The role of B cells in immune cell activation in polycystic ovary syndrome

Variations in B cell numbers are associated with polycystic ovary syndrome (PCOS) through unknown mechanisms. Here we demonstrate that B cells are not central mediators of PCOS pathology and that their frequencies are altered as a direct effect of androgen receptor activation. Hyperandrogenic women with PCOS have increased frequencies of age-associated double-negative B memory cells and increased levels of circulating immunoglobulin M (IgM). However, the transfer of serum IgG from women into wild-type female mice induces only an increase in body weight. Furthermore, RAG1 knock-out mice, which lack mature T- and B cells, fail to develop any PCOS-like phenotype. In wild-type mice, co-treatment with flutamide, an androgen receptor antagonist, prevents not only the development of a PCOS-like phenotype but also alterations of B cell frequencies induced by dihydrotestosterone (DHT). Finally, B cell-deficient mice, when exposed to DHT, are not protected from developing a PCOS-like phenotype. These results urge further studies on B cell functions and their effects on autoimmune comorbidities highly prevalent among women with PCOS.

Transgenerational transmission of reproductive and metabolic dysfunction in the male progeny of polycystic ovary syndrome

The transgenerational maternal effects of polycystic ovary syndrome (PCOS) in female progeny are being revealed. As there is evidence that a male equivalent of PCOS may exists, we ask whether sons born to mothers with PCOS (PCOS-sons) transmit reproductive and metabolic phenotypes to their male progeny. Here, in a register-based cohort and a clinical case-control study, we find that PCOS-sons are more often obese and dyslipidemic. Our prenatal androgenized PCOS-like mouse model with or without diet-induced obesity confirmed that reproductive and metabolic dysfunctions in first-generation (F₁) male offspring are passed down to F₃. Sequencing of F₁-F₃ sperm reveals distinct differentially expressed (DE) small non-coding RNAs (sncRNAs) across generations in each lineage. Notably, common targets between transgenerational DEsncRNAs in mouse sperm and in PCOS-sons serum indicate similar effects of maternal hyperandrogenism, strengthening the translational relevance and highlighting a previously underappreciated risk of transmission of reproductive and metabolic dysfunction via the male germline.

Transcriptomic survey of key reproductive and metabolic tissues in mouse models of polycystic ovary syndrome

Excessive androgen production and obesity are key to polycystic ovary syndrome (PCOS) pathogenesis. Prenatal androgenized (PNA), peripubertal androgenized, and overexpression of nerve growth factor in theca cells (17NF) are commonly used PCOS-like mouse models and diet-induced maternal obesity model is often included for comparsion. To reveal the molecular features of these models, we have performed transcriptome survey of the hypothalamus, adipose tissue, ovary and metaphase II (MII) oocytes. The largest number of differentially expressed genes (DEGs) is found in the ovaries of 17NF and in the adipose tissues of peripubertal androgenized models. In contrast, hypothalamus is most affected in PNA and maternal obesity models suggesting fetal programming effects. The Ms4a6e gene, membrane-spanning 4-domains subfamily A member 6E, a DEG identified in the adipose tissue in all mouse models is also differently expressed in adipose tissue of women with PCOS, highlighting a conserved disease function. Our comprehensive transcriptomic profiling of key target tissues involved in PCOS pathology highlights the effects of developmental windows for androgen exposure and maternal obesity, and provides unique resource to investigate molecular mechanisms underlying PCOS pathogenesis.

Prenatal androgen exposure causes a sexually dimorphic transgenerational increase in offspring susceptibility to anxiety disorders

If and how obesity and elevated androgens in women with polycystic ovary syndrome (PCOS) affect their offspring's psychiatric health is unclear. Using data from Swedish population health registers, we showed that daughters of mothers with PCOS have a 78% increased risk of being diagnosed with anxiety disorders. We next generated a PCOS-like mouse (F₀) model induced by androgen exposure during late gestation, with or without diet-induced maternal obesity, and showed that the first generation (F₁) female offspring develop anxiety-like behavior, which is transgenerationally transmitted through the female germline into the third generation of female offspring (F₃) in the androgenized lineage. In contrast, following the male germline, F₃ male offspring (mF₃) displayed anxiety-like behavior in the androgenized and the obese lineages. Using a targeted approach to search for molecular targets within the amygdala, we identified five differentially expressed genes involved in anxiety-like behavior in F₃ females in the androgenized lineage and eight genes in the obese lineage. In mF₃ male offspring, three genes were dysregulated in the obese lineage but none in the androgenized lineage. Finally, we performed in vitro fertilization (IVF) using a PCOS mouse model of continuous androgen exposure. We showed that the IVF generated F₁ and F₂ offspring in the female germline did not develop anxiety-like behavior, while the F₂ male offspring (mF₂) in the male germline did. Our findings provide evidence that elevated maternal androgens in PCOS and maternal obesity may underlie the risk of a transgenerational transmission of anxiety disorders in children of women with PCOS.

Excess of ovarian nerve growth factor impairs embryonic development and causes reproductive and metabolic dysfunction in adult female mice

Nerve growth factor (NGF) is critical for the development and maintenance of the peripheral sympathetic neurons. NGF is also involved in the ovarian sympathetic innervation and in the development and maintenance of folliculogenesis. Women with the endocrine disorder, polycystic ovary syndrome (PCOS), have an increased sympathetic nerve activity and increased ovarian NGF levels. The role of ovarian NGF excess in the PCOS pathophysiology and in the PCOS-related features is unclear. Here, using transgenic mice overexpressesing NGF in the ovarian theca cells (17NF mice), we assessed the female embryonic development, and the reproductive and metabolic profile in adult females. Ovarian NGF excess caused growth restriction in the female fetuses, and a delayed gonocyte and primary oocyte maturation. In adulthood, the 17NF mice displayed irregular estrous cycles and altered ovarian expression of steroidogenic and epigenetic markers. They also exhibited an increased sympathetic output with increased circulating dopamine, and metabolic dysfunction reflected by aberrant adipose tissue morphology and function, impaired glucose metabolism, decreased energy expenditure, and hepatic steatosis. These findings indicate that ovarian NGF excess leads to adverse fetal development and to reproductive and metabolic complications in adulthood, mirroring common features of PCOS. This work provides evidence that NGF excess may be implicated in the PCOS pathophysiology.

MON-032 Excessive Ovarian Sympathetic Activity Impairs Embryonic Development and Causes Reproductive and Metabolic Dysfunction

Nerve growth factor is a member of the neurotrophin family and within the ovary, it plays an important role in sympathetic innervation and in the development and maintenance of folliculogenesis. Despite its critical role, excessive levels of ovarian NGF may lead to ovarian pathology and to the development of features of polycystic ovary syndrome (PCOS), which is the most common endocrine disorder among women of reproductive age. Here, using a transgenic mouse model overexpressing NGF selectively in the ovary (17NF mice), we studied how ovarian sympathetic hyperactivity affects embryonic development and reproductive and metabolic function in adulthood. Firstly, we showed that ovarian NGF excess caused growth restriction in the developing female fetuses, which was driven by defects in the placenta function. Moreover, the 17NF fetuses experienced a reduction of germ cell number along with delayed gonocyte and primary oocyte maturation. The adult 17NF mice displayed irregular cyclicity and aberrant ovarian expression of steroidogenic genes and epigenetic markers. The ovarian sympathetic hyperactivity also led to increased systemic sympathetic outflow, indicated by increased circulating dopamine levels, and to metabolic dysfunction in adulthood. The 17NF mice had increased adiposity, impaired glucose metabolism and decreased energy expenditure. The subcutaneous and parametrial fat depots displayed impaired function due to ovarian NGF excess, wherein the subcutaneous fat increased mass by enhanced preadipocyte differentiation and enlarged adipocyte size, while the parametrial fat had smaller adipocyte size and a modest increase in stimulated lipolysis. These defects also led to hepatic steatosis. Overall, our findings indicate that ovarian sympathetic hyperactivity has deleterious effects on whole-body homeostasis and leads to impaired embryonic development and to reproductive and metabolic defects in adult life.

MON-035 Does Androgen Exposure Result in Germline Transmission of PCOS-Like Phenotypes and Can It Be Reversed?

Daughters of women with polycystic ovary syndrome (PCOS) are more likely to be diagnosed with PCOS, including reproductive and metabolic dysfunctions. Our recent research has demonstrated that dihydrotestosterone (DHT) exposure during late pregnancy results in transgenerational transmission of PCOS susceptibility to female offspring. But it remains unclear whether the transmission of the PCOS-like phenotypes is induced by in utero environment or via germ cell reprogramming, and whether treatment by exercise or androgen receptor blocker, flutamide, can prevent disease transmission. To model PCOS condition, donor mice were implanted with a continuous releasing DHT or vehicle pellet at 4 weeks of age. A subset of DHT exposed F0 donors had either free access to running wheels or were implanted with a slow-releasing flutamide pellet. Mice were exposed with or without treatment for either 6 weeks before IVF or 10 weeks prior to phenotypic testing. Here we present the phenotype of the F0 donors and the result of IVF to generate first (F1) and second (F2) generation offspring. Donors weigh more already after 2 weeks of DHT exposure and had more fat mass with larger adipocyte size, impaired glucose tolerance, and heavier kidney after 10 weeks of androgenization, which was reversed by both flutamide and exercise intervention. Moreover, DHT exposure increased circulating androgens and donors were completely acyclic. Simultaneous treatment with flutamide reversed the elevated androstenedione, testosterone, and restored estrus cyclicity, indicating that androgen receptor blocker can reverse hyperandrogenemia and reproductive dysfunction, whereas exercise failed to improve these phenotypes. After 6 weeks of exposure or treatment, donor oocytes were superovulated for IVF. Fewer oocytes per donor were found in androgenized + flutamide lineage, but no significant difference was observed in oocyte to two-cell embryo conversion rate after fertilization among all groups. Although the number of live offspring at weaning was similar among all groups, a trend of more F1 male than female offspring was found in both androgenized and androgenized + exercise lineage. Similar results were obtained in the F1 females when generating F2 offspring by IVF, which androgenized + flutamide lineage showed fewer oocytes per donor upon superovulation and more F2 male than female offspring was obtained in androgenized lineage at weaning. We here show that the androgenized donors develop clear PCOS-like phenotypes and give rise to more male than female F1 and F2 offspring. While blocking androgen receptor reverses both metabolic and reproductive disturbance in the donor, it also shows a negative impact on the donor and F1 female oocyte maturation process, although number of offspring via IVF is not affected. Excercise, however, only reverses the metabolic phenotypes in the F0 donor mice with no impact on IVF outcome.

SAT-201 Diet-Induced Obesity and Prenatal Androgen Exposure Increase Transgenerational Susceptibility to Metabolic Dysfunction in Male Adult Offspring

It is suggested that intrauterine environment play a role in the development of PCOS, and that first generation (F1) male offspring of the prenatal androgenized (PNA)-mice model exhibit metabolic dysfunction such as increased body weight and insulin resistance. Whether prenatal androgenisation, with or without diet-induced obesity, cause transgenerational effects on the male offspring through the paternal lineage have not previously been investigated. Therefore, we investigated how maternal high-fat high sucrose (HFHS) diet-induced obesity and in utero exposure to dihydrotestosterone (DHT) during embryonic day (E) 16.5-E18.5 (to create a PNA model) affect the metabolic phenotype of first, second and third (F1 to F3) generation male offspring. F1 and F2 male offspring were mated with females fed control diet (CD) to follow the paternal lineage. We found that F1 males born from mothers exposed to DHT and fed CD have longer anogenital distance (AGD), demonstrating androgen exposure in utero with no effect on F2 and F3 male offspring. F1 males from DHT exposed mothers with diet-induced obesity weigh more compared to F1 males from lean or obese mothers, with no differences in F2 and F3 male offspring. However, the F3 males from DHT exposed great-grand-mothers with diet-induced obesity have higher fat mass compared to other groups indicating a transgenerational effect. Moreover, F1 males from mothers with diet-induced obesity were insulin resistant with increased HOMA-IR and F3 male offspring from the same group exhibited impaired glucose tolerance as measured with oral glucose tolerance test. At night, when mice are more active, had F1 males from DHT exposed mothers fed CD or diet-induced obesity, and from vehicle treated mothers with diet-induced obesity, lower energy expenditure (EE) and respiratory exchange ratio (RER) measurement. Of note, the metabolic phenotype was exaggerated in F3 male offspring, with significantly lower EE, RER and total activity both during day and night time. These results likely reflect the higher body weight and increased fat mass in F1 and F3 male offspring. Taken together, these results demonstrate that diet-induced obesity before and during pregnancy together with androgen exposure cause a transgenerational effect on metabolic features in male offspring following the male germline.

SAT-227 Diet-Induced Obesity and Prenatal Androgen Exposure Reprogram the Fetus and Cause Transgenerational PCOS-Like Phenotypic Changes in Adult Female Offspring

The fetal life is a critical window of developmental patterning affecting growth trajectories before birth and can influence the risk of reproductive and metabolic disease in adulthood. Maternal obesity and elevated prenatal androgens are two prominent potential exposures which may affect the development of the embryo and its postnatal life. If in utero androgen exposure with or without maternal obesity increase female offspring susceptibility for transgenerational inheritance of reproductive and metabolic disease has not been investigated. Therefore we fed female mice high-fat high sucrose (HFHS) or control diet (CD) diet for 6 weeks prior mating to induce obesity and exposed pregnant female mice to prenatal androgen exposure with dihydrotestosterone (DHT) or vehicle during the embryonic day (E) 16.5-E18.5. At weaning, first, second and third generation (F1, F2, and F3) female offspring from DHT exposed mothers with diet-induced obesity had longer anogenital distance (AGD), a marker of in utero androgen exposure, and disturbed estrous cycle compared with offspring from vehicle treated mothers fed CD. F1 and F3 female offspring from DHT exposed mothers and great-grand mothers with diet-induced obesity weighed more compared to offspring from vehicle-treated obese mothers, and F3 female offspring from great-grand DHT exposed mothers had more fat mass assessed by EchoMRI. Additionally, F1 and F3 female offspring from DHT exposed mothers and great-grand mothers with or without diet-induced obesity displayed a lower respiration exchange ratio and reduced energy expenditure than offspring from vehicle-treated mothers fed CD assessed by the metabolic cages. Finally, mice were superovulated to collect MII oocytes for single-cell RNA sequencing. Our preliminary analysis reveal that genes related to preimplantation embryonic imprinting are differentially expressed in F1, F2, and F3 female offspring from DHT exposed mothers, grandmothers, and great-grandmothers fed CD, and in mice from mothers with diet-induced obesity. These results demonstrate that in utero androgen exposure and diet-induced obesity contribute to transgenerational effects on reproductive and metabolic phenotypes in adult female offspring, involving altered expression of preimplantation imprinting genes in germ cells.

ISO, via Upregulating MiR-137 Transcription, Inhibits GSK3β-HSP70-MMP-2 Axis, Resulting in Attenuating Urothelial Cancer Invasion

Our most recent studies demonstrate that miR-137 is downregulated in human bladder cancer (BC) tissues, while treatment of human BC cells with isorhapontigenin (ISO) elevates miR-137 abundance. Since ISO showed a strong inhibition of invasive BC formation in the N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN)-induced invasive BC mouse model, the elucidation of a potential biological effect of miR-137 on antagonizing BC invasion and molecular mechanisms underlying ISO upregulation of miR-137 are very important. Here we discovered that ectopic expression of miR-137 led to specific inhibition of BC invasion in human high-grade BC T24T and UMUC3 cells, while miR-137 deletion promoted the invasion of both cells, indicating the inhibitory effect of miR-137 on human BC invasion. Mechanistic studies revealed that ISO treatment induced miR-137 transcription by promoting c-Jun phosphorylation and, in turn, abolishing matrix metalloproteinase-2 (MMP-2) abundance and invasion in BC cells. Moreover, miR-137 was able to directly bind to the 3' UTR of Glycogen synthase kinase-3β (GSK3β) mRNA and inhibit GSK3β protein translation, consequently leading to a reduction of heat shock protein-70 (HSP70) translation via targeting the mTOR/S6 axis. Collectively, our studies discover an unknown function of miR-137, directly targeting the 3' UTR of GSK3β mRNA and, thereby, inhibiting GSK3β protein translation, mTOR/S6 activation, and HSP70 protein translation and, consequently, attenuating HSP70-mediated MMP-2 expression and invasion in human BC cells. These novel discoveries provide a deep insight into understanding the biomedical significance of miR-137 downregulation in invasive human BCs and the anti-cancer effect of ISO treatment on mouse invasive BC formation.

Animal Models for Studying the In Vivo Functions of Cell Cycle CDKs

Multiple Cdks (Cdk4, Cdk6, and Cdk2) and a mitotic Cdk (Cdk1) are involved in cell cycle progression in mammals. Cyclins, Cdk inhibitors, and phosphorylations (both activating and inhibitory) at different cellular levels tightly modulate the activities of these kinases. Based on the results of biochemical studies, it was long believed that different Cdks functioned at specific stages during cell cycle progression. However, deletion of all three interphase Cdks in mice affected cell cycle entry and progression only in certain specialized cells such as hematopoietic cells, beta cells of the pancreas, pituitary lactotrophs, and cardiomyocytes. These genetic experiments challenged the prevailing biochemical model and established that Cdks function in a cell-specific, but not a stage-specific, manner during cell cycle entry and the progression of mitosis. Recent in vivo studies have further established that Cdk1 is the only Cdk that is both essential and sufficient for driving the resumption of meiosis during mouse oocyte maturation. These genetic studies suggest a minimal-essential cell cycle model in which Cdk1 is the central regulator of cell cycle progression. Cdk1 can compensate for the loss of the interphase Cdks by forming active complexes with A-, B-, E-, and D-type Cyclins in a stepwise manner. Thus, Cdk1 plays an essential role in both mitosis and meiosis in mammals, whereas interphase Cdks are dispensable.

Somatic cells initiate primordial follicle activation and govern the development of dormant oocytes in mice

BACKGROUND

The majority of oocytes in the mammalian ovary are dormant oocytes that are enclosed in primordial follicles by several somatic cells, which we refer to as primordial follicle granulosa cells (pfGCs). Very little is known, however, about how the pfGCs control the activation of primordial follicles and the developmental fates of dormant oocytes.

RESULTS

By targeting molecules in pfGCs with several mutant mouse models, we demonstrate that the somatic pfGCs initiate the activation of primordial follicles and govern the quiescence or awakening of dormant oocytes. Inhibition of mTORC1 signaling in pfGCs prevents the differentiation of pfGCs into granulosa cells, and this arrests the dormant oocytes in their quiescent states, leading to oocyte death. Overactivation of mTORC1 signaling in pfGCs accelerates the differentiation of pfGCs into granulosa cells and causes premature activation of all dormant oocytes and primordial follicles. We further show that pfGCs trigger the awakening of dormant oocytes through KIT ligand (KITL), and we present an essential communication network between the somatic cells and germ cells that is based on signaling between the mTORC1-KITL cascade in pfGCs and KIT-PI3K signaling in oocytes.

CONCLUSIONS

Our findings provide a relatively complete picture of how mammalian primordial follicles are activated. The microenvironment surrounding primordial follicles can activate mTORC1-KITL signaling in pfGCs, and these cells trigger the awakening of dormant oocytes and complete the process of follicular activation. Such communication between the microenvironment, somatic cells, and germ cells is essential to maintaining the proper reproductive lifespan in mammals.

Mastl is required for timely activation of APC/C in meiosis I and Cdk1 reactivation in meiosis II

The Greatwall kinase orthologue Mastl regulates timely activation of APC/C to allow meiosis I exit and suppresses PP2A activity and thereby allows the rapid rise of Cdk1 activity that is necessary for meiosis II entry in mouse oocytes.

In mitosis, the Greatwall kinase (called microtubule-associated serine/threonine kinase like [Mastl] in mammals) is essential for prometaphase entry or progression by suppressing protein phosphatase 2A (PP2A) activity. PP2A suppression in turn leads to high levels of Cdk1 substrate phosphorylation. We have used a mouse model with an oocyte-specific deletion of Mastl to show that Mastl-null oocytes resume meiosis I and reach metaphase I normally but that the onset and completion of anaphase I are delayed. Moreover, after the completion of meiosis I, Mastl-null oocytes failed to enter meiosis II (MII) because they reassembled a nuclear structure containing decondensed chromatin. Our results show that Mastl is required for the timely activation of anaphase-promoting complex/cyclosome to allow meiosis I exit and for the rapid rise of Cdk1 activity that is needed for the entry into MII in mouse oocytes.

Two classes of ovarian primordial follicles exhibit distinct developmental dynamics and physiological functions

In the mammalian ovary, progressive activation of primordial follicles serves as the source of fertilizable ova, and disorders in the development of primordial follicles lead to various ovarian diseases. However, very little is known about the developmental dynamics of primordial follicles under physiological conditions, and the fates of distinct populations of primordial follicles also remain unclear. In this study, by generating the Foxl2-CreER(T2) and Sohlh1-CreER(T2) inducible mouse models, we have specifically labeled and traced the in vivo development of two classes of primordial follicles, the first wave of simultaneously activated follicles after birth and the primordial follicles that are gradually activated in adulthood. Our results show that the first wave of follicles exists in the ovaries for ∼3 months and contributes to the onset of puberty and to early fertility. The primordial follicles at the ovarian cortex gradually replace the first wave of follicles and dominate the ovary after 3 months of age, providing fertility until the end of reproductive life. Moreover, by tracing the time periods needed for primordial follicles to reach various advanced stages in vivo, we were able to determine the exact developmental dynamics of the two classes of primordial follicles. We have now revealed the lifelong developmental dynamics of ovarian primordial follicles under physiological conditions and have clearly shown that two classes of primordial follicles follow distinct, age-dependent developmental paths and play different roles in the mammalian reproductive lifespan.

Vision science literature of Nepal in the database "Web of Science"

INTRODUCTION

Vision Science is considered to be a quite developed discipline in Nepal, with much research currently in progress. Though the results of these endeavors are published in scientific journals, formal citation analyses have not been performed on works contributed by Nepalese vision scientists.

OBJECTIVE

To study Nepal's contribution to vision science literature in the database "Web of Science".

MATERIALS AND METHODS

The primary data source of this paper was Web of Science, a citation database of Thomas Reuters. All bibliometric analyses were performed with the help of Web of Science analysis service.

RESULTS

In the current database of vision science literature, Nepalese authors contributed 112 publications to Web of Science, 95 of which were original articles. Pokharel GP had the highest number of citations among contributing authors of Nepal. Hennig A contributed the highest number of article as a first author. The Nepal Eye Hospital contributed the highest number of articles as an institution to the field of Vision Science.

CONCLUSION

Currently, only two journals from Nepal including Journal of Nepal Medical Association (JAMA) are indexed in the Web of Science database (Sieving, 2012). To evaluate the total productivity of vision science literature from Nepal, total publication counts from national journals and articles indexed in other databases such as PubMed and Scopus must also be considered.

The safe use of a PTEN inhibitor for the activation of dormant mouse primordial follicles and generation of fertilizable eggs

Background

Primordial ovarian follicles, which are often present in the ovaries of premature ovarian failure (POF) patients or are cryopreserved from the ovaries of young cancer patients who are undergoing gonadotoxic anticancer therapies, cannot be used to generate mature oocytes for in vitro fertilization (IVF). There has been very little success in triggering growth of primordial follicles to obtain fertilizable oocytes due to the poor understanding of the biology of primordial follicle activation.

Methodology/Principal Findings

We have recently reported that PTEN (phosphatase and tensin homolog deleted on chromosome ten) prevents primordial follicle activation in mice, and deletion of Pten from the oocytes of primordial follicles leads to follicular activation. Consequently, the PTEN inhibitor has been successfully used in vitro to activate primordial follicles in both mouse and human ovaries. These results suggest that PTEN inhibitors could be used in ovarian culture medium to trigger the activation of primordial follicle. To study the safety and efficacy of the use of such inhibitors, we activated primordial follicles from neonatal mouse ovaries by transient treatment with a PTEN inhibitor bpV(HOpic). These ovaries were then transplanted under the kidney capsules of recipient mice to generate mature oocytes. The mature oocytes were fertilized in vitro and progeny mice were obtained after embryo transfer.

Results and Conclusions

Long-term monitoring up to the second generation of progeny mice showed that the mice were reproductively active and were free from any overt signs or symptoms of chronic illnesses. Our results indicate that the use of PTEN inhibitors could be a safe and effective way of generating mature human oocytes for use in novel IVF techniques.

Oxidative stress, antioxidant status and lipid profile in ischemic heart disease patients from western region of Nepal

Disturbed lipid profile is one of the most important and potent risk factors in ischemic heart disease (IHD). In recent years, it has been demonstrated that raised oxidative stress promotes several undesirable pathways including the formation of oxidised LDL (O-LDL) and oxidized cholesterol which encourages cholesterol accumulation in arterial tissues. We, therefore, aimed to ascertain the redox balance by measuring oxidative stress (OS) and total antioxidant activity (TAA) along with lipid profile to determine their possible association with IHD. Our study group comprised of 28 confirmed cases of IHD. The inclusion criterion was history of chest pain, ischemic changes in the ECG and good left ventricular (LV) function. Patients with diabetes mellitus, poor LV function, previous infarct and valvular heart disease were excluded. Lipid profile, plasma thiobarbituric acid reactive substances (TBARS), plasma total antioxidant activity (TAA) and urinary TBARS were estimated in these patients by standard procedures and the values were compared with 30 age, sex and socioeconomically matched normal healthy control subjects. Body mass index (BMI) and waist/hip ratio (W/H ratio) was also noted in both the groups. Lipid profile and OS (TBARS levels) were significantly raised in IHD patients. Though statistically not significant but TAA tended to be lower and urinary TBARS levels tended to be higher in patients. BMI, W/H ratio, smoking and alcohol did not show discernible association with lipid profile, OS or TAA. OS is significantly raised in majority of IHD patients. The non association of BMI, W/H ratio, smoking and alcohol with lipid profile, OS and TAA suggest that there are other risk factors which primarily contribute to the initiation and progression of IHD.

Spectrum of stones composition: a chemical analysis of renal stones of patients visiting NMCTH

A general observation of clinicians suggests that the prevalence ofurolithiasis is fairly high in Kathmandu but so far no systematic study has been undertaken here to explore the etiopathogenesis of disease in this region. In this preliminary communication, we present herewith the qualitative composition of 47 renal stones collected from surgical patients admitted to NMCTH over a period of 13 months (July 2005 to July 2006). All stones were of mixed type. Calcium was present in all stones. Oxalate, phosphate and uric acid were present in 95.7%, 87.2% and 34.0% patients respectively. The probable composition, as construed from analysis, suggests that calcium oxalate stones are predominant. Strikingly, the prevalence was very high in e"20 yrs age group.

Epidemiology and etiopathogenesis of urinary calculi in western Nepal (Pokhara)

Urinary stone disease is recorded in the literature from the dawn of the history and has spared no segment of society irrespective of age, gender, occupation and socio-economic status. It is still termed as "Refractory Disease" as complete medical management to prevent occurrence or recurrence is not so far available. We conducted a preliminary survey from the Manipal Teaching Hospital and carried out urinalyses to ascertain risk factors in the local population. This preliminary survey indicates the prevalence of stone disease is in moderate zone. Hyperoxaluria is an important risk factor in more than one fourth of the stone formers; and hypernatriuria is distinctly most common potentiating risk factor.

Oxidative stress and antioxidant status in cardiovascular diseases in population of western Nepal

OBJECTIVES

To observe if there is any connectivity between oxidative stress and cardiovascular diseases (CVDs).

MATERIALS AND METHODS

Patients suffering from different cardiovascular diseases (hypertension, ischemic heart disease, rheumatic heart disease) attending Manipal Teaching Hospital, Pokhara and strictly matched controls were selected for this study. Oxidative stress (OS) was measured by plasma thiobarbituric acid reacting substances (TBARS) where as antioxidant status was measured by estimating vitamin E, vitamin C and total antioxidant activity (TAA) in plasma.

RESULTS

The mean level of TBARS, TAA, vitamin C and E were 2.20+0.43 nmol/ml, 547+98 mol/l, 0.88+0.15 mg/dl and 0.75+0.20 mg/dl respectively in patients. The respective values in controls were 1.86+0.43 nmol/ml, 859+139 mol/l, 0.94+0.15 mg/dl and 1.10+0.30 mg/dl. Although the OS seems to be raised in patients, is practically insufficient to oxidize biomolecules and induce CVDs. Despite vitamin C and E levels being well within normal limits, the TAA was significantly and considerably lower in patients. This is a highly interesting observation suggesting that dietary antioxidants other than these vitamins were preferentially consumed to control OS because procedure for TAA used in this study practically measures only total dietary antioxidants.

CONCLUSION

OS does not appear to be an etiological factor for the cardiovascular diseases; rather slightly raised OS in patients seems to be a consequence. Further the raised OS was not due to lower nutrient antioxidant (vit. C and vit. E) in the local population studied herein.

Oxidative stress and antioxidant status in cancer patients and healthy subjects, a case-control study

Since raised oxidative stress (OS) or weak antioxidant defence or both are considered to be important players in multimechanistic pathogenesis of cancer, the present study was undertaken to evaluate their possible involvement in the pathogenesis of this disease in the local population. Levels of plasma vitamin C, vitamin E, total antioxidant activity (TAA) and thiobarbituric acid reacting substances (TBARS) as a marker of OS were measured in 20 cancer patients (Mean age 63.1 + 9.3 yr.) and 20 age, sex and socioeconomically matched healthy subjects (Mean age 63.7+7.8 yr.). Significantly low level of vitamin C (p <0.001), vitamin E (p <0.001) and TAA (p <0.003) were observed in cancer patients, whereas OS was significantly increased in patients as compared to control (p <0.003). Smokers had significantly lowered TAA and significantly raised OS than non-smokers, in both case and control groups. Tobacco chewer patients had raised OS as compared to control. This study supports the thesis that OS is a risk factor in carcinogenesis and that smoking, an established risk factor in cancer, at least partly appears through it.