Assessment of two glycated hemoglobin immunoassays

INTRODUCTION

Glycated hemoglobin (HbA1c) level reflects chronic glycemic status if reliable tests are used, however, in some regions worldwide high performing assays might not be readily available. This study aimed to asses two HbA1c immunoassays, comparing them with high-performance liquid chromatography (HPLC) assay, three methods available in Ecuador.

MATERIAL AND METHODS

HbA1c were measured in 114 fresh whole blood-samples by DCA-Vantage point-of-care analyzer, I-Chroma portable fluorescent scanner immunoassay and BioRad Variant II Turbo HPLC. Normal and pathological HbA1c ranges were included. Blood samples with variants of hemoglobin were excluded. HbA1c values were expressed in National Glycohemoglobin Standardization Program percentages and mmol/mol, as mean±standard deviation.

RESULTS

HbA1c results by HPLC and DCA-Vantage were similar: 6.3±1.7% (45±18.6mmol/mol) vs. 6.3±1.8% (45±19.7mmol/mol), respectively, P=0.057; while HbA1c values by I-Chroma were lower than HPLC, 5.8±1.9% (40±20.8mmol/mol), P<0.001. The coefficient of variation was below 2% for high and low HbA1c levels, in all methods studied. HbA1c values by HPLC and DCA-Vantage were highly correlated (Spearman's Rank Correlation [SRC]: 0.916), while the correlation among HPLC and I-Chroma was weak (SRC: 0.368). The mean bias between DCA-Vantage and HPLC was -0.02±0.29% (-0.2±3.2mmol/mol), while for I-Chroma and HPLC mean bias was -0.50±1.62% (-5.5±17.7mmol/mol).

CONCLUSION

HbA1c immunoassays DCA-Vantage was comparable to HPLC assay, showing good correlation, appropriate precision and low bias, whereas I-Chroma assay was precise but inaccurate. Therefore, DCA-Vantage has better performance than I-Chroma. These findings suggest that is convenient to assess the HbA1c immunoassays commercially available in our country, Ecuador.

Activation of inflammatory immune gene cascades by lipopolysaccharide (LPS) in the porcine colonic tissue ex-vivo model

The technique of challenging postmortem tissue explants with inflammation inducer such as lipopolysaccharide (LPS) followed by gene expression analysis is used widely for evaluating the immune-suppressing effect of bioactives. Using porcine colonic tissue as an ex-vivo model of mammalian intestinal gut, this study evaluated the effect of incubation time on the integrity of gene transcripts and activation of inflammatory immune gene cascade by LPS treatment. Post-slaughter colon was removed surgically and explants were incubated for 0, 3, 6 and 12 h and the abundance of mRNA transcripts of a panel of 92 immune genes were evaluated using quantitative polymerase chain reaction (qPCR) arrays. The mRNA transcripts were highly intact after 0 and 3 h of incubation; however, after 6 h the degradation was clearly evident. Following 3 h incubation, 98·8% and 100% mRNA transcripts were detectable in the colonic tissue harvested from weaned and mature pigs, respectively. In the explants of weaned piglets, LPS treatment activated inflammatory signalling pathways [high mobility group B1 (HMGB1), dendritic cell maturation, interleukin (IL)-6, IL-8, IL-17F], while these pathways were inhibited by dexamethasone treatment. Activations of inflammatory genes were also evident in the explants collected from the mature pigs subjected to ex-vivo incubation for 3 h in the absence or presence of LPS. It is concluded that the colonic explant remains physiologically viable and responsive to immunological challenge for up to 3 h ex-vivo.

The anti-inflammatory potential of a moderately hydrolysed casein and its 5 kDa fraction in in vitro and ex vivo models of the gastrointestinal tract

Bioactive peptides from milk can impart a wide range of physiological benefits without the allergies and intolerance associated with the consumption of whole milk.

The microbiological and immunomodulatory effects of spray-dried versus wet dietary supplementation of seaweed extract in the pig gastrointestinal tract

Seaweeds and seaweed extract (SWE) possess antimicrobial, anti-inflammatory, prebiotic, and growth-promoting properties. Extracts can be prepared in different ways including wet, spray-dried, and freeze-dried forms. The aim of this study was to determine if spray drying of laminarin and fucoidan derived from Laminaria digitata had an effect on the microbiological and cytokine profile of the gastrointestinal tract (GIT) compared to the wet SWE in newly weaned pigs. No differences in cytokine expression were observed between wet and spray dried SWE formulation in either the ileum or colon. Bifidobacteria counts were greater (P < 0.05) in the wet SWE formulation relative to both spray dried SWE and the basal diet in the ileum. In conclusion, neither of the SWE formulations had significant effects on the cytokine profile in the ileum or colon. However, a prebiotic effect observed in the ileum of piglets in response to the wet SWE formulation was lost following spray drying of the SWE.

Extracts of brown seaweeds can attenuate the bacterial lipopolysaccharide-induced pro-inflammatory response in the porcine colon ex vivo

Bioactive compound-rich brown seaweeds are demonstrated to have numerous health benefits including anti-microbial and immunomodulatory bioactivities in the pig intestine. In this study, the immunomodulating effects of extracts of brown seaweed (Ascophyllum nodosum and Fucus serratus) were evaluated on the porcine colon using a bacterial lipopolysaccharide (LPS) ex vivo model. Approximately 1.5 × 1.5 cm of pig colon (n = 6) was stripped of its overlying muscle layer and incubated in 1 mL Dulbecco's Modified Eagle Medium containing bacterial LPS (10 μg) and seaweed extracts (1 mg). Gene expression of interleukin-8 (IL-8) and interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNFA) were measured using quantitative real time PCR. In contrast to the low level of expression of IL-8, IL-6, and TNFA genes in the colonic tissue at 0 h, LPS treatment increased (P < 0.05) the expression of IL-8, IL-6, and TNFA genes to 2.38 ± 0.86, 1.90 ± 0.66, and 1.90 ± 0.57 fold, respectively. This pro-inflammatory response induced by the LPS was suppressed by the extracts of Ascophyllum. Ascophyllum extract reduced (P < 0.05) the expression of IL-8, IL-6, and TNFA genes to 0.99 ± 0.53, 0.75 ± 0.33, and 1.01 ± 0.17 fold, and Fucus extract reduced (P < 0.05) the expression of the corresponding genes to 0.70 ± 0.32, 0.69 ± 0.38, and 1.15 ± 0.25 fold, respectively. It is concluded that the extracts of Ascophyllum and Fucus seaweeds have potential to suppress the pro-inflammatory response induced by the bacterial LPS in the pig colon.

Effect of maternal seaweed extract supplementation on suckling piglet growth, humoral immunity, selected microflora, and immune response after an ex vivo lipopolysaccharide challenge

The present study was conducted to investigate the effect of maternal dietary supplementation (n = 10 sows/treatment) with seaweed extract (SWE: 0 vs. 10.0 g/d) from d 107 of gestation until weaning (d 26) on neonatal piglet growth, humoral immunity, intestinal morphology, selected intestinal microflora, and VFA concentrations. Furthermore, this study examined the effect of dietary treatment on the immune response after an ex vivo Escherichia coli lipopolysaccharide (LPS) tissue challenge at weaning in a 2 × 2 factorial arrangement. The main factors consisted of sow dietary treatment (SWE or control) and immunological challenge (yes or no). The SWE supplement (10.0 g/d) contained laminarin (1.0 g), fucoidan (0.8 g), and ash (8.2 g) and was extracted from a Laminaria spp. The SWE-supplemented sows had greater colostrum IgA (P < 0.01) and had a trend for greater IgG (P = 0.062) concentrations compared with non-SWE-supplemented sows. Piglets suckling SWE-supplemented sows had greater serum IgG (P < 0.05) concentrations on d 14 of lactation compared with those suckling non-SWE-supplemented sows. Dietary SWE supplementation decreased fecal Enterobacteriaceae populations in sows at parturition (P < 0.05), and piglets suckling SWE-supplemented sows had a decreased colonic E. coli population at weaning (P < 0.01) compared with non-SWE-supplemented sows. Lipopolysaccharide challenge increased the mRNA abundances of the pro-inflammatory cytokines IL-1α and IL-6 (P < 0.01) in ileal tissue and tumor necrosis factor (TNF)-α in colonic (P < 0.01) tissue. There was a treatment × LPS challenge interaction for ileal TNF-α mRNA expression (P < 0.05). Piglets suckling SWE-supplemented sows had greater TNF-α mRNA expression after ex vivo LPS challenge compared with non-SWE-supplemented sows (P < 0.05). However, there was no effect of sow dietary treatment on TNF-α mRNA expression in the unchallenged ileal tissue. Piglet BW at birth and weaning, and small intestinal morphology were unaffected by sow dietary treatment under current experimental conditions. In summary, these results demonstrate an important immunomodulatory role of SWE supplementation characterized by enhanced colostral IgA and IgG concentrations, greater piglet circulatory IgG concentrations on d 14 of lactation, and enhanced TNF-α mRNA expression in the ileum after an ex vivo LPS challenge. These results indicate that SWE supplementation enhanced piglet immune function and colonic microflora at weaning.

The effects of laminarin derived from Laminaria digitata on measurements of gut health: selected bacterial populations, intestinal fermentation, mucin gene expression and cytokine gene expression in the pig

The aim of the present study was to establish the optimum inclusion level of laminarin derived from Laminaria digitata on selected microbial populations, intestinal fermentation, cytokine and mucin gene expression in the porcine ileum and colon. A total of twenty-one pigs (mean body weight 17·9 kg) were randomly assigned to one of three dietary treatments: T1 - basal (control) diet, T2 and T3 - basal diets supplemented with laminarin included at 300 and 600 parts per million (ppm), respectively. Selected intestinal bacterial populations and volatile fatty acid (VFA) concentrations were measured in the ileum and colon. Relative gene expression levels for specific cytokine and mucin genes were investigated in ileal and colonic tissue in the absence and presence of a lipopolysaccharide (LPS) challenge. There was an up-regulation of MUC2 gene expression at the 300 ppm inclusion level in the ileum. In the colon, there was a significant reduction in the enterobacteriaceae population at the 300 ppm inclusion level (P = 0·0421). Dietary supplementation of 600 ppm laminarin led to a significant increase in MUC2 (P = 0·0365) and MUC4 (P = 0·0401) expression in the colon, and in the total VFA concentration in the caecum (P = 0·0489). A significant increase was also recorded in IL-6 (P = 0·0289) and IL-8 gene expression (P = 0·0245) in LPS-challenged colonic tissue at both laminarin inclusion levels. In conclusion, dietary inclusion of 300 ppm laminarin appears to be the optimum dose in the present study due to the reduction in the enterobacteriaceae populations and enhanced IL-6 and IL-8 cytokine expression in response to an ex vivo LPS challenge.

Bovine lactoferrin (LTF) gene promoter haplotypes have different basal transcriptional activities

Genetic polymorphisms present in the bovine lactoferrin (LTF) gene promoter have the potential to affect milk lactoferrin concentrations. The objectives were: (1) to identify, in silico, SNPs in the promoter region of the LTF gene that could affect transcription factor binding activity, (2) to investigate the effects of these SNPs in vitro by measuring promoter transcriptional activities of different bovine LTF promoter haplotypes and (3) to investigate the genetic association between LTF promoter SNPs and milk lactoferrin concentration. Haplotypes were deduced from sequencing of the 2.2-kb bovine LTF promoter in 78 unrelated animals. In silico analysis of the 2.2-kb promoter revealed two major haplotypes (BtLTF_H1a and BtLTF_H2a) that differed at 10 SNP loci that affect transcription factors of both a constitutive (at -28, -1702) and an inducible (at -131, -270, -586, -2047, -2077, -2122, -2140 and -2151) nature. The basal promoter transcriptional activity of BtLTF_H1a was 1.44-fold higher than that of BtLTF_H2a in mammary epithelial cells. Cows with the BtLTF_H1a haplotype had increased lactoferrin protein concentration in milk at various time points over the lactation curves, compared to herdmates with the BtLTF_H2a haplotype. The SNPs c.-28A>C, c.-131T>C, c.-156A>G, c.-270T>C, c.-586C>T, c.-1702A>G, c.-1953G>A, c.-2047A>G, c.-2077A>G, c.-2122C>T, c.-2140A>G and c.-2151G>A were associated (P < 0.001) with milk lactoferrin content in 372 Holstein-Friesian cows. The identification of bovine LTF promoter haplotypes with different basal transcriptional activities in vitro that are associated with lactoferrin levels in milk in vivo may facilitate the identification of designer dairy herds for increased lactoferrin content in milk.

Effects of different suture materials on wound healing and infection in subcutaneous closure techniques

BACKGROUND

In this study we aimed to investigate the effects of different suture materials on wound healing and infection in subcutaneous closure techniques.

MATERIALS AND METHODS

Twenty-nine rats were randomly allocated to 5 groups. All subjects received 2-cm vertical dermal and subdermal incisions on their backs under sterile and proper surgical conditions. The subdermal cuts were then closed with vicryl (polyglycolic acid), biosyn (monofilament glycomer), prolene (polypropylene) and tissue adhesive (2-octylcyanoacrylate). After 10 days, all sutured areas were examined for seroma, haematoma formation and cosmetic outcome. The incisional lines were excised with 1-cm-wide skin strips and tissue hydroxyproline levels were determined. The specimens obtained were evaluated for the presence of giant cells, mononuclear cells, fibrosis and neutrophils.

RESULTS

No differences in tissue hydroxyproline levels were found between any of the suture materials used. Fibrotic process and inflammatory cell infiltration were more prominent in the biosyn and prolene groups than in other groups. Foreign body giant cells were observed in the biosyn group.

CONCLUSION

Vicryl and tissue adhesive should be preferred in subcutaneous closure techniques.

Characterisation of single nucleotide polymorphisms identified in the bovine lactoferrin gene sequences across a range of dairy cow breeds

The lactoferrin gene sequences of 70 unrelated dairy cows representing six different dairy breeds were investigated for single nucleotide polymorphisms to establish a baseline of polymorphisms that exist within the Irish bovine population. Twenty-nine polymorphisms were identified within a 2.2kb regulatory region. Nineteen novel polymorphisms were identified and some of these were found within transcription factor binding sites, including GATA-1 and SPI transcription factor sites. Forty-seven polymorphisms were identified within exon sequences with unique polymorphisms that were associated with amino acid substitutions. These included a T/A SNP, identified in a Holstein Friesian animal, which resulted in a valine to aspartic acid substitution (Val89Asp) in the mature lactoferrin protein. Other SNPs of interest were associated with amino acid substitutions in the lactoferricin B peptide sequence and an A/G SNP, identified in a Jersey animal, was associated with a tyrosine to cysteine change (Tyr181Cys). The polymorphisms identified in the promoter region may have implications relating to lactoferrin expression levels in cows and those identified in the coding sequence indicate the existence of protein variants in the Irish bovine population. The data presented in this study emphasises the potential for lactoferrin to serve as a candidate gene to select for mastitis resistance with the aim of improving animal health.

The interaction between concrete pavement and corrosion-induced copper runoff from buildings

Changes in chemical speciation of copper and the capacity of concrete pavement to retain copper in runoff water from external buildings have been investigated at urban field conditions, and in parallel laboratory experiments simulating outdoor scenarios. The research study showed the concrete surface to form a copper rich surface layer ( approximately 50 microm thick) upon exposure, and a high capacity to significantly reduce the bioavailable fraction of released copper (20-95%). The retention capacity of copper varied between 5 and 20% during single runoff events in the laboratory, and between 10 and 40% of the total copper release during single natural runoff events. The capacity to retain and reduce the bioavailable fraction of non-retained copper increased with increasing wetness of the concrete surfaces, increasing pH of the runoff water and decreasing flow rates. Bioassay testing with bacterial and yeast bioreporters showed the bioavailable fraction of non-retained copper to be significantly lower than the total copper concentration in the runoff water, between 22 and 40% for bacteria and between 8 and 31% for yeast. The application of generated data to simulate a fictive outdoor scenario, suggests a significant reduction of bioavailable and total copper to background values during environmental entry as a result of dilution, and the interaction with solid surfaces, organic matter and complexing agents already in the drainage system.

Experimental determination of dietary carbon turnover in bovine hair and hoof

Stable isotopes measured in keratinized tissues like hair or hoof have proven to be a useful tool for reconstructing the dietary history of animals with a weekly to daily resolution. Quantitative reconstruction of dietary preferences requires a precise estimate of tissue turnover by means of controlled feeding experiments. We determined the turnover rates of carbon in hoof and tail hair of growing steers ( Bos taurus L., 1758) fed a C3-based diet, followed by a C4-based diet, for 168 d. As with horses, turnover in steer hair was successfully described by a three-pool modelling approach, with apparent half-lives of 1.7, 7.7, and 69.1 d for each of the pools, each contributing 53%, 20%, and 28% of the total signal, respectively. Two pools only were identified in bovine hoof, which recorded the diet switch more slowly than hair with a reduction in the amplitude of short-term isotope changes. We interpreted this result as a sampling artefact and found that the hooves reflected the same pools as the hair if growth geometry is taken into account. The model parameters defined in this study allowed us to quantitatively reconstruct previous diets of steers of different breeds and individual history with a precision of ±1‰.

Risk factors for early mortality, relapse and overall survival in new cases of APL treated by arsenic trioxide

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Background: There are several known risk factors for APL treatment by ATRA and chemotherapy, but risk factors for new cases of APL treated by Arsenic Trioxide are unknown. Methods: Between May 2000 and September 2006, we treated 141 new cases of APL (Median age 28±12.8 y/o min=11, max=71) by 2 hours iv infusion of 0.15mg/kg ATO until complete remission. Trial approved by IRB and consent form obtained. Diagnosis was by clinical and morphologic characteristics and confirmed by cytogenetic and RT-PCR for detection of t(15,17) and presence of PML-RARa. After complete remission patients received consolidation by 28 days infusion of ATO for one or four courses. Known risk factors for APL treatment outcome (including PML-RARa isoforms, presence of MRD during follow up and WBC count at presentation analyzed for early mortality, relapse rate, DFS and OS. Results: Complete remission observed in 121 cases (85.8%) and early mortality rate was 14.9%. short isoform of detected in 36% of patients and 18% presented by WBC more than 10,000/μl. For early mortality, APL differentiation syndrome during treatment and WBC count more than 10,000/μl were risk factors. (P<0.001 and p=0.011 respectively) For DFS only predicting factor for relapse was detection of MRD (by nested PCR or by real time PCR) during follow up (P=0.05). For prediction of OS, again only risk factor was detection of MRD(P<0.0001). Conclusions: Although WBC count before treatment and APL differentiation syndrome during treatment are risk factor for relapse, short isoform of APL is not a risk factor. After achieving to CR only risk factor is detection of MRD.

No significant financial relationships to disclose.

Modelling and mapping of copper runoff for Europe

A predictive runoff rate model for copper has been refined and used to generate copper runoff maps for Europe. The new model is based on laboratory and field runoff data and expresses the runoff rate R (g m(-2) yr(-1)) through two contributions, both with a physical meaning: R = (0.37SO(0.5)(2) = 0.96 rain10(-0.62 pH) (cos(theta)/cos(45 degree)). Input parameters are the SO(2) concentration (microg m(-3)), pH, amount of rain (mm yr(-1)), and surface angle of inclination (theta). The first contribution originates from dry periods between rain events (the first-flush effect) and the second from the rain events. The dry term has been refined in comparison to the original model by assuming a mass balance between measured corrosion mass loss, calculated copper retention in the patina and predicted copper runoff. The refined model predicts 76% of all reported runoff rates, worldwide, within 35% from their measured value. This includes sites with low SO(2) concentration, where the original model erroneously predicted higher runoff rates than corrosion rates. Based on environmental data from the EMEP programme for the years 1980-2000, the new model has been used to derive runoff rate maps for Europe with 50 x 50 km grid resolution. The runoff mapping shows a substantial reduction in runoff rate over the investigated time period, and with copper runoff rates now generally less than 2 g m(-2) yr(-1).

Treatment of acute promyelocytic leukemia with arsenic trioxide without ATRA and/or chemotherapy

INTRODUCTION

Arsenic trioxide is effective and approved for treatment of relapsed or refractory acute promyelocytic leukemia (APL) cases resistant to all-trans retinoic acid (ATRA), but its effect on new cases of APL is not clear.

MATERIALS AND METHODS

We studied 111 patients with APL. Arsenic trioxide was infused at 0.15 mg/kg daily dose, until complete remission was achieved. Then, after 28 days of rest, arsenic trioxide was infused daily for 28 days as consolidation therapy. We studied minimal residual disease (MRD) by semi-sensitive reverse transcription polymerase chain reaction (RT-PCR) on peripheral blood samples.

RESULTS

Complete remission was observed in 95 patients (85.6%). With the median (range) follow-up period of 16.5 (1-57) months, 1- and 2-year disease-free survival was 88.3% and 63.7%, respectively; 24 patients relapsed, 19 of whom achieved a second complete remission, again by arsenic trioxide. Third and fourth remissions were seen in some relapsed patients, again by arsenic trioxide. For patients in complete remission, 1- and 3-year survival was 95.5% and 87.6%, respectively. MRD was positive in four (8.3%) out of 48 cases during 1 year after remission induction; three of them relapsed clinically.

CONCLUSIONS

Arsenic trioxide is effective as first-line treatment for APL. Results of arsenic trioxide combination therapy with chemotherapy/ATRA requires further study.

Cyclosporin A and mini short-term methotrexate vs cyclosporin A as graft-versus-host disease prophylaxis in patients with beta thalassemia major undergoing allogeneic blood and marrow transplantation

We compared the effects of cyclosporin A (CsA) alone as graft-versus-host disease (GVHD) prophylaxis vs cyclosporine with short-course methotrexate (MTX) in patients with thalassemia. In all, 140 patients were enrolled in this study. The first group, of 50 patients, received CsA alone at 3 mg/kg i.v. from day -2 to +5 followed by 12.5 mg/kg p.o., which was tapered according to the patient's condition. The other group, of 90 patients, received the combination of CsA+MTX in which CsA was used with the above-mentioned dose and MTX was on 10 mg/m(2) day +1 and 6 mg/m(2) on days +3 and +6. Incidence of acute GVHD grade II-IV in the CsA group was 78% and in the CsA+MTX group was 52.2%, which was statistically significant (P=<0.001). There were no significant differences in the incidence of chronic GVHD between the two groups. The mean neutrophil engraftment to 0.5 x 10(9)/l was 14 and 23 days for CsA group and CsA+MTX group, respectively (P=<0.001). There were no significant differences for platelet recovery between the two groups. Graft failure in the CsA and CsA+MTX groups was seven (14%) and nine (10%) patients, respectively (P=0.58). Overall survival in the CsA and CsA+MTX groups was 77 and 85%, respectively. Disease-free survival in the CsA and CsA+MTX groups were 58 and 80%, respectively.

Effect on growth parameters of bone marrow transplantation with a chemotherapy-only conditioning regimen

INTRODUCTION

The increasing use of bone marrow transplantation (BMT) has increased survival among a growing number of children and young adults afflicted by malignant and nonmalignant hematologic disorders. Accordingly, quality of life has emerged as an important issue. Because they are a concern in this group, we assessed growth and development, following chemotherapy-only conditioning regimens.

MATERIALS AND METHODS

Twelve prepubertal children (8 boys, G(1)P(1) and 4 girls, B(1)P(1)) with a mean age of 6 +/- 2 years (age range: 3.5 to 10 years) before and at 3, 6, 9, and 12 months post-BMT.

RESULTS

Growth velocity at 1 year posttransplant was 10.0 +/- 3.5 cm/y. One year post-BMT, the statistical deviation saturation for growth velocity was 4.31 +/- 4.21. Height standard deviation score was -1.4 +/- 1.2 before and -0.5 +/- 1.3 1 year post-BMT (P <.004). The average weight of our subjects was 20 +/- 6 kg before and 26 +/- 9.5 kg 1 year post-BMT.

DISCUSSION

BMT with a chemotherapy-only conditioning regimen not only does not disturb growth in children; it is actually associated with a relative growth spurt afterward.

Thyroid, parathyroid, gonadal, and pancreatic β-cell function after bone marrow transplantation with chemotherapy-only conditioning

INTRODUCTION

Radiation and cytotoxic chemotherapy can provoke short- and long-term endocrine dysfunction. We studied the prevalence of thyroid, parathyroid, gonadal, and pancreatic beta-cell function in patients undergoing bone marrow transplantation (BMT).

MATERIALS AND METHOD

Forty-six patients (12 women, 34 men), aged 1.5 to 49 years (mean, 15.1 years), were evaluated for thyroid, parathyroid, gonadal, and pancreatic beta-cell function before and 3, 6, and 12 months after BMT with a little busulfan-cyclophosphamide conditioning regimen.

RESULTS

Thyroid and parathyroid function was unaltered by BMT. Leydig cell function was normal in 11 adult men (G5P5) before and at 3, 6, and 12 months after BMT, but injury to the germinal epithelium (oligo- or azoospermia) was seen before and 12 months after BMT. There was no relationship between serum FSH and germinal epithelial injury. Maturation was normal in six boys (G2P2 or G3P3 at BMT) 12 months post-BMT. Primary hypogonadism was seen in four adult women (B5P5) after BMT. One 14-year-old girl continued to have regular menstrual periods during the 24 months after BMT. Another girl (P1B1 pre-BMT) developed ovarian failure 12 months post-BMT. Pancreatic beta-cell function was normal pre- and post-BMT in 12 thalassemic patients with serum ferritin > 1000 ng/mL.

CONCLUSION

BMT with chemotherapy-only conditioning seems primarily to affect gonadal function, without having any significant effect on thyroid, parathyroid, or pancreatic beta-cell function.

Clinical correlations of one-carbon metabolism abnormalities

1. Ninety psychiatric inpatients with a DSM III diagnosis of schizophrenia, mania, or major depression were studied. 2. Upon admission/transfer to the Clinical Studies Unit, and prior to discharge, measurements of symptom severity (BPRS, Ham-D, Young's Mania Scale) and blood samples were obtained. 3. Erythrocytes from these paired (admission and discharge) blood samples were assayed for methionine adenosyltransferase (MAT) activity and phosphatidylcholine (PC) content. 4. Comparisons were made between the changes in MAT Vmax, or % PC, and changes in symptom severity. 5. For the majority of the patients (79.3% of the schizophrenics; 84.6% of the depressives; and 93.8% of the manics), clinical improvement was associated with a "normalization" of enzyme activity. The association between changes in % PC and clinical response did not achieve significant correlation.