CD151 Maintains Endolysosomal Protein Quality to Inhibit Vascular Inflammation

BACKGROUND

Tetraspanin CD151 is highly expressed in endothelia and reinforces cell adhesion, but its role in vascular inflammation remains largely unknown.

METHODS

In vitro molecular and cellular biological analyses on genetically modified endothelial cells, in vivo vascular biological analyses on genetically engineered mouse models, and in silico systems biology and bioinformatics analyses on CD151-related events.

RESULTS

Endothelial ablation of Cd151 leads to pulmonary and cardiac inflammation, severe sepsis, and perilous COVID-19, and endothelial CD151 becomes downregulated in inflammation. Mechanistically, CD151 restrains endothelial release of proinflammatory molecules for less leukocyte infiltration. At the subcellular level, CD151 determines the integrity of multivesicular bodies/lysosomes and confines the production of exosomes that carry cytokines such as ANGPT2 (angiopoietin-2) and proteases such as cathepsin-D. At the molecular level, CD151 docks VCP (valosin-containing protein)/p97, which controls protein quality via mediating deubiquitination for proteolytic degradation, onto endolysosomes to facilitate VCP/p97 function. At the endolysosome membrane, CD151 links VCP/p97 to (1) IFITM3, which regulates multivesicular body functions, to restrain IFITM3-mediated exosomal sorting, and (2) V-ATPase, which dictates endolysosome pH, to support functional assembly of V-ATPase.

CONCLUSIONS

Distinct from its canonical function in strengthening cell adhesion at cell surface, CD151 maintains endolysosome function by sustaining VCP/p97-mediated protein unfolding and turnover. By supporting protein quality control and protein degradation, CD151 prevents proteins from (1) buildup in endolysosomes and (2) discharge through exosomes, to limit vascular inflammation. Also, our study conceptualizes that balance between degradation and discharge of proteins in endothelial cells determines vascular information. Thus, the IFITM3/V-ATPase-tetraspanin-VCP/p97 complexes on endolysosome, as a protein quality control and inflammation-inhibitory machinery, could be beneficial for therapeutic intervention against vascular inflammation.

The IFT81-IFT74 complex acts as an unconventional RabL2 GTPase-activating protein during intraflagellar transport

Cilia are important cellular organelles for signaling and motility and are constructed via intraflagellar transport (IFT). RabL2 is a small GTPase that localizes to the basal body of cilia via an interaction with the centriolar protein CEP19 before downstream association with the IFT machinery, which is followed by initiation of IFT. We reconstituted and purified RabL2 with CEP19 or IFT proteins to show that a reconstituted pentameric IFT complex containing IFT81/74 enhances the GTP hydrolysis rate of RabL2. The binding site on IFT81/74 that promotes GTP hydrolysis in RabL2 was mapped to a 70-amino-acid-long coiled-coil region of IFT81/74. We present structural models for RabL2-containing IFT complexes that we validate in vitro and in cellulo and demonstrate that Chlamydomonas IFT81/74 enhances GTP hydrolysis of human RabL2, suggesting an ancient evolutionarily conserved activity. Our results provide an architectural understanding of how RabL2 is incorporated into the IFT complex and a molecular rationale for why RabL2 dissociates from anterograde IFT trains soon after departure from the ciliary base.

Tetraspanin Tspan8 restrains interferon signaling to stabilize intestinal epithelium by directing endocytosis of interferon receptor

Inflammation can impair intestinal barrier, while increased epithelial permeability can lead to inflammation. In this study, we found that the expression of Tspan8, a tetraspanin expressed specifically in epithelial cells, is downregulated in mouse model of ulcerative disease (UC) but correlated with those of cell-cell junction components, such as claudins and E-cadherin, suggesting that Tspan8 supports intestinal epithelial barrier. Tspan8 removal increases intestinal epithelial permeability and upregulates IFN-γ-Stat1 signaling. We also demonstrated that Tspan8 coalesces with lipid rafts and facilitates IFNγ-R1 localization at or near lipid rafts. As IFN-γ induces its receptor undergoing clathrin- or lipid raft-dependent endocytosis and IFN-γR endocytosis plays an important role in Jak-Stat1 signaling, our analysis on IFN-γR endocytosis revealed that Tspan8 silencing impairs lipid raft-mediated but promotes clathrin-mediated endocytosis of IFN-γR1, leading to increased Stat1 signaling. These changes in IFN-γR1 endocytosis upon Tspan8 silencing correlates with fewer lipid raft component GM1 at the cell surface and more clathrin heavy chain in the cells. Our findings indicate that Tspan8 determines the IFN-γR1 endocytosis route, to restrain Stat1 signaling, stabilize intestine epithelium, and subsequently prevent intestine from inflammation. Our finding also implies that Tspan8 is needed for proper endocytosis through lipid rafts.

Single-molecule imaging in the primary cilium

The primary cilium is an important signaling organelle critical for normal development and tissue homeostasis. Its small dimensions and complexity necessitate advanced imaging approaches to uncover the molecular mechanisms behind its function. Here, we outline how single-molecule fluorescence microscopy can be used for tracking molecular dynamics and interactions and for super-resolution imaging of nanoscale structures in the primary cilium. Specifically, we describe in detail how to capture and quantify the 2D dynamics of individual transmembrane proteins PTCH1 and SMO and how to map the 3D nanoscale distributions of the inversin compartment proteins INVS, ANKS6, and NPHP3. This protocol can, with minor modifications, be adapted for studies of other proteins and cell lines to further elucidate the structure and function of the primary cilium at the molecular level.

Myristoylated Neuronal Calcium Sensor-1 captures the ciliary vesicle at distal appendages

The primary cilium is a microtubule-based organelle that cycles through assembly and disassembly. In many cell types, formation of the cilium is initiated by recruitment of ciliary vesicles to the distal appendage of the mother centriole. However, the distal appendage mechanism that directly captures ciliary vesicles is yet to be identified. In an accompanying paper, we show that the distal appendage protein, CEP89, is important for thef ciliary vesicle recruitment, but not for other steps of cilium formation (Tomoharu Kanie, Love, Fisher, Gustavsson, & Jackson, 2023). The lack of a membrane binding motif in CEP89 suggests that it may indirectly recruit ciliary vesicles via another binding partner. Here, we identify Neuronal Calcium Sensor-1 (NCS1) as a stoichiometric interactor of CEP89. NCS1 localizes to the position between CEP89 and a ciliary vesicle marker, RAB34, at the distal appendage. This localization was completely abolished in CEP89 knockouts, suggesting that CEP89 recruits NCS1 to the distal appendage. Similarly to CEP89 knockouts, ciliary vesicle recruitment as well as subsequent cilium formation was perturbed in NCS1 knockout cells. The ability of NCS1 to recruit the ciliary vesicle is dependent on its myristoylation motif and NCS1 knockout cells expressing myristoylation defective mutant failed to rescue the vesicle recruitment defect despite localizing proper localization to the centriole. In sum, our analysis reveals the first known mechanism for how the distal appendage recruits the ciliary vesicles.

A hierarchical pathway for assembly of the distal appendages that organize primary cilia

Distal appendages are nine-fold symmetric blade-like structures attached to the distal end of the mother centriole. These structures are critical for formation of the primary cilium, by regulating at least four critical steps: ciliary vesicle recruitment, recruitment and initiation of intraflagellar transport (IFT), and removal of CP110. While specific proteins that localize to the distal appendages have been identified, how exactly each protein functions to achieve the multiple roles of the distal appendages is poorly understood. Here we comprehensively analyze known and newly discovered distal appendage proteins (CEP83, SCLT1, CEP164, TTBK2, FBF1, CEP89, KIZ, ANKRD26, PIDD1, LRRC45, NCS1, C3ORF14) for their precise localization, order of recruitment, and their roles in each step of cilia formation. Using CRISPR-Cas9 knockouts, we show that the order of the recruitment of the distal appendage proteins is highly interconnected and a more complex hierarchy. Our analysis highlights two protein modules, CEP83-SCLT1 and CEP164-TTBK2, as critical for structural assembly of distal appendages. Functional assay revealed that CEP89 selectively functions in RAB34+ ciliary vesicle recruitment, while deletion of the integral components, CEP83-SCLT1-CEP164-TTBK2, severely compromised all four steps of cilium formation. Collectively, our analyses provide a more comprehensive view of the organization and the function of the distal appendage, paving the way for molecular understanding of ciliary assembly.

AB0763 IGG4-RELATED CORONARY PERIARTERITIS: SYSTEMATIC LITERATURE REVIEW WITH OUR CASE SERIES

Background:

Coronary periarteritis is one of the clinical manifestations of IgG4-related disease. It can cause serious conditions such as angina and ruptured aneurysms. Therefore, it is important to recognize the clinical and radiological characteristics, which was little known.

Objectives:

We report four patients with IgG4-related coronary periarteritis with a systematic literature review.

Methods:

We identified four patients with IgG4-related coronary periarteritis at the St. Luke’s International Hospital in Tokyo, Japan from 2014 to 2020. A systematic literature review was conducted for English articles on IgG4-related coronary periarteritis cases with a full text or abstract available. We summarized patient demographics, IgG and IgG4 titers, the site and morphological type of coronary lesion, and other organ involvements.

Results:

Our 4 cases and 38 cases identified by the literature review were assessed. Coronary artery lesions were detected by a coronary CT in all but two cases. Wall thickening was the most common type of the lesion. Moreover, there were 32 (76.1%) patients with other organ involvements. The commonest other lesion was peri-aortitis in 21 (50.0%) patients. In cases with peri-aortitis, IgG and IgG4 titers were significantly higher than those without peri-aortitis (IgG4; 1540 [705.0, 2570.0] vs 246.0 [160.0, 536.3]; p = 0.001, IgG; 3596.5 [2838.3, 4260.0] vs 1779.0 [1288.3, 1992.8]; p =0.040). In addition, 15 (71.4%) patients of them had three or more IgG4 related organ involvements.

Conclusion:

Coronary CT was a useful imaging modality for the diagnosis of IgG4-related coronary periarteritis, and wall thickening was the most common lesion. Moreover, about half cases coexisted with peri-aortitis. Peri-aortitis and other organ involvements should be screened in those with higher IgG and IgG4.

Table 1.

Characteristics of our cases and the literature review cases.

RCA: right coronary artery, LAD: left anterior descending artery, LCx: left circumflex artery

Disclosure of Interests:

None declared

Connecting autoimmune disease to Bardet-Biedl syndrome and primary cilia

Bardet-Biedl syndrome (BBS) is a genetic disorder caused by the dysfunction of the primary cilium. To date, immunological defects in the disease have not been systematically assessed. In this issue, Tsyklauri and colleagues find, through detailed analysis of BBS mutant animals, that B-cell development is altered in mutant mice (Tsyklauri et al, 2021). The authors further report that BBS patients are more susceptible to autoimmune disorders. This study sheds new light on the potential role of primary cilia in controlling immune function in disease.

Twenty-year trends in clinical outcome of randomized controlled trial for coronary intervention: systematic review and meta-regression analysis of 46 randomized controlled trials

Aim

The technology of percutaneous coronary intervention (PCI) has been developed after the advent of coronary stent. However, the impact of the technological development on clinical outcomes is still unclear, whereas a remarkable improvement of clinical outcomes after PCI has not been observed in the trials comparing to medical therapy or coronary bypass graft. The current analysis aims to investigate trends in clinical outcomes after PCI after the emargence of coronary stent, using the randomized controlled trials (RCTs) comparing coronary stents.

Methods and results

We performed a systematic review of RCTs investigating coronary stents in non-specific population (excluding the trials particularly enrolling diabetic or myocardial infarction etc.) conducted between 1996 and 2015 (publication between 1997 and 2019) with independent clinical event adjudication. The random-effect meta-regression analysis including 90 arms with 94,831 patients in 46 RCTs was performed investigating the 20-year trends in clinical outcomes such as death, cardiac death, myocardial infarction, target lesion revascularization (TLR) and stent thrombosis at one and five years after the index procedure. The sensitivity analysis was performed by limiting to 20 all comer trials. In the meta-regression analysis, we did not observe significant change in the incidences of cardiac death and myocardial infarction after PCI over 20 years (P values for cardiac death: 0.666 at one year, 0.256 at five years and P values for myocardial infarction: 0.121 at one year, 0.376 at five years; R2 for cardiac death: <0.01 at one year and five years and R2 for myocardial infarction: <0.01 at one year and five years), whereas the incidences of clinically indicated TLR (P value <0.001, R2 = 0.40 at one year, P value = 0.002, R2 = 0.22 at five years) and stent thrombosis were decreased steeply in the first decade and slightly in the second decade (P value = 0.040, R2 = 0.09 at one year; P value = 0.017, R2 = 0.17 at five year). The sencitivity analysis limiting all-comer population revealed the consistent results.

Conclusion

The development of PCI had an impact on the 20-year trends in TLR and ST, despite there were no trends in the cardiac death and myocardial infarction.

Trends in the incidence of the outcomes

Funding Acknowledgement

Type of funding source: None

ACE2 localizes to the respiratory cilia and is not increased by ACE inhibitors or ARBs

The coronavirus SARS-CoV-2 is the causative agent of the ongoing severe acute respiratory disease pandemic COVID-19. Tissue and cellular tropism is one key to understanding the pathogenesis of SARS-CoV-2. We investigate the expression and subcellular localization of the SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2), within the upper (nasal) and lower (pulmonary) respiratory tracts of human donors using a diverse panel of banked tissues. Here, we report our discovery that the ACE2 receptor protein robustly localizes within the motile cilia of airway epithelial cells, which likely represents the initial or early subcellular site of SARS-CoV-2 viral entry during host respiratory transmission. We further determine whether ciliary ACE2 expression in the upper airway is influenced by patient demographics, clinical characteristics, comorbidities, or medication use, and show the first mechanistic evidence that the use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARBs) does not increase susceptibility to SARS-CoV-2 infection through enhancing the expression of ciliary ACE2 receptor. These findings are crucial to our understanding of the transmission of SARS-CoV-2 for prevention and control of this virulent pathogen.

Robust ACE2 protein expression localizes to the motile cilia of the respiratory tract epithelia and is not increased by ACE inhibitors or angiotensin receptor blockers

We investigated the expression and subcellular localization of the SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2), within the upper (nasal) and lower (pulmonary) respiratory tracts of healthy human donors. We detected ACE2 protein expression within the cilia organelle of ciliated airway epithelial cells, which likely represents the initial or early subcellular site of SARS-CoV-2 viral entry during respiratory transmission. We further determined whether ACE2 expression in the cilia of upper respiratory cells was influenced by patient demographics, clinical characteristics, co-morbidities, or medication use, and found no evidence that the use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARBs) increases ACE2 protein expression.

Guanine Nucleotide Exchange Assay Using Fluorescent MANT-GDP

GTPases are molecular switches that cycle between the inactive GDP-bound state and the active GTP-bound state. GTPases exchange nucleotides either by its intrinsic nucleotide exchange or by interaction with guanine nucleotide exchange factors (GEFs). Monitoring the nucleotide exchange in vitro, together with reconstitution of direct interactions with regulatory proteins, provides key insights into how a GTPase is activated. In this protocol, we describe core methods to monitor nucleotide exchange using fluorescent N-Methylanthraniloyl (MANT)-guanine nucleotide.

The CEP19-RABL2 GTPase Complex Binds IFT-B to Initiate Intraflagellar Transport at the Ciliary Base

Highly conserved intraflagellar transport (IFT) protein complexes direct both the assembly of primary cilia and the trafficking of signaling molecules. IFT complexes initially accumulate at the base of the cilium and periodically enter the cilium, suggesting an as-yet-unidentified mechanism that triggers ciliary entry of IFT complexes. Using affinity-purification and mass spectrometry of interactors of the centrosomal and ciliopathy protein, CEP19, we identify CEP350, FOP, and the RABL2B GTPase as proteins organizing the first known mechanism directing ciliary entry of IFT complexes. We discover that CEP19 is recruited to the ciliary base by the centriolar CEP350/FOP complex and then specifically captures GTP-bound RABL2B, which is activated via its intrinsic nucleotide exchange. Activated RABL2B then captures and releases its single effector, the intraflagellar transport B holocomplex, from the large pool of pre-docked IFT-B complexes, and thus initiates ciliary entry of IFT.

Development of mice without Cip/Kip CDK inhibitors

Timely exit of cells from the cell cycle is essential for proper cell differentiation during embryogenesis. Cyclin-dependent kinase (CDK) inhibitors (CKIs) of the Cip/Kip family (p21, p27, and p57) are negative regulators of cell cycle progression and are thought to be essential for development. However, the extent of functional redundancy among Cip/Kip family members has remained largely unknown. We have now generated mice that lack all three Cip/Kip CKIs (TKO mice) and compared them with those lacking each possible pair of these proteins (DKO mice). We found that the TKO embryos develop normally until midgestation but die around embryonic day (E) 13.5, slightly earlier than p27/p57 DKO embryos. The TKO embryos manifested morphological abnormalities as well as increased rates of cell proliferation and apoptosis in the placenta and lens that were essentially indistinguishable from those of p27/p57 DKO mice. Unexpectedly, the proliferation rate and cell cycle profile of mouse embryonic fibroblasts (MEFs) lacking all three Cip/Kip CKIs did not differ substantially from those of control MEFs. The abundance and kinase activity of CDK2 were markedly increased, whereas CDK4 activity and cyclin D1 abundance were decreased, in both p27/p57 DKO and TKO MEFs during progression from G(0) to S phase compared with those in control MEFs. The extents of the increase in CDK2 activity and the decrease in CDK4 activity and cyclin D1 abundance were greater in TKO MEFs than in p27/p57 DKO MEFs. These results suggest that p27 and p57 play an essential role in mouse development after midgestation, and that p21 plays only an auxiliary role in normal development (although it is thought to be a key player in the response to DNA damage).

p57 is required for quiescence and maintenance of adult hematopoietic stem cells

Quiescence is required for the maintenance of hematopoietic stem cells (HSCs). Members of the Cip/Kip family of cyclin-dependent kinase (CDK) inhibitors (p21, p27, p57) have been implicated in HSC quiescence, but loss of p21 or p27 in mice affects HSC quiescence or functionality only under conditions of stress. Although p57 is the most abundant family member in quiescent HSCs, its role has remained uncharacterized. Here we show a severe defect in the self-renewal capacity of p57-deficient HSCs and a reduction of the proportion of the cells in G(0) phase. Additional ablation of p21 in a p57-null background resulted in a further decrease in the colony-forming activity of HSCs. Moreover, the HSC abnormalities of p57-deficient mice were corrected by knocking in the p27 gene at the p57 locus. Our results therefore suggest that, among Cip/Kip family CDK inhibitors, p57 plays a predominant role in the quiescence and maintenance of adult HSCs.

Physical and mechanical properties of PMMA resins containing gamma-methacryloxypropyltrimethoxysilane

The polymethylmethacrylate (PMMA) resins containing gamma-methacryloxypropyltrimethoxysilane (gamma -MPS) of 0, 2, 4, 6, 10, 15, 20 and 30 mo1%, added to methylmethacrylate, were prepared using a monomer-polymer technique and stored in air or water at 37 +/- 0.5 degrees C for 28 days. The flexural strength and flexural modulus of the PMMA resins containing gamma -MPS of 20 and 30 mo1% were significantly smaller than those containing 2-6 mo1% and the same statements were true for the adhesive strength to porcelain tooth. However, its value of adhesive strength to Co-Cr alloy was remarkably less than to porcelain tooth. By contrast, there was no significant difference among the Knoop hardness of the PMMA resins examined. On the other hand, the thermal expansion had an increasing tendency with an increase of a gamma -MPS content. The dynamic shear modulus within a temperature measured (20-140 degrees C) decreased s1ightly as the gamma -MPS content of the PMMA resins increased, and the peak temperature of mechanical loss tangent also tended to decrease. These results indicated that the PMMA resin containing gamma -MPS of 6 mol% was the best composition from the standpoint of an excellent adhesive strength against porcelain, although its water absorption was 1.9 times that of PMMA.

Intestinal thrombotic microangiopathy after allogeneic bone marrow transplantation: a clinical imitator of acute enteric graft-versus-host disease

Thrombotic microangiopathy after bone marrow transplantation (post-BMT TMA) is a serious transplant-related complication. We identified 16 patients with TMA after allogeneic BMT who showed histopathological evidence of intestinal TMA in their gut specimens (six autopsies, 10 biopsies). In all, 14 patients had grade II-IV acute graft-versus-host disease (GVHD). The first seven patients were retrospectively diagnosed with TMA. Since six of them were diagnosed with progressive GVHD at that time because there was no awareness of the existence of intestinal TMA, they received more intensive treatment for GVHD, but all died between days +49 and +253. In contrast, the remaining nine patients were recently diagnosed with intestinal TMA on the basis of colonoscopic biopsies. For eight of these patients, the immunosuppressants were reduced, and the patients' intestinal symptoms improved gradually. Six of the nine patients were still alive 12 months after the diagnosis of TMA. Our findings suggest that the gut may be a site involved in post-BMT TMA, presenting as ischemic enterocolitis. Differentiating intestinal TMA from acute GVHD is important in patients suffering from severe and refractory diarrhea after BMT.

TEL-Syk fusion constitutively activates PI3-K/Akt, MAPK and JAK2-independent STAT5 signal pathways

We previously reported the fusion of the TEL gene to the Syk gene in myelodysplastic syndrome with t(9;12)(q22;p12). TEL-Syk fusion transformed interleukin-3 (IL-3)-dependent murine hematopoietic cell line BaF3 to growth factor independence. Here, we investigate the intracellular signal transduction of the stable transfectants. TEL-Syk fusion protein was associated with the p85 subunit of phosphatidyl inositol 3 kinase (PI3-K) followed by the activation of Akt in the absence of IL-3. Vav, phospholipase C-gamma2 and mitogen-activated protein kinase (MAPK) were also constitutively activated. TEL-Syk also activated the signal transducer and activator of transcription 5 (STAT5) in the absence of Janus kinase 2 activation. None of these kinases were phosphorylated in the BaF3 cells transfected with TELDeltaPNT-Syk in which the oligomerization domain of TEL was deleted. Inhibitor analysis showed that the MAPK pathway was important in TEL-Syk-mediated cell proliferation. The immunofluorescence technique revealed that the TEL-Syk fusion protein was located in the cytoplasm. These data suggest that TEL-Syk fusion protein in the cytoplasm leads to the constitutive activation of PI3-K/Akt, MAPK and STAT5 signal pathways, which are closely involved in IL-3-independent cell proliferation of BaF3 cells.

Bending strength and depth of cure of light-cured composite resins irradiated using filters that simulate enamel

This study evaluates the light-attenuating effects of enamel on the properties of light-cured restorative resins using simple experimental filters. Three filters were designed to replicate the light transmittance characteristics of 0.5, 1.0 and 1.5 mm thick human enamel. The bending strength, depth of cure, and levels of residual monomer for 12 shades of three commercial light-cured composite resins were examined. These resins were cured either using direct irradiation from a light source or irradiation through one of the filters. For all materials, the bending strength and depth of cure of specimens irradiated through a filter were lower and the levels of residual monomer were higher than those found in specimens irradiated directly. The results indicate that the light-attenuating effect of enamel reduces the polymerization efficiency, resulting in poorer mechanical properties of light-cured composite resins.

Dynamic viscoelastic properties of commercial glass-fibre reinforced resin used for crowns and bridges

In order to investigate the thermal stability, the physical and mechanical, and dynamic viscoelastic properties of glass-fibre reinforced composite materials were measured. The G' of the seven materials examined was within 5;20 +/- 14; 55 and 4;50-14; 35 GPa for dry and wet specimens in air at 37 degrees C, respectively, and decreased with increasing temperature. The G' values of dry specimens decreased by 7;74-15;4% when heated to 60 degrees C. The value of tan delta ranged from 0;0102 to 0;0295 and from 0.0181 to 0.0406 for dry and wet specimens in air at 37 degrees C, respectively. The coefficient of linear thermal expansion between 30 and 60 degrees C ranged from 0;557 to 3; 95 x 10-5/ degrees C. Moreover, the filler content ranged from 56; 36 to 88; 87 wt%. These results showed that the magnitudes of G', tan delta, and the coefficient of linear thermal expansion and water absorption depend on the inorganic filler or glass-fibre content; i.e. the amount of resin matrix. Moreover, for all the materials examined, the G' values were thermostable in the temperature range encountered in the oral cavity.

Effect of ethanol on the hardness and relaxation modulus of experimental photo-activated soft lining materials stored in aqueous solutions

We studied changes in the hardness, relaxation modulus [Er(t)], and weight change ratio (Wc) of experimental photo-activated acrylic soft lining materials (EPLs) stored in three aqueous solutions [distilled water (DW), physiological saline solution (PS), and artificial saliva (AS)] at 37 degrees C for 8 weeks. The hardness of the EPLs increased markedly during the first 4 days of storage, and subsequently changed little. The greatest hardness occurred in the EPL specimen containing the largest amount of ethanol (Et). The relaxation modulus [Er(8)] of the EPLs ranged from 1.35 to 1.66 MPa immediately before storage, and from 1.43 to 2.21 MPa after an 8-week immersion. Like hardness, the increase in [Er(t)] was greatest when the EPL contained large amounts of Et. The Wc ranged from 0.118 to 0.661% after storage for 8 weeks, and increased most for the EPL specimen containing the smallest amount of Et. Furthermore, 3-7 days after the start of immersion many hollows were observed in the surface of specimens with a high Et content. The results indicate that Wc and hollow formation are sensitive to the Et content of the EPL, and that Et content is closely tied to the change in hardness and relaxation modulus with time.

Effect of photo-irradiation on hardness of soft lining materials for denture base

Nine photo-activated acrylic-type (EPL) soft lining materials were produced experimentally to examine their durability. The purpose of this study was to investigate the effect of photo-irradiation on the hardness of experimental soft lining materials. The hardness (Hex) of the nine EPLs was increased 4.3-170.1% by exposing them to light. The effect of irradiation on the Hex of the EPLs was remarkable when the material contained much ethylmethacrylate, together with smaller amounts of di-n-butyl phthalate. Moreover, the Hex tended to increase for EPLs in which the liquid portion contained less di-n-butyl phthalate or more ethanol (Et). The weight change ratio (Wc) was greater for EPL specimens containing less Et. The Wcs ranged from 0.118 to 0.661% after 8 weeks. These results showed that the Hexs of six of the EPLs were approximately equal to those of four commercially available soft lining materials, and these six EPLs may have properties favouring their use in clinical dentistry.

Dynamic viscoelastic properties of photo-activated composite resins containing short glass fibres

The dynamic shear modulus in torsion (G'), water absorption, thermal expansion and residual monomer of the reinforced materials produced by adding four short glass fibres (19 microm in mean diameter and 86.1--763 microm in mean length) and one spherical E glass (11.1 microm in mean diameter) were examined and discussed in comparison with those of the materials without filler. G' of short fibre reinforced composites increased with fibre length and reached a maximum value near 382 microm for a dry specimen and near 156 microm for a wet one. In addition, the coefficient of thermal expansion of the fibre reinforced composites and the amount of residual monomer decreased considerably compared with those of composites containing spherical glass. There was no significant difference in water absorption between the fibre reinforced composites and the composites containing spherical glass. Therefore, it was concluded that the reinforcement method of adding short glass fibres is favourable for improving the viscoelastic properties of the materials.

Adding silanes to MMA: the effects on the water absorption, adhesive strength and mechanical properties of acrylic denture base resins

The adhesive strength of porcelain artificial teeth and polymethylmethacrylates (PMMAs), which contained silanes with various number of vinyl or ethoxy groups, and the mechanical and physical properties of the PMMAs were measured. Four types of PMMAs with silanes showed high adhesive shear strength and caused fractures in the porcelain. Water absorption of the PMMAs increased with the addition of silane, but that of one type with silane was almost the same as the PMMA only type. The flexural strengths of the PMMAs with silane, except for one type, showed no significant differences compared with that of PMMA (p < 0.05). The Tg levels of all PMMAs with silane fell less than that of PMMA. From these results, it was found that PMMA with silane from three vinyl groups and one ethoxy group showed excellent chemical bonding to porcelain and low water absorption.

A method for evaluating color stability of light-cured composite resins using an experimental filter

The purpose of this study was to investigate a method for evaluating color stability of light-cured composite resins using an experimental filter that simulates human enamel. The light transmission coefficients and their spectral distributions from 400 to 600 nm of twelve enamel specimens were measured. The experimental filter was designed so that its light transmittance characteristics were similar to those of enamel. Color stability tests for ten shades of two light-cured composite resins, which were irradiated directly and indirectly through the experimental filter with a light source, were performed. Despite different irradiation procedures, most materials exhibited significant color changes in the color stability test. Although the differences were small, the group of specimens irradiated indirectly through the filter showed significantly higher color differences in comparison with those irradiated directly. Our results indicate that the light attenuating effect of enamel affects the color stability of light-cured composite resins.

Acute renal failure after a sea anemone sting

A 27-year-old man suffering from severe swelling and pain in his right arm was referred to our hospital. He showed signs of acute renal failure (ARF) with severe dermatitis of his right arm. Three days before being admitted, he accidentally touched some kind of marine organism with his right hand while snorkeling in the Sulu Sea around Cebu Island. Within a few minutes, he was experiencing severe pain in his right hand. Then his right hand gradually became swollen. The marine creature responsible for this injury was thought to have been a sea anemone, which is a type of coelenterate. Histologic findings of a renal biopsy indicated that acute tubular necrosis (ATN) had caused ARF in this patient's case. Supportive therapies improved renal function of this patient, and steroid pulse therapy attenuated the severe skin discoloration. The ATN was thought to have been caused by the poison from a sea anemone because there were no other conceivable reasons for the patient's condition. This is the first time that a marine envenomation case has been reported in which the sting of a sea anemone has caused ATN without the failure of any other organs.

Quality of life in adult patients after stem cell transplantation

Many articles pertaining to quality of life (QOL) following stem cell transplantation have been published in the US and western Europe. However, since the actions of health insurance systems and overall cultural aspects are strongly associated with QOL, investigations into QOL should be carried out within all countries. Therefore, we have investigated the QOL of adult patients following stem cell transplantation at 31 hospitals in Japan. The survivors, who were surveyed by mail questionnaire, were 20 years or older at the time of this study. The underlying diseases were acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, myelodysplastic syndrome, and multiple myeloma. Median age at the time of the study was 36 years, and median interval after transplantation was 35.3 months. Of 383 patients surveyed, 282 (73.6%) responded to the questionnaire. One hundred and ninety-two patients were treated with an allogeneic-related transplantation, 52 with allogeneic-unrelated, and 38 with an autologous transplantation. Our data revealed that the length of time since transplantation and the diagnosis of chronic GVHD were associated with QOL. When unrelated and related transplantation recipients were compared, ratings on relief from pain, stability in weight, and confidence in dealing with daily life were lower among unrelated transplantation patients.

Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors

Intravenous ribavirin was given to nine patients who had developed severe adenovirus-induced hemorrhagic cystitis (AD-HC) which was resistant to conventional therapy or where there was involvement of other organs after allogeneic BMT. Three patients recovered completely from AD-HC, two of whom had been resistant to vidarabine. All three had received sibling BMTs (2 HLA matched, 1 HLA mismatched). Five patients who received BMTs from related (2 HLA mismatched) or unrelated (1 HLA matched, 2 HLA mismatched) showed an improvement in symptoms but had recurrent AD-HC after discontinuation of ribavirin. Improvement in clinical symptoms and termination of virus excretion were well correlated. The last patient who received a mismatched unrelated BMT died during ribavirin therapy. Ribavirin was notably more effective among patients receiving BMTs from siblings in contrast to patients receiving BMTs from alternative donors (<0.05). One patient experienced severe pancytopenia during the second treatment with ribavirin after HC recurrence and recovered after ceasing ribavirin. Thus, ribavirin seems to be very effective for severe AD-HC for some recipients who receive transplants from a genetically close donor. Bone Marrow Transplantation (2000) 25, 545-548.

Flexural properties and impact strength of denture base polymer reinforced with woven glass fibers

OBJECTIVES

The present investigation was undertaken to determine the reinforcing effect of woven glass fibers on deflection, flexural strength, flexural modulus and impact strength of acrylic denture base polymer.

METHODS

Three silanized or unsilanized woven glass fibers were used. Specimens were made by heating the denture cure resin dough containing glass fibers, which were sheathed in the dough. Specimens with four different thicknesses and of five different types were made, incorporating the glass fiber. Three-point flexural test and flywheel type impact test were employed to determine the flexural properties and impact strength.

RESULTS

When specimens contained unsilanized glass fiber, the flexural strength in specimens of 1 and 2 mm thickness and the impact strength in specimens of 2 mm thickness were higher than those of specimens without glass fiber (p < 0.01). On the contrary, the flexural strength and deflection in specimens reinforced with silanized glass fiber of 1 mm thickness were significantly higher (p < 0.01, p < 0.05) than those of unreinforced specimens. Further, the impact strength in specimens reinforced with silanized glass fiber of 2 mm thickness was significantly higher (p < 0.01) than that of unreinforced specimens. Statistically significant differences were found in the flexural strength (p < 0.05) and in the impact strength (p < 0.01) when specimens of 4 mm thickness were reinforced with two or three unsilanized glass fibers.

SIGNIFICANCE

The reinforcement with glass fiber was effective in thin specimens, and the reinforcing effect increased with the increase of the number of glass fibers in the case of thick specimens.

Effects of thermal cycling on dynamic viscoelastic properties of four commercial resins for crown and bridge

To elucidate the effects of thermal cycling on the viscoelastic properties of four commercial resins for crown and bridge, dynamic shear modulus (G'), mechanical loss tangent (tan delta), Knoop hardness, water sorption and appearance of specimen surfaces before and after thermal cycling test were determined. The changes of G' and tan delta for two materials were insignificant with increased repetitions of thermal cycling. Those of the other two materials were statistically significant: in particular, G' at temperatures above 60 degrees C was inclined to increase slightly and tan delta decreased considerably. While the Knoop hardness of the materials was a little decreased over a number of 75,000 thermal cycles, the water sorption almost attained an equilibrium in uptake after 14,000 thermal cycles. Furthermore, cracks on the specimen surface were observed after 37,500 to 75,000 thermal cycles. From these results, the deterioration of materials was observed as damage to the specimen surface. Moreover, it could be presumed that the materials would be further polymerized during the period of thermal cycling.

An evaluation of acrylic complete dentures using the discrimination of elastic bodies or viscous fluids

The discrimination test on elastic bodies and viscous fluids was carried out for 16 young dentists and 13 denture patients, because it is considered that dentures affect the ability to discriminate food. The materials used in this test were six thermoplastic polyurethane elastomers with compressive elastic moduli from 11.8 to 62.0 MPa and six silicone impression pastes with coefficients of viscosity from 1.77 x 10(-2) to 23.0 x 10(-2) MPa x s. The subjects (dentists and patients) discriminated the materials based on differences in elastic moduli or coefficients of viscosity by chewing the materials for 10 s. From these experiments, it became clear that the ability to discriminate between elastic bodies or viscous fluids upon chewing, of subjects who use complete-dentures in combination with their own teeth and either an upper or lower complete-denture (S/D) or who have a set of complete-dentures in both jaws (D/D) decreased considerably, compared with that of subjects who have their own teeth in upper and lower jaws (S/S). The ratios of S/D and D/D against S/S were 0.5 and 0.3, respectively. This indicates that with an increase in the area occupied by dentures in the oral cavity, the value of the differential threshold increased markedly and made food discrimination more difficult. In addition, discriminating viscous fluids was 2.4 to 3.1 times more difficult compared with the discrimination of elastic bodies, independent of denture placement.

A new preconditioning regimen with melphalan, busulphan and total body irradiation followed by low-dose immunosuppressant in allogeneic haemopoietic stem cell transplantation

Twenty adult patients with high-risk leukaemia underwent allogeneic haemopoietic stem cell transplantation after melphalan, busulphan and total body irradiation followed by short-term methotrexate and low-dose cyclosporine or tacrolimus. Three patients developed veno-occlusive disease and no patient developed renal dysfunction. Seven patients experienced grade II-IV acute graft-versus-host disease (aGVHD) and five patients experienced grade III-IV. The 3-year probabilities of relapse and leukaemia-free survival were 22 +/- 11% (95% confidence interval) and 50 +/- 11%, respectively. These data suggest that this preconditioning regimen followed by a low-dose immunosuppressant provided a more anti-leukaemic effect without increased regimen-related toxicity and aGVHD.

Consistency of alginate impression materials and their evaluation

The apparent viscosity of 17 commercially available alginate impression materials was examined using a rheometer. Each material was mixed for 15 s at a temperature of 23 +/- 0.5 degrees C, using a specially designed alginate mixing instrument. The water powder ratio was determined according to the manufacturer's instruction. The mixed alginate paste was immediately transferred to the sample stage of the rheometer or to a commercial perforated metal tray. Over the same time scale adjusted according to the rheometer test, a discrimination test (subjective test) was performed by 16 young dentists (each with more than 4 years experience). The apparent viscosity of all materials rose as a function of time after mixing and most of the material had properties similar to pseudoplastic fluids. The relationship between the results of the subjective test and the experimental values (objective test) with the rheometer was expressed in a quadratic equation. The maximum value of the apparent viscosity derived from this result was 1.52 x 10(3) Pa.s.

Light transmittance characteristics of light-cured composite resins

OBJECTIVES

The purpose of this study was: (1) to examine the light transmittance characteristics of various shades of light-cured composite resins, and (2) to evaluate the effect of light transmittance characteristics on the color of the resins.

METHODS

Eleven shades of two composite resins were used. Specimens with four different thicknesses (0.5, 1.0, 2.0 and 3.0 mm) were prepared. The transmittance at wavelengths from 400 to 700 nm was measured. Also, the color values and the color differences among thicknesses of a specimen on the CIE L*a*b* color system were determined by a digital chroma meter. The differences in the transmittance, color values and color difference were determined by using a one-way analysis of variance (ANOVA) combined with a Tukey multiple-range test.

RESULTS

Significant differences were found in the wavelength dependence of transmittance between the two materials, and among shades of each material. The transmittances of the darker shades of one material were significantly lower at lower wavelengths than the other shades, but were nearly equal or significantly higher at higher wavelengths. There was a significant correlation between the changing ratio of transmittance and the color difference. Two materials showed significant differences in delta a* and delta b* of the chromatic component of color difference.

SIGNIFICANCE

The results of this study indicate that light transmittance characteristics, including the wavelength dependence, play an important role for the color of a composite resin. The significant difference in light transmittance characteristics among materials and shades will affect their clinical appearance.

[FK506 for the prophylaxis of graft-versus-host-disease after bone marrow transplantation from HLA-genotypically mismatched unrelated donor]

Eleven leukemia patients who had undergone bone marrow transplants from HLA-A, B, DR genotypically mismatched unrelated donors received FK506 and short-term methotrexate as prophylaxis for graft-versus-host disease (GVHD). Grade III-IV acute GVHD developed in 2 of the patients, and chronic GVHD developed in 4 of the other patients. Adverse drug reaction included reversible nephrotoxicity, hyperglycemia (all patients) and hypertension (9 patients). Hyperglycemia and hypertension of grade 3 or higher occurred mostly in the patients who were on supplemental steroids. However, severe nephrotoxicity was not observed. Complications included cystitis (4 patients), cytomegalovirus colitis (3 patients), Interstitial Pneumonitis (IP) (3 patients), tuberculosis (1 patient), and thrombotic microangiopathy (1 patient). None of patients relapsed. Although close monitoring of FK506 blood concentration and patient clinical signs are required, we concluded that FK506 is effective for GVHD prophylaxis after bone marrow transplantation from HLA-A, B, DR genotypically mismatched unrelated donors, and that adverse reactions due to FK506 are controllable. To determine the long-term effectiveness of this drug, it will be necessary to conduct prospective randomized studies that compare it wiht cycloporin A as a preventive treatment against GVHD in patients who receive bone marrow transplants from HLA genotypically mismatched unrelated donors.

Hepatic injury localized to the field of total lymphoid irradiation

A 37-year-old woman with severe aplastic anemia underwent allogeneic bone marrow transplantation following cyclophosphamide (CY) and total lymphoid irradiation (TLI). On day +30, a CT scan was carried out because of a mild elevation in liver enzymes, and it revealed a low density area with a sharp border in the left lobe corresponding to the irradiated area. MRI showed a hypersignal intensity on both T1 and T2-weighted images and suggested that hepatic damage was mainly severe fatty change. These abnormalities resolved with no treatment. CY with TLI for adult patients with severe aplastic anemia may induce hepatic injury.

Unrelated bone marrow transplantation from the National Marrow Donor Program

Between November 1992 and December 1996, we carried out bone marrow transplantation through the National Marrow Donor Program (NMDP) for 11 patients who lacked an appropriate donor among their family members and the Japan Marrow Donor Program (JMDP). They accounted for 11% of 101 patients who had registrated to the NMDP Transplant Center Office in Japan. The median time required from the initiation of preliminary search to transplant for these 11 patients was 198 days. The 11 donors included four Caucasians, one Native American and the others were Asian/Pacific islanders. A median of 17 h was required to transport bone marrow from harvest institutes to our hospital and their viability determined in our laboratory had a median of 96%. Engraftment was observed in all recipients and the incidence of grade III-IV acute graft-versus host disease was 27%. Of four patients three (75%) with chronic myelogenous leukemia in chronic phase (standard-risk) and two (29%) of seven patients in progressive state of the disease (high-risk), are alive at present. Cooperation between the JMDP and the NMDP, which began in April 1997, could shorten the time for donor search and allow transplantation to more patients with more appropriate timing.

[Comparative study of bone marrow transplantation from unrelated donors and identical sibling donors in a single institute]

This retrospective study analyzes the result of bone marrow transplantation in 28 patients with unrelated donors compared with 75 patients transplanted from identical HLA sibling donors at a single institute during the same time period. One unrelated donor patient with severe aplastic anemia died without evidence of engraftment. The incidence of grade III-IV acute graft-versus-host disease (GVHD) in unrelated donor patients (19%) was higher than sibling donors (0%) and the probability of survival more than 30 years was lower compared with sibling donors. However, the probability of survival without grade III-IV acute GVHD was similar in the two groups, 62% (n = 21) vs. 65% (n = 75), and there was no significant difference in relapse-free survival, good prognostic factors; 76% (n = 11) vs. 66% (n = 37), higher risk factors; 30% (n = 11) vs. 31% (n = 21). Death due to viral infection were significantly higher among unrelated donor patients. We conclude that bone marrow transplantation for patients younger than 30 years old from unrelated donors should be considered equally to sibling donors with great care to engraftment for severe aplastic anemia, grade III-IV acute GVHD and viral infection.

Serum thrombopoietin level after allogeneic bone marrow transplantation: possible correlations with platelet recovery, acute graft-versus-host disease and hepatic veno-occlusive disease. Nagoya Bone Marrow Transplantation Group

Thrombopoietin (TPO) is a growth and differentiation factor for megakaryocytes and platelets. An ELISA was developed for measuring TPO concentrations in human sera. The mean +/- S.D. of TPO level obtained in 29 control subjects was 0.87 +/- 0.35 fmol/ml. We measured the TPO level in 36 patients after allogeneic bone marrow transplantation (BMT) and determined the relationship between blood levels of TPO and changes in the circulating platelet mass. In general, a reciprocal relationship was observed between TPO and platelet count (r = -0.609, P < 0.0001; n = 165). With the decrease in the platelet mass after myeloablative therapy, the TPO level increased proportionally and peaked during the platelet nadir. The peak concentration of TPO ranged from 20-50 fmol/ml. The TPO level decreased with the normalization of the platelet mass. In contrast, the TPO level decreased during acute graft-versus-host disease (GVHD) in several patients. Furthermore, the TPO level was significantly lower in the patients with hepatic veno-occlusive disease (VOD) than in the patients after BMT without GVHD and VOD in the samples of less than 50000/microliters platelets (P < 0.005). These findings suggest that in the patients given allogeneic BMT, TPO has an important role in the physiologic regulation of platelet production and that liver damage due to acute GVHD and VOD may decrease the TPO level.

Deterioration of mechanical properties of composite resins

The deterioration of the mechanical properties of composite resins was examined. The bending strength and the stress relaxation rate for sixteen experimental composite resins with different filler shapes, particle sizes and filler contents immersed in distilled water for 0-60 days were measured. The bending strength of all of the composites decreased with the increase of the immersion time in water. The composites with a high filler content (65 vol%) showed a greater decreasing ratio of bending strength than those with low filler content (40 vol%). The stress relaxation rate also increased with and increase of immersion time. The phenomena may be caused by the hydrolytic degradation of the silane coupling agent (gamma-MPTMS).

Photothermoelastic probing for a clamped plate sample

In this paper we report a photothermal probing technique for a clamped thin plate sample that uses thermoelastic bending. Irradiation of the modulated laser light focused on the clamped plate sample generates the flexural vibration caused by thermoelastic bending. By scaning with the focused beam and optically sensing the bending, the irregularity of the plate is detectable nondestructively as changes in amplitude and phase of the flexural vibration. Characteristics of thermoelastic bending are also examined from the viewpoint of bending hot spot theory.