumatic stress disorder

Attempts to correlate blood levels of brain-derived neurotrophic factor (BDNF) with post-traumatic stress disorder (PTSD) have provided conflicting results. Some studies found a positive association between BDNF and PTSD diagnosis and symptom severity, while others found the association to be negative. The present study investigated whether serum levels of BDNF are different cross-sectionally between combat trauma-exposed veterans with and without PTSD, as well as whether longitudinal changes in serum BDNF differ as a function of PTSD diagnosis over time. We analyzed data of 270 combat trauma-exposed veterans (230 males, 40 females, average age: 33.29 ± 8.28 years) and found that, at the initial cross-sectional assessment (T0), which averaged 6 years after the initial exposure to combat trauma (SD=2.83 years), the PTSD positive group had significantly higher serum BDNF levels than the PTSD negative controls [31.03 vs. 26.95 ng/mL, t(268) = 3.921, p < 0.001]. This difference remained significant after excluding individuals with comorbid major depressive disorder, antidepressant users and controlling for age, gender, race, BMI, and time since trauma. Fifty-nine of the male veterans who participated at the first timepoint (T0) were re-assessed at follow-up evaluation (T1), approximately 3 years (SD=0.88 years) after T0. A one-way ANOVA comparing PTSD positive, "subthreshold PTSD" and control groups revealed that serum BDNF remained significantly higher in the PTSD positive group than the control group at T1 [30.05 vs 24.66 ng/mL, F(2, 56)= 3.420, p = 0.040]. Serum BDNF levels did not correlate with PTSD symptom severity at either time point within the PTSD group [r(128) = 0.062, p = 0.481 and r(28) = 0.157, p = 0.407]. Serum BDNF did not significantly change over time within subjects [t(56) = 1.269, p = 0.210] nor did the change of serum BDNF from T0 to T1 correlate with change in PTSD symptom severity within those who were diagnosed with PTSD at T0 [r(27) = -0.250, p = 0.192]. Our longitudinal data are the first to be reported in combat PTSD and suggest that higher serum BDNF levels may be a stable biological characteristic of chronic combat PTSD independent of symptom severity.

Use of the Tissue Common Rejection Module Score in Kidney Transplant as an Objective Measure of Allograft Inflammation

Long-term kidney transplant (KT) allograft outcomes have not improved as expected despite a better understanding of rejection and improved immunosuppression. Previous work had validated a computed rejection score, the tissue common rejection module (tCRM), measured by amplification-based assessment of 11 genes from formalin-fixed paraffin-embedded (FFPE) biopsy specimens, which allows for quantitative, unbiased assessment of immune injury. We applied tCRM in a prospective trial of 124 KT recipients, and contrasted assessment by tCRM and histology reads from 2 independent pathologists on protocol and cause biopsies post-transplant. Four 10-μm shaves from FFPE biopsy specimens were used for RNA extraction and amplification by qPCR of the 11 tCRM genes, from which the tCRM score was calculated. Biopsy diagnoses of either acute rejection (AR) or borderline rejection (BL) were considered to have inflammation present, while stable biopsies had no inflammation. Of the 77 biopsies that were read by both pathologists, a total of 40 mismatches in the diagnosis were present. The median tCRM scores for AR, BL, and stable diagnoses were 4.87, 1.85, and 1.27, respectively, with an overall significant difference among all histologic groups (Kruskal-Wallis, p < 0.0001). There were significant differences in tCRM scores between pathologists both finding inflammation vs. disagreement (p = 0.003), and both finding inflammation vs. both finding no inflammation (p < 0.001), along with overall significance between all scores (Kruskal-Wallis, p < 0.001). A logistic regression model predicting graft inflammation using various clinical predictor variables and tCRM revealed the tCRM score as the only significant predictor of graft inflammation (OR: 1.90, 95% CI: 1.40–2.68, p < 0.0001). Accurate, quantitative, and unbiased assessment of rejection of the clinical sample is critical. Given the discrepant diagnoses between pathologists on the same samples, individuals could utilize the tCRM score as a tiebreaker in unclear situations. We propose that the tCRM quantitative score can provide unbiased quantification of graft inflammation, and its rapid evaluation by PCR on the FFPE shave can become a critical adjunct to help drive clinical decision making and immunosuppression delivery.

Effect of benzimidazole drugs on the uptake of low molecular weight nutrients in Trichuris globulosa

Thiabendazole (100 microM) and fenbendazole (250 microM) were found to inhibit U-14 C-glucose, (Na)-1-14C-palmitate and (Na)-1-14 C-acetate uptake markedly (P less than 0.001) in adult Trichuris globulosa. The inhibition was more pronounced with thiabendazole than with fenbendazole. 14C-Glucose was found to be Na(+)-dependent and a mediated process. Bile salts, viz. sodium cholate and sodium desoxycholate in the concentration range of 5-10 mM, were found to inhibit the uptake of 14C-glucose and 14C-palmitate (P less than 0.01) by the parasites. The optimum pH for (Na)-1-14C-palmitate and (Na)-1-14C-acetate uptake was 6.7 and 6.2, respectively while the optimum temperature for the uptake of these compounds was 37 degrees C.

Lipid metabolism in Trichuris globulosa (Nematoda)

Adult males and females of Trichuris globulosa, an intestinal nematode parasite of goats, were studied for their lipid composition, capability of incorporation of (Na)-1-14C-acetate into different lipid classes and the activity of certain key enzymes of lipid metabolism. The parasite possesses a large variety of lipids including certain complex lipids. These are phosphatidylcholine (PC), diphosphatidylglycerol (cardiolipin), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), phosphatidylserine (PS), phosphatidylinositol (PI), plasmalogens (choline + ethanolamine), mono-, di- and triacylglycerols, free and esterified cholesterol, non-esterified fatty acids (NEFA), gangliosides, cerebrosides (glycosyl ceramide) and sulphuric acid esters of cerebrosides (sulphatides). The females contain more lipids than males, particularly the acylglycerols and phospholipids, possibly to meet the energy requirement and structural entities for the daily production of large numbers of eggs. Incorporation studies of labelled substrate, sodium-1-14C acetate demonstrate that the adult female has extremely active mechanisms for biosynthesizing these lipids. Most of the labels are found in PC, PE, SM, acylglycerols, NEFA, gangliosides, cerebrosides and sulphatides. Cholesterol, although a minor component of the parasitic lipids, incorporates large amount of label and also undergoes fast turnover. Kinetic analysis of the incorporation by measuring the rate constant (k) and half life (t1/2) reveals that gangliosides are the fastest biosynthesizing and turning over lipids, although they constitute only 0.1% of the total lipids. The presence of important enzymes of lipid biosynthesis, glucose-6-phosphate dehydrogenase, malate dehydrogenase and hydroxymethyl glutaryl-CoA reductase and an enzyme of lipid ester hydrolysis, triacylglycerol lipase, is also established in T. globulosa. Michaelis-Menten kinetic characteristics of the parasitic enzymes (Km, Vmax, v and the first order rate constant, k) are comparable with those of rat liver homogenates.