Laboratory diagnosis of measles infection using molecular and serology during 2019-2020 outbreak in Brazil

INTRODUCTION

Laboratory diagnosis of measles can be challenging, and the reintroduction of the measles virus in Brazil has brought about new issues. The aim of this study was to analyze the qPCR results of swab and urine samples and compare them with those of immunological methods for the diagnosis of measles.

METHODS

This was a cross-sectional study based on a retrospective analysis of 3,451 suspected cases using laboratory test surveillance databases for qPCR (respiratory swabs and urine) and serologic tests for IgM and paired IgG. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and agreement through kappa and adjusted kappa coefficients (PABAK) were calculated using different diagnostic strategies.

RESULTS

The swab and urine samples obtained using real-time qPCR were equivalent. Samples collected simultaneously and the combined samples showed moderate agreement between IgM ELISA and real-time qPCR; however, 48.9 % of the IgM ELISA analyses did not demonstrate detectable qPCR concentrations during simultaneous collections and 43.9 % of combined collections. The paired analysis of IgG showed an accuracy of 67.5 % for IgM and 90.7 % for real-time qPCR.

CONCLUSIONS

Diagnosis based on IgM presents detection delimitation in samples collected early (1-5 days), suggesting that these individuals satisfy at least two criteria. In addition to qPCR, paired analysis of IgG using ELISA can be used to increase the sensitivity and specificity of laboratory diagnoses.

Epidemiology and Outcomes of HIN1 Pneumonia in ICU

Introduction

Pandemic influenza H1N1/09 emerged for the first time in April 2009 and has spread widely across India since then. The number of cases have increased over time with the increasing need for respiratory support, causing significant morbidity and mortality. We evaluated the clinical course and outcomes of patients infected with Influenza A (H1N1) admitted to three multidisciplinary intensive care units (ICU) in Chennai.

Materials and methods

We performed a combined retrospective and prospective observational study of all patients admitted with H1N1 pneumonia at three multidisciplinary ICUs in Chennai from October 1, 2018, to January 31, 2019. Data including demographics, risk factors, and clinical courses were recorded. Outcome data including mortality was tracked up to 28 days.

Results

A total of 167 patients were admitted during the study period of which 154 were included in this analysis. The mean age of presentation was 58.2 ± 15.6 years and 59.1% of them were males. The mean acute physiology and chronic health evaluation (APACHE) IV and sequential organ failure assessment (SOFA) scores were 62.8 ± 23.2 and 5.8 ± 3.9 respectively. Oxygen delivery devices were required in 25.3% for a mean duration of 26.5 ± 5.7 hours. Non-invasive ventilation or high-flow nasal cannula (HFNC) was needed in 33.1% of patients for 59.9 ± 64.5 hours. The proportion of patients requiring mechanical ventilation was 41.6%. Rescue measures in the form of proning, use of inhaled nitric oxide (iNO), and extracorporeal membrane oxygenation (ECMO) were initiated for refractory hypoxemia in 26.6%, 14.1%, and 6.3% respectively. The mean duration of ventilator support was 8.5 ± 8 days. Tracheostomy was required in 20.3% of patients and 7.8% were ventilator dependent at 28 days. The mean ICU and Hospital length of stay were 8.3 ± 10.3 and 12.2 ± 14.1 days respectively and overall 28-day mortality was 20.1%.

Conclusion

A significant proportion of H1N1 patients admitted to the ICU required high-level respiratory support including non-invasive ventilation (NIV), HFNC, or invasive ventilation. Deployment of rescue therapies was common and the overall mortality rate was similar to those reported from Western countries.

How to cite this article

Golagana V, Venkataraman R, Mani AK, Rajan ER, Ramakrishnan N, Vidyasagar DD. Epidemiology and Outcomes of HIN1 Pneumonia in ICU. Indian J Crit Care Med 2023;27(7):470-474.

Immunohistochemistry versus PCR Technology for Molecular Subtyping of Breast Cancer: Multicentered Expereinces from Addis Ababa, Ethiopia

The application of immunohistochemistry (IHC) for molecular characterization of breast cancer (BC) is of paramount importance; however, it is not universally standardized, subject to observer variability and quantifying is a challenge. An alternative molecular technology, such as endpoint reverse transcription (RT)-PCR gene expression analysis, may improve observer variability and diagnostic accuracy. This study was intended to compare IHC with the RT-PCR based technique and assess the potential of RT-PCR for molecular subtyping of BC. In this comparative cross-sectional study, 54 BC tissues were collected from three public hospitals in Addis Ababa and shipped to Gynaecology department at Martin-Luther University (Germany) for laboratory analysis. Only 41 samples were qualified for IHC and RT-PCR investigation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 protein expression analysis. Kappa statistics was used to assess the concordance between the two techniques. The overall percent agreement between RT-PCR and IHC was 68.3% for ER (positive percent agreement [PPA] 71.1%; negative percent agreement [NPA] 33.3%), 39.0% for PR (PPA 14.3%; NPA 92.3%), and 82.9% for HER2 (PPA 62.5%; NPA 87.9%). Cohen's κ-values of 0.018 (< 0.20), 0.045 (< 0.200), and 0.481 (0.41-0.60) were generated for ER, PR, and HER2, respectively. Concordance for molecular subtypes was only 56.1% (23/41) and 0.20 kappa value. IHC and endpoint RT-PCR techniques have shown to be discordant for 43% samples. Molecular subtyping using endpoint RT-PCR was fairly concordant with IHC. Thus, endpoint RT-PCR may give an objective result, and can be applied for BC subtyping.

Correlation of serum SARS-CoV-2 IgM and IgG serology and clinical outcomes in COVID-19 patients: Experience from a tertiary care centre

BACKGROUND

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has become a pandemic for the last 2 years. Inflammatory response to the virus leads to organ dysfunction and death. Predicting the severity of inflammatory response helps in managing critical patients using serology tests IgG and IgM.

AIM

To investigate the correlation of the serology (IgM and IgG) with reverse transcriptase polymerase chain reaction (RT-PCR) status, disease severity [mild to critical], intensive care unit (ICU) admission, septic shock, acute kidney injury, and in-hospital mortality.

METHODS

We conducted a longitudinal study to correlate serum SARS-CoV-2 immunoglobulin M (IgM) and immunoglobulin G (IgG) serology with clinical outcomes in coronavirus disease 2019 (COVID-19) patients. We analyzed patient data from March to December 2020 for those who were admitted at All India Institute of Medical Sciences Rishikesh. Clinical and laboratory data of these patients were collected from the e-hospital portal and analyzed. A correlation was seen with clinical outcomes and was assessed using MS Excel 2010 and SPSS software.

RESULTS

Out of 494 patients, the mean age of patients was 48.95 ± 16.40 years and there were more male patients in the study (66.0%). The patients were classified as mild-moderate 328 (67.1%), severe 131 (26.8%), and critical 30 (6.1%). The mean duration from symptom onset to serology testing was 19.87 ± 30.53 d. In-hospital mortality was observed in 25.1% of patients. The seropositivity rate (i.e., either IgG or IgM > 10 AU) was 50%. IgM levels (AU/mL) (W = 33428.000, P ≤ 0.001) and IgG levels (AU/mL) (W = 39256.500, P ≤ 0.001), with the median IgM/ IgG levels (AU/mL), were highest in the RT-PCR-Positive group compared to RT-PCR-Negative clinical COVID-19. There was no significant difference between the two groups in terms of all other clinical outcomes (disease severity, septic shock, ICU admission, mechanical ventilation, and mortality).

CONCLUSION

The study showed that serology levels are high in RT-PCR positive group compared to clinical COVID-19. However, serology cannot be useful for the prediction of disease outcomes. The study also highlights the importance of doing serology at a particular time as antibody titers vary with the duration of the disease. In week intervals there was a significant correlation between clinical outcomes and serology on week 3.

Identification of SARS-CoV-2 variants using viral sequencing for the Centers for Disease Control and Prevention genomic surveillance program

BACKGROUND

The Centers for Disease Control and Prevention contracted with laboratories to sequence the SARS-CoV-2 genome from positive samples across the United States to enable public health officials to investigate the impact of variants on disease severity as well as the effectiveness of vaccines and treatment. Herein we present the initial results correlating RT-PCR quality control metrics with sample collection and sequencing methods from full SARS-CoV-2 viral genomic sequencing of 24,441 positive patient samples between April and June 2021.

METHODS

RT-PCR confirmed (N Gene Ct value < 30) positive patient samples, with nucleic acid extracted from saliva, nasopharyngeal and oropharyngeal swabs were selected for viral whole genome SARS-CoV-2 sequencing. Sequencing was performed using Illumina COVIDSeq™ protocol on either the NextSeq550 or NovaSeq6000 systems. Informatic variant calling, and lineage analysis were performed using DRAGEN COVID Lineage applications on Illumina's Basespace cloud analytical system. All sequence data and variant calls were uploaded to NCBI and GISAID.

RESULTS

An association was observed between higher sequencing coverage, quality, and samples with a lower Ct value, with < 27 being optimal, across both sequencing platforms and sample collection methods. Both nasopharyngeal swabs and saliva samples were found to be optimal samples of choice for SARS-CoV-2 surveillance sequencing studies, both in terms of strain identification and sequencing depth of coverage, with NovaSeq 6000 providing higher coverage than the NextSeq 550. The most frequent variants identified were the B.1.617.2 Delta (India) and P.1 Gamma (Brazil) variants in the samples sequenced between April 2021 and June 2021. At the time of submission, the most common variant > 99% of positives sequenced was Omicron.

CONCLUSION

These initial analyses highlight the importance of sequencing platform, sample collection methods, and RT-PCR Ct values in guiding surveillance efforts. These surveillance studies evaluating genetic changes of SARS-CoV-2 have been identified as critical by the CDC that can affect many aspects of public health including transmission, disease severity, diagnostics, therapeutics, and vaccines.

Clinical assessment of SARS-CoV-2 antigen rapid detection compared with RT-PCR assay for emerging variants at a high-throughput community testing site in Taiwan

Objectives

With the emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) B.1.1.7 lineage in the ongoing coronavirus disease 2019 (COVID-19) pandemic, Taiwan confronted a COVID-19 flare up in May 2021. Large-scale, accurate, affordable and rapid diagnostic tests such as the lateral flow assay can help to prevent community transmission, but their performance characteristics in real-world conditions and relevant subpopulations remain unclear.

Methods

The COVID-19 Antigen Rapid Test Kit (Eternal Materials, New Taipei City, Taiwan) was used in a high-throughput community testing site; the paired reverse transcription polymerase chain reaction (RT-PCR) results served as a reference for sensitivity and specificity calculations.

Results

Of 2096 specimens tested using the rapid antigen test, 70 (3.33%) were positive and 2026 (96.7%) were negative. This clinical performance was compared with the RT-PCR results. The sensitivity and specificity of the rapid antigen test were 76.39% [95% confidence interval (CI) 64.91–85.60%] and 99.26% (95% CI 98.78–99.58%), respectively, with high sensitivity in subjects with cycle threshold values ≤24. Further, the rapid antigen test detected the SARS-CoV-2 B.1.1.7 lineage effectively.

Conclusions

Considering the short turnaround times and lower costs, this simple SARS-CoV-2 antigen detection test for rapid screening combined with RT-PCR as a double confirmatory screening tool can facilitate the prevention of community transmission during COVID-19 emergencies.

Role of serological rapid antibody test in the management of possible COVID-19 cases

BACKGROUND

Although the detection of viral particles by reverse transcription polymerase chain reaction (RT-PCR) is the gold standard diagnostic test for coronavirus disease 2019 (COVID-19), the false-negative results constitute a big challenge.

AIM

To examine a group of patients diagnosed and treated as possible COVID-19 pneumonia whose multiple nasopharyngeal swab samples were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by RT-PCR but then serological immunoglobulin M/immunoglobulin G (IgM/IgG) antibody against SARS-CoV-2 were detected by rapid antibody test.

METHODS

Eighty possible COVID-19 patients who had at least two negative consecutive COVID-19 RT-PCR test and were subjected to serological rapid antibody test were evaluated in this study.

RESULTS

The specific serological total IgM/IgG antibody against SARS-CoV-2 was detected in twenty-two patients. The mean age of this patient group was 63.2± 13.1-years-old with a male/female ratio of 11/11. Cough was the most common symptom (90.9%). The most common presenting chest computed tomography findings were bilateral ground glass opacities (77.2%) and alveolar consolidations (50.1%). The mean duration of time from appearance of first symptoms to hospital admission, to hospital admission, to treatment duration and to serological positivity were 8.6 d, 11.2 d, 7.9 d, and 24 d, respectively. Compared with reference laboratory values, serologically positive patients have shown increased levels of acute phase reactants, such as C-reactive protein, ferritin, and procalcitonin and higher inflammatory markers, such as erythrocyte sedimentation rate, lactate dehydrogenase enzyme, and fibrin end-products, such as D-dimer. A left shift on white blood cell differential was observed with increased neutrophil counts and decreased lymphocytes.

CONCLUSION

Our study demonstrated the feasibility of a COVID-19 diagnosis based on rapid antibody test in the cases of patients whose RT-PCR samples were negative. Detection of antibodies against SARS-CoV-2 with rapid antibody test should be included in the diagnostic algorithm in patients with possible COVID-19 pneumonia.

Diagnosis of COVID-19 by Serology in Admitted Patients with Negative RT-PCR Assay

Considering the increasing prevalence and burden of coronavirus disease 2019 (COVID-19) disease and false-negative results in routine reverse transcription-polymerase chain reaction (RT-PCR) tests, additional diagnostic methods are needed to diagnose active cases of this disease. This prospective study was conducted on patients, in whom clinical and radiological symptoms/signs were in favor of COVID-19 while their first PCR test was negative. Later on, a second RT-PCR was performed and serological evaluation was carried out and results were compared with each other. Out of 707 patients who had been referred to the hospital and were clinically and radiologically suspicious of disease, 137 patients with negative RT-PCR tests entered the study. RT-PCR assay became positive for the second time in 45 (32.8%). Anti-COVID-19 IgM and IgG antibodies were positive in 83 (60.6%) and 86 (62.8%) patients, respectively. Finally, it was determined that serological test was diagnostic in 73% of patients and the diagnostic yield of serology was significantly higher after the first week of illness (54.8% in the first week and 88% after that). Taking advantage of both serological tests and RT-PCR helps in diagnosing 83.9% of cases. Based on the present study, the serology may be useful as a complementary test and in parallel to RT-PCR assay for diagnosis of COVID-19 among admitted symptomatic cases.

Scat-NET: COVID-19 diagnosis with a CNN model using scattergram images

The acute respiratory syndrome COVID-19 disease, which is caused by SARS-CoV-2, has infected many people over a short time and caused the death of more than 2 million people. The gold standard in detecting COVID-19 is to apply the reverse transcription polymerase chain reaction (RT-PCR) test. This test has low sensitivity and produces false results of approximately 15%-20%. Computer tomography (CT) images were checked as a result of suspicious RT-PCR tests. If the virus is not infected in the lung, the virus is not observed on CT lung images. To overcome this problem, we propose a 25-depth convolutional neural network (CNN) model that uses scattergram images, which we call Scat-NET. Scattergram images are frequently used to reveal the numbers of neutrophils, eosinophils, basophils, lymphocytes and monocytes, which are measurements used in evaluating disease symptoms, and the relationships between them. To the best of our knowledge, using the CNN together with scattergram images in the detection of COVID-19 is the first study on this subject. Scattergram images obtained from 335 patients in total were classified using the Scat-NET architecture. The overall accuracy was 92.4%. The most striking finding in the results obtained was that COVID-19 patients with negative RT-PCR tests but positive CT test results were positive. As a result, we emphasize that the Scat-NET model will be an alternative to CT scans and could be applied as a secondary test for patients with negative RT-PCR tests.

Evaluation of Sandwich Enzyme-Linked Immunosorbent Assay and Reverse Transcription Polymerase Chain Reaction for the Diagnosis of Foot-and-Mouth Disease

BACKGROUND

Foot-and-mouth disease (FMD) is an infectious and highly contagious disease of cloven-hoofed domestic and wild animals, causing heavy economic losses to the livestock industry. Rapid and reliable diagnosis of the disease is essential for the implementation of effective control measures. This study compared sandwich enzyme-linked immunosorbent assay (S-ELISA) and conventional reverse transcription polymerase chain reaction (RT-PCR) for the diagnosis of FMD.

METHODS

A total of 60 epithelial samples from suspected cases of FMD were tested using both S-ELISA and RT-PCR assays. The level of agreement between the assays was assessed by calculating the Kappa value.

RESULTS

S-ELISA detected 38 (63%) samples positive for FMD virus (FMDV). Being predominant, serotype O was detected in 22 (57.9%) of the total samples tested positive, whereas 9 (23.7%) and 7 (18.4%) samples were found positive for serotypes A and Asia-1, respectively. RT-PCR detected viral genome in 51 (85%) of the samples using pan-FMDV primers set, 1F/1R. Thirty-six samples were found positive and 7 negative by both the tests. The level of agreement between the tests was assessed by calculating the Kappa value, which was found to be fair (Kappa value = 0.303 and 95% CI = 0.089; 0.517) and significant (p = 0.009). However, 2 samples, which were found positive on S-ELISA tested negative on RT-PCR. This may be attributed to the presence of nucleotide mismatch(es) in the primer-binding sites that may have resulted in failure of amplification of the viral genome. The serotype-specific RT-PCR assays not only confirmed serotyping results of S-ELISA but were also able to establish serotype in 9 S-ELISA-negative but pan-FMDV RT-PCR-positive samples.

CONCLUSIONS

The RT-PCR assay contributes significantly to establishing a quick, sensitive, and definitive diagnosis of FMD in resource-constrained countries. Samples giving negative results in S-ELISA should be tested in RT-PCR for the disease detection and virus typing.

Recent advances and challenges of RT-PCR tests for the diagnosis of COVID-19

Since the outbreak of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the control of virus spread has remained challenging given the pitfalls of the current diagnostic tests. Nevertheless, RNA amplification techniques have been the gold standard among other diagnostic methods for monitoring clinical samples for the presence of the virus. In the current paper, we review the shortcomings and strengths of RT-PCR (real-time polymerase chain reaction) techniques for diagnosis of coronavirus disease (COVID)-19. We address the repercussions of false-negative and false-positive rates encountered in the test, summarize approaches to improve the overall sensitivity of this method. We discuss the barriers to the widespread use of the RT-PCR test, and some technical advances, such as RT-LAMP (reverse-transcriptase-loop mediated isothermal amplification). We also address how other molecular techniques, such as immunodiagnostic tests can be used to avoid incorrect interpretation of RT-PCR tests.

Predictors of severe symptomatic laboratory-confirmed SARS-CoV-2 reinfection

OBJECTIVE

The aim of the study was to evaluate factors predicting severe symptomatic laboratory-confirmed (via Reverse transcription polymerase chain reaction, RT-PCR polymerase chain reaction) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection.

STUDY DESIGN

This is a nationwide retrospective cohort study that was conducted in Mexico.

METHODS

Data from 258 reinfection cases (at least 28 days between both episodes onset) were analyzed. We used risk ratios (RRs) and 95% confidence intervals (CIs) to evaluate predictors of severe (dyspnea requiring hospital admission) secondary SARS-CoV-2 infection.

RESULTS

The risk of severe disease was 14.7%, and the observed overall fatality rate was 4.3%. Patients with more serious primary disease were more likely to develop severe symptoms (39.5% vs. 5.5%, P < 0.001) during reinfection. In multiple analysis, factors associated with an increased risk of severe symptomatic SARS-CoV-2 reinfection were increasing age (RRper year = 1.007, 95% CI = 1.003-1.010), comorbidities (namely, obesity [RR = 1.12, 95% CI = 1.01-1.24], asthma [RR = 1.26, 95% CI = 1.06-1.50], type 2 diabetes mellitus [RR = 1.22, 95% CI = 1.07-1.38]), and previous severe laboratory-confirmed coronavirus disease 2019 (RR = 1.20, 95% CI = 1.03-1.39).

CONCLUSIONS

To the best of our knowledge, this is the first study evaluating disease outcomes in a large set of laboratory-positive cases of symptomatic SARS-CoV-2 reinfection, and factors associated with illness severity were characterized. Our results may contribute to the current knowledge of SARS-CoV-2 pathogenicity and to identify populations at increased risk of a poorer outcome after reinfection.

Primary clear cell sarcoma of the femur: a unique case with RT-PCR and direct sequencing confirmation of EWSR1/ATF1 fusion gene

Background

It is very rare for clear cell sarcomas (CCS) to arise in the bone. During diagnosis, it is important to distinguish primary CCS of bone from bone metastasis of melanoma because this difference fundamentally changes the therapeutic options. Recently, characteristic fusion genes of CCS have been detected using reverse transcription polymerase chain reaction (RT-PCR) or direct sequencing which allowed to distinguish CCS from melanoma. However, there was no study applying these analyses with positive results. In this case, we describe the use of fusion gene analysis to diagnose a primary CCS of the bone.

Case presentation

A 36-year-old male presented with a four-months history of left knee pain. Magnetic resonance imaging showed a lesion in the left femoral medial epicondyle. Histological examination of the biopsy specimen revealed proliferating oval or rounded cells. These cells had clear cytoplasm arranged in fascicles or compact nests with frequent deposits of brown pigment. Furthermore, immunohistochemistry analysis revealed that tumor cells were positive for S-100 protein, HMB-45, Melan-A, and SOX10. It stained negative for CD34 and BRAF v600e. Conclusively, detection of the EWSR1/ATF1 fusion gene using RT-PCR and direct sequencing confirmed that the lesion was a primary CCS of the bone. Wide-margin resection and reconstruction with a tumor endoprosthesis were performed.

Conclusions

Herein, we diagnosed a rare case of primary CCS of the bone by detecting EWSR1/ATF1 fusion gene using RT-PCR and direct sequencing. Since fluorescence-in situ hybridization (FISH) and RT-PCR could show false positive by mainly due to technical problems, it is better to perform direct sequencing to confidently diagnose the tumor as a primary CCS especially at very rare site such as bone.

[Abnormal expression of WWP1 in chronic lymphocytic leukemia and its clinical significance]

目的

检测E3泛素连接酶（WWP1）在慢性淋巴细胞白血病（CLL）患者中的表达，分析其与经典预后指标TP53、CD38、IGHV突变等的相关性及预后价值。

方法

48例初诊CLL患者肿瘤细胞WWP1的mRNA水平通过实时定量PCR（qPCR）检测，以9名年龄匹配的正常人作为对照组，分析其临床意义。

结果

对照组WWP1 mRNA表达中位数为0.007（95％CI 0.005～0.010），CLL组表达水平为0.031（95％CI 0.019～0.044），两者的差异有统计学意义（P<0.001）。WWP1相对高转录者和低转录者中位诊断至第一次治疗的时间分别为24个月和35个月，两者的差异有统计学意义（P＝0.022）。进一步亚组分析显示WWP1 mRNA表达水平与CD38表达和ZAP-70表达相关：CD38、ZAP-70阳性CLL患者较CD38、ZAP-70阴性患者的WWP1 mRNA表达水平显著升高（P值分别为0.012和0.029）。

结论

WWP1在CLL患者中存在异常高表达，而且与CLL临床预后因素ZAP-70和CD38的表达密切相关。

Management of primary Ewing sarcoma of the kidney with inferior vena cava (IVC) tumor thrombosis

Ewing sarcoma (ES) is an entity which belongs to a spectrum of neoplastic diseases called the Ewing sarcoma family of tumors (EFT). EFTs of the kidney represent less than 1% of all renal tumors. Herein, we presented a case of primary renal ES with tumor thrombosis up to vena cava who underwent radical nephrectomy and IVC tumor thrombectomy followed by adjuvant chemotherapy. Histopathology showed that the tumor composed of small uniform, dark, round cells arranged in sheets, and rosettoid pattern. The diagnosis of ESFT was confirmed by detecting EWS/FLI-1 fusion gene using reverse transcription polymerase chain reaction (RT-PCR).

Molecular epidemiology of human respiratory syncytial virus (HRSV) in Iranian military trainees with acute respiratory symptoms in 2017

Background and Objectives

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection in many populations, including military recruits receiving basic training. Therefore, this study was set out to determine the molecular epidemiology, genotype and phylogenetic features of RSVs in patients with respiratory infection as a case study.

Materials and Methods

In this study, military barracks of Tehran, Iran, between January to March 2017 exposed to respiratory diseases were used for sampling. Throat swabs were taken, a reverse transcriptase-polymerase chain reaction (RTPCR) assay was performed to identify RSV and then the genotyping and phylogenetic analyses of RSVs in patients with a respiratory infection.

Results

Among 400 Iranian military trainees with respiratory symptoms, RSV infection was identified in 2.75% (11/400) using RT-PCR. Sequencing showed the incidence of type A (2.5%, n=10) to be much higher than type B (0.25%, n=1); Sore throat was the most common symptom among RSV patients. Phylogenetic analysis revealed that the majority of strains from the studied samples were more consistent with those from the Philippines and the US strains.

Conclusion

This study is the first to document RSV as a major cause of acute respiratory illness among military trainees in Iran. The prevalence of RSV is substantial in the cold season and the prevalence of genotype A is dominant in the country, leading to take essential steps in preparing a preventive vaccine against this viral infection.

Analysis of the potential impact of genomic variants in global SARS-CoV-2 genomes on molecular diagnostic assays

An epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus diseases (C0VID-19) initially reported in Wuhan, China has rapidly emerged into a global pandemic affecting millions of people worldwide. Molecular detection of SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) forms the mainstay in screening, diagnosis and epidemiology of the disease. Since the virus evolves by accumulating base substitutions, mutations in the viral genome could possibly affect the accuracy of RT-PCR-based detection assays. The recent availability of genomes of SARS-CoV-2 isolates motivated us to assess the presence and potential impact of variations in target sites of the oligonucleotide primers and probes used in molecular diagnosis. We catalogued a total of 132 primer or probe sequences from literature and data available in the public domain. Our analysis revealed that a total of 5862 unique genetic variants mapped to at least one of the 132 primer or probe binding sites in the genome. A total of 29 unique variants were present in ≥ 1% of genomes from at least one of the continents (Asia, Africa, Australia, Europe, North America, and South America) that mapped to 36 unique primers or probes binding sites. Similarly, a total of 27 primer or probe binding sites had cumulative variants frequency of ≥ 1% in the global SARS-CoV-2 genomes. These included primers or probes sites which are used worldwide for molecular diagnosis as well as approved by national and international agencies. We also found 286 SARS-CoV-2 genomic regions with low variability at a continuous stretch of ≥ 20bps that could be potentially used for primer designing. This highlights the need for sequencing genomes of emerging pathogens to enable evidence-based policies for development and approval of diagnostics.

Genetic analysis of sapoviruses detected in outbreaks and sporadic cases of acute gastroenteritis in Miyagi Prefecture, Japan

BACKGROUND

Human sapovirus (SaV) causes sporadic and endemic acute gastroenteritis worldwide. However, little is known about the relationship between the mode of transmission and genetic characteristics of SaV.

OBJECTIVE

To investigate the molecular characteristics of SaV-associated acute gastroenteritis among sporadic cases, foodborne, and nonfoodborne outbreaks.

STUDY DESIGN

We performed a systematic review of publications and genetic analysis of SaV in fecal specimens from 98 outpatients with acute gastroenteritis, 32 stool samples from 8 foodborne outbreaks, and 63 stool samples from 23 nonfoodborne outbreaks in Miyagi Prefecture, Japan from 1993 and between 2004 and 2020. Reverse transcription polymerase chain reaction (RT-PCR) was employed for the detection of SaV, and the partial capsid gene was sequenced for genotyping and phylogenetic analysis.

RESULTS

The overall detection rate of SaV in sporadic cases, foodborne, and nonfoodborne outbreaks was 5.8, 1.7, and 4.3%, respectively. Genotypic analysis revealed GI.1 to be the predominant genotype in sporadic cases (31.5%) and nonfoodborne outbreaks (52.1%), whereas it was not detected in foodborne outbreaks. Some outbreaks occurred following sporadic cases with the same genotype.

CONCLUSIONS

The distribution of SaV genotypes was different between foodborne outbreaks and other settings. The effective SaV infection control may differ depending on the genomic characteristics.

Systematic Review of Ocular Involvement of SARS-CoV-2 in Coronavirus Disease 2019

Purpose of Review

Studies have reported ocular involvement in the coronavirus disease 2019 (COVID-19), with SARS-CoV-2 having been detected in ocular swab samples. This has implicated the eye as a portal of transmission. The aim of this systemic review is to summarise and discuss the current literature regarding ocular involvement of SARS-CoV-2 in COVID-19.

Recent Findings

In this systematic review, the prevalence of ocular symptoms and signs was low (from 0 to 31.58%) and conjunctivitis was a relatively rare occurrence. The rate of detection of SARS-CoV-2 in the ocular swab samples was low as well and this ranged from 0 to 11.11%. The development of ocular symptoms and signs was not always accompanied by the detection of SARS-CoV-2 in the ocular swab samples. The opposite was described as well. This may reflect issues related to the characteristics of SARS-CoV-2 and of the study design. Nonetheless, the nature of research in a pandemic is that conclusions can change as more information is obtained.

Summary

Whilst the eye is unlikely to be a main transmission route, we need to consider the possibilities of conjunctivitis as a presenting complaint and of the eye playing a role in the transmission of SARS-CoV-2. Furthermore, we need to take the appropriate precautions in our practice. Further studies are needed to evaluate the viral tropism of SARS-CoV-2 and its role in the eyes.

Influenza: Underestimated in Children Below 2 Years of Age

Children under 2 years of age may receive antiviral therapy when influenza is suspected. Signs of influenza are frequently unclear and testing is indicated. The aim of the study was to assess the usefulness of clinical signs and the rapid influenza diagnostic test (RIDT) in diagnosing influenza and in choosing the appropriate treatment. In the 2015-2016 influenza season, 89 children under 2 years of age (56.7% of 157 children diagnosed with influenza) were hospitalized. There were 74 RIDT and 70 reverse transcription polymerase chain reactions (RT-PCR) performed for the purpose of diagnosis, either test per child. Eighty-three percent of children (74/89) presented with fever, 55.1% (49/89) with cough, and 39.3% (35/89) with both cough and fever. The RIDT was positive in 31.1% (23/74) of cases. The highest percentage of positive RIDT was within the first 24 h of disease, decreasing dramatically thereafter (70% vs. 13-17%, respectively). The RIDT shortened the time to diagnosis by 43.8 h/patient (an average €149 gain in treatment costs). The mean delay for RT-PCR-based diagnosis was 33.5 h/patient (an average €114 loss in treatment costs). We conclude that clinical signs have a low diagnostic sensitivity in children under 2 years of age. Likewise, RIDT is of low sensitivity, being diagnostically useful only in the first 24 h. The PCR is recommended for the diagnosis, but that requires a constant access to the method.

[Expression and correlation of Fra-1 and HMGA1 in laryngeal squamous cell carcinoma]

Objective: To investigate the expressions of Fra-1 and HMGA1 in laryngeal squamous cell carcinoma and their correlation. Methods: Immunohistochemistry and reverse transcription-polymer chain reaction (RT-PCR) were used to detect the expressions of HMGA1 and Fra-1 in laryngeal squamous carcinoma tissues in 47 cases and para-carcinoma tissues in 21 cases(the First Hospital of Shijiazhuang). The relationship between the gene expressions in carcinoma tissues and clinopathological parameters such as pathological grade, clinical stage, lymph metastasis, age and anatomic site and the relevance of the two gene expressions were analyzed. SPSS 13.0 software was used to analyze the data. Results: The positive expression rates of Fra-1 and HMGA1 proteins in laryngeal squamous cancer tissue were 48.9% and 53.2%, which were respectively higher than the rates of 19.0% for Fra-1 (χ(2)=5.416, P<0.05) and of 23.8% for HMGA1 (χ(2)=5.083, P<0.05) in adjacent tissues. The expression of Fra-1 gene was correlation with pathological grade, clinical stage and lymph metastasis (t values were -1.079, -1.066 and -1.067, all P<0.05), but not with age and anatomic site (t values were -1.068 and -1.054, both P>0.05). The expression of HMGA1 gene was correlation with pathological grade, clinical stage, lymph metastasis and age (t values were -1.112, -1.065, -1.009 and -1.066, all P<0.05), but not with anatomic site (t=-1.036, P>0.05). The expressions of Fra-1 and HMGA1 gene were positively correlation (r=0.672, P<0.05). Conclusions: In laryngeal squamous cancer, Fra-1 and HMGA1 are excessive expression, with a positive correlation between the expressions of both genes.

Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon

AIM

To assess the burden of norovirus (NoV) and to determine the diversity of circulating strains among hospitalized children in Lebanon.

METHODS

Stool samples were collected from children presenting with acute gastroenteritis to six major hospitals in Lebanon. A total of 739 eligible stool samples, testing negative for diarrhea caused by rotavirus as a possible viral pathogen, were collected between January 2011 and June 2013. A standardized questionnaire including demographic, epidemiological and clinical observations was used at the time of hospitalization of children presenting with diarrhea. Viral RNA was extracted from stool samples followed by reverse transcription polymerase chain reaction and nucleotide sequencing of a fragment of the viral protein 1 capsid gene. Multiple sequence alignments were carried out and phylogenetic trees were constructed using the MEGA 6 software.

RESULTS

Overall, 11.2% of stool samples collected from children aged < 5 years tested positive for NoV genogroups I (GI) and II (GII). GII accounted for 10.6% of the gastroenteritis cases with only five samples being positive for GI (0.7%). The majority of hospitalized children showed symptoms of diarrhea, dehydration, vomiting and fever. Upon sequencing of positive samples and based on their clustering in the phylogenetic tree, 4/5 of GI gastroenteritis cases were designated GI.3 and one case as GI.4. GII.4 was predominantly detected in stool of our study participants (68%). We report a JB-15/KOR/2008 GII.4 Apeldoorn 2008-like variant strain circulating in 2011; this strain was replaced between 2012 and 2013 by a variant sharing homology with the Sydney/NSW0514/2012/AUS GII.4 Sydney 2012 and Sydney 2012/FRA GII.4 strains. We also report the co-circulation of non-GII.4 genotypes among hospitalized children. Our data show that NoV gastroenteritis can occur throughout the year with the highest number of cases detected during the hot months.

CONCLUSION

The majority of NoV-associated viral gastroenteritis cases among our participants are attributable to GII.4, which is compatible with results reported worldwide.

Surveillance, epidemiological, and virological detection of highly pathogenic H5N1 avian influenza viruses in duck and poultry from Bangladesh

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. Influenza A viruses were detected using reverse transcription PCR targeting the virus matrix (M) gene in 41/4360 (0.94%) samples including both cloacal and oropharyngeal swab samples, 31 of which were subtyped as H5N1 using subtype-specific primers. Twenty-one live H5N1 virus isolates were recovered from those 31 samples. Screening of 1,868 blood samples collected from the same birds using H5-specific ELISA identified 545/1603 (34%) positive samples. Disconcertingly, an analysis of 221 serum samples collected from vaccinated layer chicken in four districts revealed that only 18 samples (8.1%) were seropositive for anti H5 antibodies, compared to unvaccinated birds (n=105), where 8 samples (7.6%) were seropositive. Our result indicates that the vaccination program as currently implemented should be reviewed and updated. In addition, surveillance programs are crucial for monitoring the efficacy of the current poultry vaccinations programs, and to monitor the circulating AIV strains and emergence of AIV subtypes in Bangladesh.

Cytokeratin 20 positive cells in blood of colorectal cancer patients as an unfavorable prognostic marker

OBJECTIVES

Cytokeratin 20 (CK20) is one of the most investigated markers for the detection of circulating colorectal cancer (CRC) cells by reverse transcription polymerase chain reaction (RT-PCR). The aim of this study was to evaluate prognostic value of RT-PCR detection of circulating CRC cells using CK20 as a marker, and to compare the value of preoperative and postoperative blood sample analysis for that purpose.

METHODS

Ribonucleic acid (RNA) was isolated from mononuclear cell fraction of blood samples taken from 95 CRC patients before and after tumor resection and from 23 healthy volunteers and assayed by real-time RT-PCR for CK20 expression.

RESULTS

In patients positive for CK20 postoperatively both progression-free survival (PFS) and overall survival were significantly shorter than in patients negative for CK20 postoperatively, while the difference between patients positive and negative for CK20 preoperatively was not statistically significant in terms of neither PFS nor overall survival.

CONCLUSION

Our results have shown prognostic value of circulating cancer cells detected in postoperative blood samples from CRC patients using CK20 as marker for RT-PCR, which has potential implications for treatment of these patients. In clinical practice, CK20 expression profile could be a factor in weighting treatment options in CRC patients. In cases where multiple treatment options are possible, patients with positive postoperative CK20 expression could be candidates to receive more aggressive treatment.

Anti-cancer Effects of a Novel Quinoline Derivative 83b1 on Human Esophageal Squamous Cell Carcinoma through Down-Regulation of COX-2 mRNA and PGE2

PURPOSE

83b1 is a novel quinoline derivative that has been shown to inhibit cancer growth in human esophageal squamous cell carcinoma (ESCC). This study was conducted to comprehensively evaluate the cytotoxic effects of 83b1 on a series of ESCC cell lines and investigate the mechanisms by which 83b1 suppresses cancer growth based on molecular docking analysis.

MATERIALS AND METHODS

A series of ESCC and nontumor immortalized cell lines were exposed to 83b1 and cisplatin (CDDP) in a dose-dependent manner, and the cytotoxicity was examined by a MTS assay kit. Prediction of the molecular targets of 83b1 was conducted by molecular docking analysis. Expression of cyclooxygenase 2 (COX-2) mRNA and COX-2-derived prostaglandin E₂ (PGE₂) were measured by quantitative real-time polymerase chain reaction and enzymelinked immuno-sorbent assay, respectively. In vivo anti-tumor effect was determined using a nude mice xenografted model transplanted with an ESCC cell line, KYSE-450.

RESULTS

83b1 showed the significant anti-cancer effects on all ESCC cell lines compared to CDDP; however, 83b1 revealed much lower toxic effects on non-tumor cell lines than CDDP. The predicted molecular target of 83b1 is peroxisome proliferator-activated receptor delta (PPARδ), which is a widely known oncoprotein. Additionally the expression of COX-2 mRNA and COX-2-derived PGE₂ were down-regulated by 83b1 in a dose-dependent manner in ESCC cell lines. Furthermore, 83b1 was shown to significantly reduce the tumor size in nude mice xenograft.

CONCLUSION

The results of this study suggest that the potential anti-cancer effects of 83b1 on human esophageal cancers occur through the possible oncotarget, PPARδ, and down-regulation of the cancer related genes and molecules.

Recent viral pathogen in acute gastroenteritis: a retrospective study at a tertiary hospital for 1 year

PURPOSE

Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region.

METHODS

We evaluated 345 pediatric patients (203 males, 142 females; age, 1 month to 16 years) who visited the CHA Bundang Medical Center because of gastroenteric symptoms between June 2014 and May 2015. The specimens were simultaneously tested for norovirus, rotavirus, astrovirus, and adenovirus via multiplex reverse transcription polymerase chain reaction. Clinical characteristics of patients were analyzed retrospectively.

RESULTS

The most common virus was norovirus, followed by rotavirus, adenovirus, and astrovirus. Of all viral infections, 45.2% occurred mainly between 6 and 24 months of age; in particular, norovirus infection mostly occurred in all age groups except those below 6 months of age, when rotavirus was most prevalent. In addition, seasonal variation was observed, such as norovirus infection from December to February, rotavirus infection from February to April, and adenovirus infection from July to October.

CONCLUSION

Our results showed that the most common cause of acute pediatric viral gastroenteritis had changed from rotavirus to norovirus in our patients, because of effective rotaviral vaccination. We recommend the management of food and personal hygiene in accordance with age or seasons as well as active vaccination for preventing viral gastroenteritis.

The Arabian camel Camelus dromedarius heat shock protein 90α: cDNA cloning, characterization and expression

Heat shock protein 90 (Hsp90) is a highly conserved ubiquitous molecular chaperone contributing to assisting folding, maintenance of structural integrity and proper regulation of a subset of cytosolic proteins. In the present study, a heat shock protein 90α full length coding cDNA was isolated and cloned from the Arabian one-humped camel by reverse transcription polymerase chain reaction (RT-PCR). The full length cDNA sequence was submitted to NCBI GeneBank under the accession number KF612338. The sequence analysis of the Arabian camel Hsp90α cDNA showed 2202bp encoding a protein of 733 amino acids with estimated molecular mass of 84.827kDa and theoretical isoelectric point (pI) of 5.31. Blast search analysis revealed that the C. dromedarius Hsp90α shared high similarity with other known Hsp90α. Comparative analyses of camel Hsp90α protein sequence with other mammalian Hsp90s showed high identity (85-94%). Heterologous expression of camel Hsp90α cDNA in E. coli JM109 (DE3) gave a fusion protein band of 86.0kDa after induction with IPTG for 4h.

Explore the dynamic alternation of gene PLAC4 mRNA expression levels in maternal plasma in second trimester for nonivasive detection of trisomy 21

OBJECTIVE

Noninvasive prenatal detection of trisomy 21 (T21) has been achieved by measuring the ratio of two alleles of a single nucleotide polymorphism in circulating placenta specific 4 (PLAC4) mRNA in maternal plasma with a few assays in recent years. Our research is to explore the variations of PLAC4 mRNA expression level in maternal plasma with normal pregnancies in second trimester, which can provide pregnant women deeper insights with suitable detection period for the non-invasive prenatal detection of T21.

METHODS

We measured a serial plasma PLAC4 mRNA concentrations weekly from the same 25 singleton normal pregnant women. We recruited maternal plasma samples from 45 singleton pregnant women, comprising of 25 euploid pregnancies (control group; range, 17 to 21 weeks) and 20 T21 pregnancies (T21 group; range, 19 to 24 weeks). With the application of reverse transcription polymerase chain reaction, we achieved an insight of PLAC4 mRNA expression levels in maternal plasma during second trimester with euploid pregnancies.

RESULTS

Among the control group, the levels of PLAC4 mRNA expression in the gestation of 17 to 18 weeks were significantly less than those in the gestation of 18 to 21 weeks (P<0.05). The average PLAC4 mRNA concentration of the normal pregnant women was not higher than that of the T21 group (P>0.05).

CONCLUSION

The PLAC4 mRNA showed a higher level of expression in the gestation of 18 to 21 weeks with an euploid pregnancy of pregnant women. We also found that there was no significant difference in plasma PLAC4 mRNA concentration between the normal and the T21 pregnancies in second trimester.

Identification and comparison of gonadal transcripts of testis and ovary of adult common carp Cyprinus carpio using suppression subtractive hybridization

The limited number of gonad-specific and gonad-related genes that have been identified in fish represents a major obstacle in the study of fish gonad development and sex differentiation. In common carp Cyprinus carpio from China's Yellow River, the ovary and testis differ in volume and weight in adult fish of the same age. Comparing sperm, egg, and somatic cell transcripts in this carp may provide insight into the mechanisms of its gonad development and sex differentiation. In the present work, gene expression patterns in the carp ovary and testis were compared using suppression subtractive hybridization. Two bidirectional subtracted complementary DNA (cDNA) libraries were analyzed in parallel using testis or ovary as testers. Eighteen nonredundant clones were identified in the male library, including 15 known cDNAs. The expression patterns of selected genes in testis and ovary were analyzed using reverse transcriptase polymerase chain reaction. Tektin-1, GAPDS, FGFIBP, IGFBP-5, and an unknown gene from the Ccmg4 clone were observed to be expressed only in testis. GSDF, BMI1b, Wt1a, and an unknown gene from the Ccme2 clone were expressed at higher levels in testis than in ovary at sexual maturity. Thirty functional expressed sequence tags (ESTs) were identified in 43 sequenced clones in the female library, including 28 known cDNAs, one uncharacterized cDNA (EST clone), and one novel sequence. Eight identified ESTs showed significant differences in expression between the testis and the ovary. ZP3C and Psmb2 were expressed exclusively in ovary, whereas the expression levels of IFIPGL-1, Setd6, ATP-6, CDC45, AIF-1, and an unknown gene from the Ccfh2 clone were more strongly expressed in ovary than in testis. In addition, the expression of ZP3C, Wt1a, and Setd6 was analyzed in male and female gonads, heart, liver, kidney, and brain. ZP3C was expressed only in ovary. Setd6 expression was significantly stronger in female tissues than that in the male, except in the liver, and Wt1a expression showed sexual dimorphism in the kidney and liver. Results suggest that these genes could play key roles during carp growth, both in the gonad and other tissues. The results provide a resource for further investigation of molecular mechanisms responsible for gonad development and sex differentiation in Yellow River common carp.

Pharmacologic inhibition of small-conductance calcium-activated potassium (SK) channels by NS8593 reveals atrial antiarrhythmic potential in horses

BACKGROUND

Small-conductance calcium-activated potassium (SK) channels have been found to play an important role in atrial repolarization and atrial fibrillation (AF).

OBJECTIVE

The purpose of this study was to investigate the existence and functional role of SK channels in the equine heart.

METHODS

Cardiac biopsies were analyzed to investigate the expression level of the most prominent cardiac ion channels, with special focus on SK channels, in the equine heart. Subcellular distribution of SK isoform 2 (SK2) was assessed by immunohistochemistry and confocal microscopy. The electrophysiologic and anti-AF effects of the relative selective SK channel inhibitor NS8593 (5 mg/kg IV) were evaluated in anesthetized horses, focusing on the potential of NS8593 to terminate acute pacing-induced AF, drug-induced changes in atrial effective refractory period, AF duration and vulnerability, and ventricular depolarization and repolarization times.

RESULTS

Analysis revealed equivalent mRNA transcript levels of the 3 SK channel isoforms in atria compared to ventricles. Immunohistochemistry and confocal microscopy displayed a widespread distribution of SK2 in both atrial and ventricular cardiomyocytes. NS8593 terminated all induced AF episodes (duration ≥15 minutes), caused pronounced prolongation of atrial effective refractory period, and reduced AF duration and vulnerability. QRS duration and QTc interval were not affected by treatment.

CONCLUSION

SK channels are widely distributed in atrial and ventricular cardiomyocytes and contribute to atrial repolarization. Inhibition by NS8593 terminates pacing-induced AF of short duration and decreases AF duration and vulnerability without affecting ventricular conduction and repolarization. Thus, inhibition by NS8593 demonstrates clear atrial antiarrhythmic properties in healthy horses.

Expression of high mobility group protein B1 in the lungs of rats with sepsis

BACKGROUND

Vibrio vulnificus inside the body could activate the NF-κB signaling pathway and initiate the inflammatory cascade. The lung is one of the earliest organs affected by sepsis associated with acute lung injury. High mobility group protein B1 (HMGB1) is an important late-acting pro-inflammatory cytokine involving in the pathophysiology of sepsis. It is also involved in the injury process in the lung, liver and intestine. There has been no report on the involvement of HMGB1 in Vibrio vulnificus sepsis-induced lung injury.

METHODS

Sixty rats were randomly divided into a normal control group (group A, n=10) and a Vibrio vulnificus sepsis group (group B, n=50). Sepsis was induced in the rats by subcutaneous injection of Vibrio vulnificus (concentration 6×10(8) cfu/mL, volume 0.1 mL/100g)) into the left lower limbs. The rats in group B were sacrificed separately 1, 6, 12, 24, and 48 hours after the infection. Their lungs were stored as specimens, lung water content was measured, and lung pathology was observed under a light microscope. The expressions of the HMGB1 gene and protein in the lungs were detected by RT-PCR and Western blot. Data were analyzed with one-way analysis of variance (ANOVA) and the LSD method for pair-wise comparison between the two groups. P<0.05 was considered statistically significant.

RESULTS

Compared to group A (0.652±0.177), HMGB1 mRNA expression in the lungs of group B was significantly higher at 0 hour (1.161±0.358, P=0.013), 24 hours (1.679±0.235, P=0.000), and 48 hours (1.258±0.274, P=0.004) (P<0.05), and peaked at 24 hours. Compared to group A (0.594±0.190), HMGB1 protein expression at 6 hours (1.408±0.567, P=0.026) after infection was significantly increased (P<0. 05), and peaked at 24 hours (2.415±1.064, P=0.000) after infection. Compared to group A (0.699±0.054), lung water content was significantly increased at 6 hours (0.759±0.030, P=0.001),12 hours (0.767±0.023, P=0.000), 24 hours (0.771±0.043, P=0.000) and 48 hours (0.789±0.137, P=0.000) after infection (P<0.05). Compared to group A, pathological changes at 12 hours in group B indicate marked pulmonary vascular congestion, interstitial edema and inflammatory infiltration. Alveolar cavity collapse and boundaries of the alveolar septum could not be clearly identified.

CONCLUSION

Vibrio vulnificus sepsis can lead to injury in rat lungs, and increased HMGB1 expression in lung tissue may be one of the mechanisms for injury from Vibrio vulnificus sepsis.

Comparison of primer sets and one-step reverse transcription polymerase chain reaction kits for the detection of bluetongue viral RNA

Bluetongue virus is the etiological agent of bluetongue, one of the most important insect-transmitted animal diseases in the world. To establish a feasible diagnostic procedure for detecting the viral RNA, seven commercially available one-step RT-PCR kits in combination with three primer sets were evaluated. Results of this study showed remarkable differences in analytical sensitivity between the examined RT-PCR kits. In addition, it was found that a World Organization for Animal Health-recommended primer set may not be effective in detecting most BTV RNA.

Novel homozygous mutations in the WNT10B gene underlying autosomal recessive split hand/foot malformation in three consanguineous families

Split-hand/split-foot malformation (SHFM), representing variable degree of median clefts of hands and feet, is a genetically heterogeneous group of limb malformations with seven loci mapped on different human chromosomes. However, only 3 genes (TP63, WNT10B, DLX5) for the seven loci have been identified. The study, presented here, described three consanguineous Pakistani families segregating SHFM in autosomal recessive manner. Linkage in the families was searched by genotyping microsatellite markers and mutation screening of candidate gene was performed by Sanger DNA sequencing. Clinical features of affected members of these families exhibited SHFM phenotype with involvement of hands and feet. Genotyping using microsatellite markers mapped the families to WNT10B gene at SHFM6 on chromosome 12q13.11-q13. Subsequently, sequence analysis of WNT10B gene revealed a novel 4-bp deletion mutation (c.1165_1168delAAGT) in one family and 7-bp duplication (c.300_306dupAGGGCGG) in two other families. Structure-based analysis showed a significant conformational shift in the active binding site of mutated WNT10B (p.Lys388Glufs*36), influencing binding with Fzd8. The mutations identified in the WNT10B gene extend the body of evidence implicating it in the pathogenesis of SHFM.

Resveratrol enhances chemosensitivity of doxorubicin in multidrug-resistant human breast cancer cells via increased cellular influx of doxorubicin

BACKGROUND

Multidrug resistance is a major problem in the treatment of breast cancer, and a number of studies have attempted to find an efficient strategy with which to overcome it. In this study, we investigate the synergistic anticancer effects of resveratrol (RSV) and doxorubicin (Dox) against human breast cancer cell lines.

METHODS

The synergistic effects of RSV on chemosensitivity were examined in Dox-resistant breast cancer (MCF-7/adr) and MDA-MB-231 cells. In vivo experiments were performed using a nude mouse xenograft model to investigate the combined sensitization effect of RSV and Dox.

RESULTS AND CONCLUSION

RSV markedly enhanced Dox-induced cytotoxicity in MCF-7/adr and MDA-MB-231 cells. Treatment with a combination of RSV and Dox significantly increased the cellular accumulation of Dox by down-regulating the expression levels of ATP-binding cassette (ABC) transporter genes, MDR1, and MRP1. Further in vivo experiments in the xenograft model revealed that treatment with a combination of RSV and Dox significantly inhibited tumor volume by 60%, relative to the control group.

GENERAL SIGNIFICANCE

These results suggest that treatment with a combination of RSV and Dox would be a helpful strategy for increasing the efficacy of Dox by promoting an intracellular accumulation of Dox and decreasing multi-drug resistance in human breast cancer cells.

Major cis-regulatory elements for rice bidirectional promoter activity reside in the 5'-untranslated regions

Bidirectional promoters are defined as those that regulate adjacent genes organized in a divergent fashion (head to head orientation) and separated by <1 kb. In order to dissect bidirectional promoter activity in a model plant, deletion analysis was performed for seven rice promoters using promoter-reporter gene constructs, which identified three promoters to be bidirectional. Regulatory elements located in or close to the 5'-untranslated regions (UTR) of one of the genes (divergent gene pair) were found to be responsible for their bidirectional activity. DNA footprinting analysis identified unique protein binding sites in these promoters. Deletion/alteration of these motifs resulted in significant loss of expression of the reporter genes on either side of the promoter. Changes in the motifs at both the positions resulted in a remarkable decrease in bidirectional activity of the reporter genes flanking the promoter. Based on our results, we propose a novel mechanism for the bidirectionality of rice bidirectional promoters.

Identification and differentiation into hepatocyte-like cells of mouse marrow stromal stem cells in vitro

AIM: To isolate and identify mouse marrow stromal stem cells (MSCs), then to explore whether MSCs cultured in the directed differentiation media including HGF, EGF and FGF-4 could differentiate into hepatocytes.

METHODS: Bone marrow cells were collected from C57BL/6 mouse by density gradient centrifugalization, and were purified by adherent culture. Cell morphology was observed, and cell surface markers were identified by flow cytometry. MSCs were cultured in the directed differentiation media including HGF, EGF and FGF-4, and the expression patterns of some genes of the hepatocytes, AFP, ALB and CK18 were validated and confirmed by RT-PCR. The ALB and CK18 expressed cells were confirmed by Western blot.

RESULTS: Cell morphology tended to be uniform fusiform shape with passage. The percentage of hematopoietic lineage marker CD45 decreased from 86.49% to 2.77% while the percentage of CD90 increased obviously from 25.42% in primary culture cells to 93.47% at the fifth generation. AFP mRNA expression appeared on culture day 7 and decreased in the later days; ALB and CK18 mRNA expression also appeared on culture day 7, but increased with the differentiation of MSCs. ALB and CK18 were confirmed to express in the differentiated MSCs by Western blot analysis.

CONCLUSION: MSCs can be isolated and purified in vitro, then induced to differentiate into hepatocytes or hepatocyte-like cells by directed differentiation media including HGF, EGF and FGF-4.

Protective effects of N-acetylcysteine against liver injury in rats with severe acute pancreatitis

AIM: To investigate the role of nuclear factor-kappa B (NF-κB) activation in liver injury in rats with severe acute pancreatitis (SAP), and to explore the protective effect of N-acetylcysteine (NAC) against SAP-associated liver injury in rats.

METHODS: Forty-two Wistar male rats were divided into sham operation group (SO, n = 6), SAP group (n = 18), and SAP + NAC group (NAC, 300 mg/kg body wt, n = 18). SO group underwent laparotomy only. SAP model was established by retrograde injection of 50 g/L sodium taurocholate into the bili-pancreatic duct in Wistar rats. SAP + NAC group were given NAC 300 mg/kg body weight intaperitoneally 2 h before SAP model was established. Rats were sacrificed at 3, 6 and 12 h after operation. The liver and pancreas tissues were obtained to observe their pathological changes with light microscopy. The levels of serum ALT and AST were determined at three time points (8 rats for each time point). The expression of TNF-α mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). The activity of NF-κB in liver was examined by immunohistochemical methods.

RESULTS: The levels of serum ALT and AST increased significantly in SAP group as compared with those in SO group at 3, 6 and 12 h (ALT: 186.67 ± 27.28, 321.17 ± 56.14, 492.50 ± 69.77 vs 36.83 ± 7.02; AST: 255.50 ± 44.15, 343.17 ± 43.70, 425.33 ± 58.37 vs 41.67 ± 5.35; P < 0.05 or 0.01). The level of TNF-α mRNA in SAP group was significantly higher than that in SO group at 3, 6 and 12 h (0.37 ± 0.03, 0.77 ± 0.04, 0.54 ± 0.04 vs 0.24 ± 0.03; P < 0.05 or 0.01). The activity of NF-κB was also higher in SAP group than that in SO group at 3 or 6 h (51.95 ± 4.76, 24.67 ± 4.93 vs 9.33 ± 2.05; P < 0.01 or 0.05). Liver and pancreas pathological damages were more severe in SAP group than those in SO group under light microscope. In SAP + NAC group, the levels of serum ALT and AST (143.67 ± 16.62, 203.33 ± 25.41, 301.17 ± 26.82; 136.33 ± 26.27, 221.50 ± 38.31, 310.50 ± 38.17) decreased significantly in comparison with those in SAP group (P < 0.05 or 0.01), and the expression of TNF-α mRNA was significantly lower than that in SAP group at the three time points (0.25 ± 0.03, 0.50 ± 0.05, 0.43 ± 0.03, P < 0.05 or 0.01). The activity of NF-κB in SAP + NAC group was lower than that in SAP group at 3 or 6 h (37.60 ± 6.37, 12.88 ± 2.66, P < 0.05).

CONCLUSION: NF-κB activation and TNF-α mRNA up-regulation involve in the pathogenesis of liver injury in SAP rats. NAC at a dose of 300 mg/kg can alleviate the pathological damage to liver, and its mechanism might relate to inhibition of NF-κB activation and reduction of cytokines such as TNF-α.

Expression of ADAM23 gene and its significance in human colorectal cancer

AIM: To investigate the expression of ADAM23 mRNA and protein in human colorectal cancer and its clinical significance.

METHODS: Forty-five cases with colorectal cancer undergoing surgical treatment in our hospital from 2007 to 2008 were collected. Reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry were performed to detect the expression of ADAM23 mRNA and protein respectively in tumor and paratumorous tissues.

RESULTS: The expression levels of ADAM23 mRNA and protein were significantly lower in tumor tissues than those in paratumorous tissues (37.8% vs 95.6%, 28.9% vs 86.7%; both P < 0.01). ADAM23 expression had no correlation with patients' age, sex and tumor size, but markedly related to tumor differentiation degree, infiltration depth, lymph node metastasis and clinical stages (χ² = 5.688, 14.79, 11.8172, 11.8172; P < 0.01 or 0.05).

CONCLUSION: ADAM23, which is associated with partial biological behaviors, may be involved in the development of colorectal cancer, and it may serve as an important molecular biological indicator in diagnosing and predicting the biological behaviors of colorectal cancer.

Expression and clinical significance of mTOR/P70S6K signaling pathway in hepatocellular carcinoma

AIM: To investigate expression of mTOR/P70S6K signaling pathway in human hepatocellualr carcinoma (HCC) and to discuss its role in the hepatocellular carcinogenesis.

METHODS: Reverse transcription polymerase chain reactions (RT-PCR) was employed to determine the mRNA expression of mTOR/P70S6K signaling pathway in cancerous and paracancerous tissuess of 20 HCC cases and normal healthy liver tissues of 10 cases. The relationship between expression of the genes mRNA in HCC tissues and related clinical parameters was analyzed.

RESULTS: The expression level of mTOR/P70S6K signaling pathway was markedly higher in the HCC tissues than in the paracancerous tissues or normal healthy liver tissues (mTOR mRNA: 0.594 ± 0.218 vs 0.437 ± 0.156, 0.594 ± 0.218 vs 0.383 ± 0.081, both P < 0.05; P70S6K mRNA: 0.610 ± 0.147 vs 0.486 ± 0.162, 0.610 ± 0.147 vs 0.440 ± 0.141, both P < 0.05). There was a positive correlation between mTOR mRNA and P70S6K mRNA expression in HCC tissues (r = 0.548, P = 0.012). There was also a positive correlation between mTOR mRNA and P70S6K mRNA expressions in paracancerous tissues and the normal liver tissues (r = 0.607, 0.737, P = 0.005, 0.015). The expression of mTOR/P70S6K signaling pathway in the HCC tissues was significantly correlated with the pathological grading, the pylic cancer embolus, but not with the diameter, level of the serous alpha - fetoprotein (AFP), and gender.

CONCLUSION: The mTOR/P70S6K signaling pathway is specifically activated in HCC tissues. The mTOR/P70S6K signaling pathway might play an important role in the pathogenesis of HCC.

Expression of P14ARF, ARF-BP1 and c-myc mRNAs in hepatocellular carcinoma and their significances

AIM: To investigate the expression of P14^ARF, ARF-BP1 and c-myc mRNAs in hepatocellular carcinoma (HCC) and their clinical significances.

METHODS: Abundance of P14^ARF, ARF-BP1 and c-myc mRNAs was detected by semi-quantification reverse transcription polymerase chain reaction (RT-PCR) technique in the samples from 52 HCCs and their 45 non-tumorous liver tissues, and their clinical significances were assayed with the clinical parameters.

RESULTS: The expression levels of P14^ARF, ARF-BP1 and c-myc mRNAs (77.0%, 77.0%, 75.0%) were higher in HCC tissues than those in the non-tumorous liver tissues (11.1%, 20.0%, 53.3%), respectively. The expression of P14^ARF mRNA and ARF-BP1 mRNAs were related to tumor size (t = 2.169, 2.087; both P < 0.05), but the expression of c-myc mRNA was not. The expression of P14^ARF, ARF-BP1 and c-myc mRNAs were not related to the gender, age, AFP level, clinical stageing, HBV infection, envelopes, infiltration and metastasis. There was a positive correlation between P14^ARF and ARF-BP1 expression, P14^ARF and c-myc expression as well as ARF-BP1 and c-myc expression (r = 0.565, 0.436, 0.584; all P < 0.01).

CONCLUSION: Over-expression of P14^ARF, ARF-BP1 and c-myc mRNAs are markers in the early stage of HCC, and ARF-BP1 over-expression play an important role in the genesis and development of HCC. ARF-BP1 may become a novel therapeutic target against HCC.

Screening and annotation of genes associated with Peutz-Jeghers syndrome using gene chip technique

AIM: To explore the genes associated with Peutz-Jeghers syndrome (PJS) using gene chip technique.

METHODS: Differentially expressed genes of PJS polyps and colorectal adenoma tissues were identificated using DNA microarray. Part of differentially expressed genes were identificated by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR).

RESULTS: In comparison with normal mucosa and adenoma, 270 genes were differentially expressed in PJS polyps, of which 166 were up-regulated and 104 were down-regulated. PJS-specific differently expressed genes included EPHB4, EPHB3, EPHB1, EFNB2, EFNA1, COL4A1, COL4A2, COL6A3 and COL6A2.

CONCLUSION: Ephrin, COL4A1, COL4A2, COL6A2 and COL6A3 are the novel genes associated with PJS, and they may play important roles in the pathogenesis of PJS polyps.

Effect of acupuncturing at the acupoint ST 36 on substance P and proopiomelanocortin expression in hypothalamus and adrenal in rats with cold-restraint stress-induced ulcer

AIM: To study the protective effect of acupuncturing at the acupoint ST 36 against cold-restraint stress-induced ulcer and the expression of substance P (SP) and proopiomelanocortin (POMC) associated with stress in hypothalamus and adrenal in rats.

METHODS: Twenty-two rats were randomized into 3 groups: normal control group (n = 6), stress group (n = 8), acupuncturing group (n = 8). The rats in the acupuncutring group received acupuncture at the acupoint ST 36 before cold-restraint stress. Ulcer index and serum cortisol level were used to evaluate the protective effect of acupuncturing at the acupoint ST 36; reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of SP and POMC in hypothalamus and adrenal, and the images were analyzed with semi-quantitative method.

RESULTS: The ulcer index and serum cortisol level in the acupuncturing group were significantly lower than those in the stress group (9.75 ± 1.91 vs 26.25 ± 4.40, P < 0.01; 66.83 nmol/L ± 12.25 nmol/L vs 104.38 nmol/L ± 8.31 nmol/L, P < 0.01). The expression of SP was up-regulated in hypothalamus (1.02 ± 0.42 vs 0.45 ± 0.12, P < 0.05) but down-regulated in adrenal (1.88 ± 0.82 vs 2.93 ± 1.08, P < 0.05) in the acupuncturing group as compared with that in the stress group. Acupuncturing at the acupoint ST 36 inhibited the sress-induced POMC expression in hypothalamus (0.56 ± 0.14 vs 0.82 ± 0.19, P < 0.01). There was no POMC expression in adrenal in the rats with sress-induced ulcer.

CONCLUSION: Acupuncturing at acupoint ST 36 can protect gastric mucosa against cold-restraint stress-induced ulcer by up-regulating SP expression in hypothalamus and down-regulating POMC expression in hypothalamus and SP expression in adrenal.

Effects of insulin-like growth factor -Ⅰ on bax and bcl-2 mRNA expression in intestinal mucosal epithelial cells of rats with severe acute pancreatitis

AIM: To investigate the effects of exogenous insulin-like growth factor-Ⅰ (IGF-Ⅰ) on the intestinal mucosal epithelial cell apoptosis and the associated genes bax and bcl-2 in rats with severe acute pancreatitis (SAP), and to explore the protective effect of IGF-Ⅰ on intestinal mucosal barrier function and its possible mechanisms.

METHODS: Seventy-two male Wistar rats were randomly divided into 3 groups: sham operation (SO) group, SAP group and IGF-Ⅰ treatment group. Eight rats were killed in each group at 6, 12, and 24 h, respectively. Serum amylase level was detected by iodine-starch colorimetry. Pathological changes in the small intestine were observed. Apoptosis of mucosal cells was detected by TUNEL methods, and the variation of the bax and bcl-2 gene expression in small intestinal tissue was detected by reverse transcription polymerase chain reaction (RT-PCR).

RESULTS: In the IGF-Ⅰ treatment group, the apoptosis index of intestinal epithelial cells was decreased significantly as compared with that in the SAP group (6 h: 13.88 ± 1.73 vs 19.00 ± 2.78; 12 h: 10.13 ± 1.55 vs 17.63 ± 1.60; 24 h: 9.50 ± 1.07 vs 17.25 ± 2.76; all P < 0.05), and the pathological changes in intestinal tissues were obviously improved. Compared with that in the SAP group, the bax mRNA expression was notably reduced in the IGF-Ⅰ treatment group (6 h: 1.10 ± 0.02 vs 1.19 ± 0.04; 12 h: 0.97 ± 0.04 vs 1.16 ± 0.02; 24 h, 0.87 ± 0.03 vs 1.14 ± 0.03; all P < 0.05), while, the bcl-2 mRNA expression was increased significantly in the IGF-Ⅰ treatment group (6 h: 0.65 ± 0.02 vs 0.57 ± 0.02; 12 h: 0.69 ± 0.04 vs 0.57 ± 0.01; 24 h: 0.72 ± 0.02 vs 0.58 ± 0.01; all P < 0.05).

CONCLUSION: Exogenous IGF-Ⅰ may alleviate SAP-induced injury of intestinal mucosa by altering the transcription of bax and bcl-2 genes.

Effects of HDAC1 silence by RNA interference on the apoptosis and proliferation of colorectal cancer cells

AIM: To construct the HDAC1 specific recombinant plasmid vector and investigate its effects on the apoptosis, proliferation and cell cycle distribution of colorectal cancer cells.

METHODS: HDAC1 specific short hairpin RNA (shRNA) plasmid vector was constructed and then transfected into the cultured SW480 cell line with lipofectamine 2000. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to detect the expression of HDAC1 mRNA and protein, respectively, and p21^/WAF-1/CIP-1, CdK2, and Cyclin E proteins were detected by Western blot, too. The growth inhibition of SW480 cells was evaluated by MTT assay. Cell apoptosis and cell cycle distribution were determined by flow cytometry.

RESULTS: The levels of HDAC1 mRNA and protein in HDAC1-shRNA group were significantly lower than those in negative control group (30.4% ± 4.5% vs 64.6% ± 4.4%, P < 0.01; 27.4% ± 4.5% vs 58.1% ± 3.3%; both P < 0.01). In comparison with negative control group, HDAC1 silence led to a significant increase of p21^/WAF-1/CIP-1 protein (97.4% ± 2.6% vs 62.6% ± 3.4%, P < 0.01) and decrease of CdK2 and Cyclin E protein (27.7% ± 6.0% vs 42.6% ± 4.1%, P < 0.01; 42.0% ± 8.5 % vs 82.8% ± 3.7%, P < 0.01). MTT assay revealed that transfection of HDAC1-shRNA inhibited the growth of SW480 cells, and the inhibitory rates were markedly higher at 24, 48, 72, and 96 h time points than those in negative control group (24 h: 35.9% ± 4.9% vs 1.2% ± 0.6%, P < 0.01; 48 h: 47.5% ± 7.0% vs 1.3% ± 0.6%, P < 0.01; 72 h: 45.7% ± 6.2% vs 1.0% ± 0.5%, P < 0.01; 96 h: 48.2% ± 4.7% vs 1.2% ± 0.7%, P < 0.01). The percentage of apoptosis cells in HDAC1-shRNA group was significantly higher than that in negative control group (31.3% ± 2.8% vs 3.9% ± 0.7%, P < 0.01) and the cells were increased at G₀/G₁ and G₂/M phase (G₀/G₁: 64.5% ± 0.9% vs 57.8% ± 1.8%, P < 0.01; G₂/M: 17.4% ± 1.3% vs 14.5% ± 0.6%, P < 0.05), but decreased at S phase (17.5% ± 1.0% vs 27.7% ± 1.5%, P < 0.01).

CONCLUSION: HDAC1 silence by shRNA can inhibit the growth of colorectal cancer cells through inducing apoptosis and cell cycle arrest.

Expression of pituitary homeobox 1 gene in human gastric carcinogenesis and its clinicopathological significance

AIM: To investigate the effect of pituitary homeobox 1 (PITX1) expression in cases of human gastric cancer on cancer differentiation and progression, and carcinogenesis.

METHODS: Using polyclonal PITX1 antibodies, we studied the expression of PITX1 in normal gastric mucosa, atypical hyperplasia, intestinal metaplasia, and cancer tissue samples from 83 gastric cancer patients by immunohistochemistry. Moreover, semi-reverse transcription polymerase chain reaction (semi-RT-PCR) was performed to detect the mRNA level of PITX1 in three gastric cancer cell lines and a normal gastric epithelial cell line. Subsequently, somatic mutations of the PITX1 gene in 71 gastric cancer patients were analyzed by a combination of denaturing high performance liquid chromatography (DHPLC) and DNA sequencing.

RESULTS: Immunohistochemistry showed that PITX1 was strongly or moderately expressed in the parietal cells of normal gastric mucosa (100%), while 55 (66.3%) out of 83 samples of gastric cancers showed decreased PITX1 expression. Moreover, PITX1 expression was reduced in 20 out of 28 cases (71.5%) of intestinal metaplasia, but in only 1 out of 9 cases (11%) of atypical hyperplasia. More importantly, PITX1 expression was significantly associated with the differentiation, position and invasion depth of gastric cancers (r = -0.316, P < 0.01; r = 0.213, P < 0.05; r = -0.259, P < 0.05, respectively). Similarly, levels of PITX1 mRNA were significantly decreased in 2 gastric cancer cell lines, BGC-823 and SGC-7901, compared with the normal gastric epithelial cell line GES-1 (0.306 ± 0.060 vs 0.722 ± 0.102, P < 0.05; 0.356 ± 0.081 vs 0.722 ± 0.102, P < 0.05, respectively). Nevertheless, no somatic mutation of PITX1 gene was found in 71 samples of gastric cancer by DHPLC analysis followed by sequencing.

CONCLUSION: Down-regulation of PITX1 may be a frequent molecular event in gastric carcinogenesis. Aberrant levels of PITX1 expression may be closely correlated with the progression and differentiation of gastric cancer.

Effect of Jiangzhi Yigan Chongji on resistin mRNA in the liver of rats with non-alcoholic steatohepatitis

AIM: To explore the effects of resistin in the pathogenesis of a rat model of non-alcoholic steatohepatitis (NASH), and to observe the effect of Jiangzhi Yigan Chongji on resistin mRNA in the liver of that model, to explore its mechanism of action.

METHODS: 24 male Wistar rats were randomly divided into three groups (eight rats in each): normal group fed with standard diet, model group, and treated group fed with a high-fat diet. The treated group was given Jiangzhi Yigan Chongji (1 mL/100 g, its concentration is 0.8 g/mL, twice daily) by intragastric administration after 12 weeks. Meanwhile, the normal and model groups were separately given drinking water by the same means. After 17 weeks, they were killed. Resistin mRNA in the liver of the rat model of NASH induced by high-fat diet was detected with RT-PCR. Level of alanine aminotransferase (ALT) and asparate aminotransferase (AST) was detected by an automatic biochemistry analyzer; fasting blood glucose (FBG) was detected by glucose oxidase method; and tumor necrosis factor α (TNF-α) and fasting insulin (FINS) in serum were detected by radioimmunoassay. Degrees of steatosis and steatohepatitis were observed.

RESULTS: A positive correlation was found between mRNA expression of resistin and TNF-α, ALT and AST, and the degree of steatohepatitis (r = 0.873, 0.772, 0.716 and 0.892, P < 0.05) in the model group, but had no correlation with ISI. The relative level of resistin mRNA in the liver tissue of the model group (2.14 ± 0.11) was significantly higher than that in the normal group (0.42 ± 0.08), and that in the treated group (0.90 ± 0.06) was significantly lower than that in the model group (P < 0.01).

CONCLUSION: Resistin may play an important role in the damage of NASH. Jiangzhi Yigan Chongji can significantly decrease the expression of resistin mRNA in liver tissue of NASH rats, and resistin may be a pharmacological target.

Effects of berberine on expression of hepatocyte nuclear factor 6 and glucokinase activity in mouse primary hepatocytes

AIM: To observe the expression of hepatocyte nuclear factor 6 (HNF6) and the activity of glucokinase (GK), the key enzyme in glucose metabolism, and to investigate the possible mechanism of berberine in treating type II diabetes.

METHODS: Mouse primary hepatocytes were isolated by an improved single two-step perfusion method. The murine hepatocytes were incubated with berberine (0, 1, 3, 10, 30 and 100 μmol/L) and 1 mmol/L metformin for 24 hours. mRNA expression for HNF6 was determined by RT-PCR and analyzed by consequent quantification, and the activity of GK was detected by an enzyme kinetics method.

RESULTS: Compared with the negative control group, 1, 3, 10 or 30 μmol/L berberine promoted the expression of HNF6 mRNA (1.00 ± 0.21, 1.11 ± 0.06, 1.37 ± 0.10 or 1.40 ± 0.09 vs 0.68 ± 0.02; P < 0.01). At 10 or 30 μmol/L, berberine up-regulated GK activity (0.069 ± 0.082, 0.080 ± 0.073 vs 0.009 ± 0.007; P < 0.05). Both of these reached a maximum at a concentration of 30 μmol/L. At 100 μmol/L berberine, expression of HNF6 mRNA and activity of GK decreased, probably because high-concentration berberine inhibited the growth of primary hepatocytes.

CONCLUSION: It is suggested the effects of berberine in improving glucose metabolism may be associated with its up-regulation of HNF6 mRNA expression and induction of hepatic GK activity.

p38 mitogen-activated protein kinase modulates Bcl-2 expression during FAS-induced apoptosis in Bel-7402 cells

AIM: To investigate whether p38 mitogen-activated protein kinase (p38MAPK) is involved in Fas- and actinomycin D (AD)-induced apoptosis in Bel-7402 cells, and the relationship between p38MAPK and Bcl-2 expression.

METHODS: We measured the viability of Bel-7402 cells by MTT assay, p38MAPK, p-p38MAPK and Bcl-2 expression by Western blotting and reverse transcription polymerase chain reaction (RT-PCR), and the location of p-p38MAPK in Bel-7402 cells after Fas and AD treatment by immunofluorescene.

RESULTS: Bel-7402 cell viability was significantly inhibited by Fas (P < 0.01). p38MAPK and p-p38MAPK increased significantly with increasing Fas (P < 0.01), leading to cell death as assessed by MTT after 24 hours of Fas and AD treatment. p-p38MAPK translocation into the nucleus was dependent on Fas stimulation. Bcl-2 expression decreased significantly and was prevented by SB203580 during Fas- and AD-induced apoptosis (P < 0.01).

CONCLUSION: p38MAPK is involved in Fas- and AD-induced apoptosis, and p38MAPK modulates Bcl-2 expression during this apoptosis pathway.

Vitamin E and Se interfere in cytochrome P4501A1 and lipid peroxidation in nonalcoholic fatty liver diseases in rats

AIM: To study the effects of vitamin E and Se on cytochrome P4501A1 and lipid peroxidation in nonalcoholic fatty liver diseases in rats.

METHODS: Forty male SD rats were randomly divided into 5 groups: normal control group, model group, VE group, Se group and VE + Se group. Each subgroup comprised 8 rats, which were respectively fed with normal diets, fat-rich diets and interfering diets (VE, Se, VE + Se). All animals were sacrificed at the end of the 5th week. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels in the serum and liver were detected by biochemical analysis. The expression levels of cytochrome P4501A1 mRNA in liver tissue were measured by reverse transcription polymerase chain reaction (RT-PCR). The levels of tumor necrosis factor alpha (TNF-α) and nuclear factor kappa B (NF-κB) proteins in hepatic tissue were examined by immunohistochemistry.

RESULTS: Compared with the control group, MDA levels in the serum and livers of model group animals were elevated (serum, 13.40 ± 4.24 mmol/L vs 6.43 ± 1.76 mmol/L; liver, 9.79 ± 0.94 nmol/mgprot. vs 6.80 ± 0.97 nmol/mgprot., P < 0.01), while SOD levels were decreased (serum, 312.72 ± 49.51 kU/L vs 583.23 ± 63.37 kU/L; liver, 8.13 ± 0.63 U/mgprot. vs 13.99 ± 2.33 U/mgprot.; P < 0.01). The levels of NF-κB and TNF-α proteins and cytochrome P4501A1 mRNA in liver tissue were significantly increased in model group animals (0.069 ± 0.01, 0.230 ± 0.013 and 0.628 ± 0.116, respectively) compared with control animals (0.003 ± 0.001, 0.03 ± 0.006, and 0, respectively; P < 0.05). Compared with the model group, in the VE group and Se group, MDA decreased in serum and liver while SOD heightened, levels of cytochrome P4501A1 mRNA in liver tissue also decreased. Expression of NF-κB and TNF-α proteins also decreased (P < 0.05). The SOD levels in the serum of VE + Se group animals clearly increased, and approached the levels of the control group, compared with those in model group animals, whereas the levels of cytochrome P4501A1 mRNA in liver tissue significantly decreased (0.324 ± 0.070 vs 0.628 ± 0.116; P < 0.05).

CONCLUSION: Lipid peroxidation and the expression of some correlation factors in nonalcoholic fatty liver diseases is probably relevant to the up-regulation of cytochrome P4501A1 mRNA in liver tissue. Vitamin E and Se can protect against nonalcoholic fatty liver diseases owing to their antioxidant capabilities. The function of the administration of both Vitamin E and Se combined was significantly larger than those of vitamin E and sodium selenite alone.