Analysis of serum Haptoglobin using glycoproteomics and lectin immunoassay in liver diseases in Hepatitis B virus infection

BACKGROUND

Hepatocellular carcinoma (HCC) due to Hepatitis B viral (HBV) infection is a major cause in Asia-Pacific countries. Its early detection is of paramount importance using a marker having both sensitivity and specificity. The present study promises diagnostic and prognostic markers by the identification of site-specific glycoforms on Haptoglobin (Hp) using LC-MS/MS and lectin ELISA in liver diseased conditions in HBV infection.

METHODS

Three groups of patients: chronic, liver cirrhosis and HCC with HBV infection along with controls were enrolled. Hp was purified using affinity column chromatography and, peptide sequence, N-glycosylation site, glycan composition and glycoforms were identified using mass spectrometry. Quantitative lectin ELISA was used to measure levels of fucosylation on Hp in liver diseases due to HBV.

RESULTS

Hp levels were significantly lower in HCC when compared with Non-HCC cases (p < .05). Fucosylated glycoforms were significantly increased at site Asn184, Asn207 and Asn211 in liver diseased stages versus controls. A significant association was observed between the Fuc-Hp/Hp Elisa index and, advanced liver disease stages and controls using lectin Elisa (p < .001).

CONCLUSION

Quantitation of fucosylation levels on Hp protein using Lectin ELISA may be useful glycobiomarker either alone or in combination (AFP + DCP + FucHp; AUC = 0.94) in HBV HCC diagnosis in clinical practice.

Internal medicine fellowship directors' perspectives on the quality and utility of letters conforming to residency program director letter of recommendation guidelines

Background: In May 2017, the Alliance for Academic Internal Medicine (AAIM) published guidelines intending to standardize and improve internal medicine residency program director (PD) letters of recommendation (LORs) for fellowship applicants. Objectives: This study aimed to examine fellowship PDs impressions of the new guidelines, letter writers' adherence to the guidelines, and the impact of LORs that conformed to guidelines compared to non-standardized letters. Methods: The authors anonymously surveyed fellowship PDs from January to March 2018 to gather input about LORs submitted to their programs during the 2017 fellowship application cycle. Results: A total of 78% of survey respondents were satisfied with letters that followed the AAIM guidelines, whereas 48% of respondents were satisfied with letters that did not. Fellowship PDs felt that letters that followed the AAIM guidelines were more helpful than letters that did not, especially for differentiating between applicants from the same institution and for understanding residents' performance across the six core competency domains. Fellowship PDs provided several suggestions for residency PDs to make the LORs even more helpful. Conclusion: Fellowship PD respondents indicated that LORs that followed the new AAIM guidelines were more helpful than letters that did not.

Effect of Gd and Cr substitution on the structural, electronic and magnetic phases of SrRuO3: a case study of doping and chemical phase separation

We explore the crystal structure, electrical resistivity and magnetic behavior of the compositional series (SrRuO₃)[Formula: see text] (GdCrO₃) _x (where [Formula: see text]), which resides between orthorhombic ferromagnetic (FM) metal SrRuO₃ ([Formula: see text] K) and orthorhombic antiferromagnetic (AFM) insulator GdCrO₃ ([Formula: see text] K). Crystal structure analysis reveals that complete solid solution exists only up to [Formula: see text], above which chemical phase separation of two/three phases occurs, and persists up to [Formula: see text]. X-ray photoelectron spectroscopy measurement also corroborates the existence of [Formula: see text] for the intermediate composition [Formula: see text], which reinforces the astonishing scheelite-type GdCrO₄ formation (at ambient pressure) for [Formula: see text] compositions. Electrical resistivity measurements affirm the temperature driven metal to insulator (M-I) transition for [Formula: see text] and [Formula: see text] samples. Low temperature insulating state in these samples is interpreted by electron-electron interaction of weak disordered systems. Precise analysis of temperature dependent resistivity for [Formula: see text] samples (which have insulating ground state) dictate that the transport phenomenon is mainly associated with Arrhenius-type charge conduction, Mott's variable range hopping, short-range and long-range Coulomb interaction mediated hopping processes, due to the high degree of randomness. Interruption of magnetic Ru-O-Ru interaction by Ru-O-Cr and Cr-O-Cr interactions lowers the FM transition temperature (T _C), and thereby introduces Griffiths phase in phase separated samples. Furthermore, we believe that a sharp rise in magnetization at low temperature for [Formula: see text] samples is due to the formation of AFM GdCrO₄ phase. Prominent thermal hysteresis in temperature dependent magnetization curves for [Formula: see text], and appearance of spin-reorientation transition for [Formula: see text] are the distinct indications for transformation into canted AFM GdCrO₃ oxide at higher x. The effective magnetic moment ([Formula: see text]) continuously increases with the incorporation of higher moment elements (Gd and Cr); while coercive field (H _C) exhibits an abrupt variation as a function of x at the onset of phase separation.

Role of particle inertia in adsorption at fluid-liquid interfaces

It is shown that the inertia of a particle plays an important role in its motion in the direction normal to a fluid-liquid interface, and in determining its adsorption trajectory and orientation in the adsorbed state. Although the importance of inertia diminishes with decreasing particle size, on an air-water interface the inertia continues to be important even when the size is as small as a few nanometers. Furthermore, similar to an underdamped system, an adsorbed particle has characteristic linear and rotational frequencies that can be excited by an external forcing.

Quantitation of primitive and lineage-committed progenitors in mobilized peripheral blood for prediction of platelet recovery post autologous transplant

Leukapheresis collections obtained following one of four mobilization regimens from 90 cancer patients were analyzed for their content of various progenitor cell types including erythroid and granulopoietic colony-forming cells in methylcellulose (total CFC), CFC-megakaryocyte (CFC-Mk), CFC detected after 10, 35 and 56 days in long-term culture (LTC), and total CD34+ cells. The number of each of these progenitor cell types collected from individual patients varied over 1000-fold. Nevertheless, within an individual leukapheresis, there was a significant correlation between the number of CD34+ cells and each progenitor type (except day 56 LTC CFC) suggesting that all of them are mobilized by a common mechanism. Patients who had previously received extensive chemotherapy and/or radiotherapy mobilized fewer of all these cell types than those who had not. For the 65 patients who proceeded to autologous transplantation, the median times to an absolute neutrophil count (ANC) of > or =0.5 x 109/l and the last platelet transfusion post transplant were 13 and 11 days, respectively, with 14 (22%) of patients having platelet recovery delayed beyond day 21. There was no significant difference between patients who had or had not received extensive chemo/radiotherapy or among the different mobilization regimens for time to neutrophil or platelet recovery or the number of platelet or red blood cell transfusions received post transplant. Threshold doses of the different cell types transplanted (per kg of patient weight) which predicted rapid platelet recovery were 2 x 106 CD34+ cells, 5 x 105 total CFC and 2.5 x 104CFC-Mk. Corresponding thresholds for progenitor activity measured in LTC could not be established. These results further support the view that standard mobilization regimens yield progenitor numbers that are, in most cases, nonlimiting for generating neutrophil and platelet recoveries within 2 to 3 weeks after myeloablative therapy. Assessment of the CD34+ cell and/or CFC content of leukapheresis collections may identify patients in whom platelet recovery is likely to be significantly delayed although CFC-Mk enumeration does not appear to offer any unique predictive advantage.

Doctors' legal position in treating temporarily incompetent patients

Doctors in accident and emergency departments are sometimes presented with patients with potentially life threatening conditions who refuse to consent to treatment. The doctors then face a dilemma: to withhold necessary treatment or to act against a patient's express wishes. Two such cases are presented, and we asked a lawyer, two medical ethicists, a psychiatrist, and an accident and emergency physician to comment on the implications.

Receptor for myo-inositol trisphosphate from the microsomal fraction of Vigna radiata

The microsomal fraction from mung-bean (Vigna radiata) hypocotyl was found to contain Ins (1,4,5)P3- and Ins(2,4,5)P3-binding activity. Preincubation of the microsomal fraction with thiol-containing reagents reduced specific InsP3 binding. A single class of binding site with a Kd value of 1.5 nM and Bmax. of 1.1 pmol/mg of protein was detected. Other myo-inositol phosphates exhibited little affinity for this protein. The binding protein was purified to homogeneity and the molecular mass of the native form recorded as 400 kDa. However, under denaturing conditions the molecular mass was 110 kDa, suggesting that the protein is a homotetramer. That this protein is associated with Ca2+ release was confirmed by including it in proteoliposomes and adding Ins(1,4,5)P3 or Ins(2,4,5)P3. The affinity of Ins(1,4,5)P3 is 3-fold higher than that of Ins(2,4,5)P3. The binding affinity of InsP3 is also reflected in the extent of Ca2+ released from the microsomal fraction. Heparin inhibits binding of InsP3 to the protein, the K1/2 being 0.26 microM. It is also shown that the protein acts as a receptor for InsP3 with characteristics of high affinity and low density.

Myo-inositol trisphosphate-mediated calcium release from internal stores of Entamoeba histolytica

Calcium mobilisation from internal stores of the parasitic protozoan Entamoeba histolytica was studied by fluorescence measurements of the calcium indicator quin 2 and 45Ca2+ incorporation studies in saponin-permeabilised amoebae. Prior energy-dependent calcium sequestration was found to be necessary for subsequent release of calcium by inositol 1,4,5-trisphosphate (Ins(1,4,5)P3). Both Ins(1,4,5)P3 and inositol 2,4,5-trisphosphate (Ins(2,4,5)P3) could release calcium equally well from permeabilised E. histolytica with similar EC50 (concentration which produced half maximal release) values for calcium release. Ins(1,4,5)P3-mediated calcium release occurred from a vesicular store, was sensitive to prior treatment by heparin and was attenuated by prior addition of a lower concentration of Ins(1,4,5)P3. cAMP failed to influence inositol trisphosphate induced calcium release, indicating the absence of control mechanisms through cAMP-dependent phosphorylation. GTP neither induced calcium release nor could potentiate inositol trisphosphate mediated calcium mobilisation. A saturating concentration of Ins(1,4,5)P3 could release 50% of radiolabelled calcium sequestered by energy-dependent mechanisms in E. histolytica. The energy-dependent calcium sequestration was inhibited by vanadate and the calcium antagonist Diltiazem but not by dicyclohexylcarbodiimide (DCCD), suggesting the involvement of an endoplasmic reticulum-like structure in calcium storage. Binding studies showed specific association of [3H]Ins(1,4,5)P3 to crude membrane fractions of E. histolytica, which was significantly inhibited by heparin in a dose-dependent manner. IC50 (concentration which produced half-maximal inhibition) values for displacement of radiolabelled Ins(1,4,5)P3 binding by unlabelled Ins(1,4,5)P3 and Ins(2,4,5)P3 were estimated to be 0.99 microM for both isomers. Our results suggested that Ins(1,4,5)P3-mediated calcium release from internal stores of E. histolytica most probably occurred in an inositol trisphosphate receptor-dependent manner.

Myoinositol tris-phosphate-phytase complex as an elicitor in calcium mobilization in plants

Mobilization of Ca2+ from microsomal/vacuolar fractions was detected when InsP6-phytase was added after a definite time of hydrolysis which coincides with the time (20-30 min) of optimal production of Ins(2,4,5)P3 bound to phytase. The in vitro constituted Ins(1,4,5)P3 or Ins(2,4,5)P3-phytase complex is also effective in releasing Ca2+. InsP3-phytase complex releases 45% more microsomal Ca2+ than that released by free InsP3 under identical conditions. Other inositol-phytase complexes are ineffective. Furthermore InsP3-phytase complex is recognised by putative receptor associated with microsomal fraction suggesting that the myoinositol tris-phosphate-phytase complex can act as an elicitor in Ca2+ mobilization in plant systems where phytate and phytase occur.

Suppression of natural killing in vitro by monocytes and polymorphonuclear leukocytes: requirement for reactive metabolites of oxygen

Natural killer cells spontaneously lyse certain tumor cells and may defend against malignancy. We have previously shown that natural killing (NK) by human peripheral blood mononuclear cells (PBMC) is suppressed in vitro by phorbol diester tumor promoters, including 12-O-tetradecanoylphorbol-13-acetate (TPA). We here demonstrate that suppression of NK is mediated by monocytes or polymorphonuclear leukocytes (PMN) and that suppression is dependent on the generation of reactive forms of molecular oxygen (RO), particularly hydrogen peroxide (H2O2). NK was suppressed not only by TPA but also by opsonized zymosan (yeast cell walls), which, like TPA, was not toxic to PBMC. Both TPA and zymosan stimulated the production of superoxide anion (O2-) and H2O2 by PBMC. Production of RO correlated with suppression of NK. When PBMC were depleted of monocytes, the production of RO and the suppression of NK were both markedly reduced. Suppression could be restored by monocytes or PMN, both of which produced RO in response to TPA or zymosan. Suppression of NK was dependent on RO. Monocytes or PMN from a patient with chronic granulomatous disease, whose cells cannot generate RO, did not mediate suppression of NK. Suppression was also reduced in glucose-free medium, which did not support the generation of RO. Suppression of NK by TPA was inhibited by catalase. Bovine superoxide dismutase had a limited effect on suppression, even in high concentration, and tyrosine-copper (II) complex, which also enhances dismutation of O2- to H2O2, had almost no effect on suppression. When H2O2 was directly generated enzymatically from glucose oxidase and glucose, NK was suppressed and suppression was reversed by catalase. NK was also suppressed by the enzymatic generation of O2- from xanthine oxidase and xanthine, but suppression under these conditions was again inhibited by catalase and not by superoxide dismutase, indicating that suppression was due to the secondary formation of H2O2 from O2-. These results indicate that H2O2 is important in suppression of NK. Myeloperoxidase did not appear to play a role in suppression because inhibition of this enzyme by sodium azide, cyanide, or aminotriazole did not prevent suppression of NK. Suppression of NK was reversible; after exposure to zymosan, NK could be partially restored by the addition of catalase and superoxide dismutase or by the removal of zymosan. These studies demonstrate cellular regulation of NK by monocytes or polymorphonuclear leukocytes and indicate a role for RO in immunoregulation.

Natural killing of tumor cells by human peripheral blood cells. Suppression of killing in vitro by tumor-promoting phorbol diesters

Tumor-promoting phorbol diesters were shown to suppress natural killing in vitro by human peripheral blood mononuclear cells. The inhibitory effect of different phorbol diesters and their analogues correlated with their potency as tumor promoters, the most effective agent being 12-O-tetradecanoylphorbol-13-acetate (TPA). Both peripheral blood cells and targets specifically bound TPA, and natural killing could be inhibited by pretreatment of either cell population with TPA, though this was less effective than direct addition of TPA to the assay. Cells that had been pretreated with TPA released TPA and metabolites of tPA during subsequent incubation in fresh medium. This release of tPA was evidently responsible for the inhibition of natural killing by pretreated target cells; in experiments where labeled and unlabeled target cells were mixed, pretreatment of unlabeled targets with TPA inhibited killing of labeled targets. Suppression of natural killing by TPA was greatly reduced when adherent cells were removed from the peripheral blood cells, suggesting that monocytes mediate suppression. Inhibition of natural killing by TPA provides a model for examining the regulation of natural killing. Suppression of natural killing by phorbol diesters may contribute to their activity as tumor promoters.