Conjugate of Enkephalin and Temporin Peptides as a Novel Therapeutic Agent for Sepsis

Antimicrobial peptides (AMPs) exhibit a wide spectrum of actions, ranging from a direct bactericidal effect to multifunctional activities as immune effector molecules. The aim of this study was to examine the anti-inflammatory properties of a DAL-PEG-DK5 conjugate composed of a lysine-rich derivative of amphibian temporin-1CEb (DK5) and dalargin (DAL), the synthetic Leu-enkephalin analogue. Detailed study of the endotoxin-neutralizing activity of the peptide revealed that DAL-PEG-DK5 interacts with LPS and the LPS binding protein (LBP). Moreover, DAL-PEG-DK5 prevented dimerization of TLR4 at the macrophage surface upon LPS stimulation. This inhibited activation of the NF-κB signaling pathway and markedly reduced pro-inflammatory cytokine production. Finally, we showed that aggregation of DAL-PEG-DK5 into amyloid-like structures induced by LPS neutralized the endotoxin proinflammatory activity. Consequently, DAL-PEG-DK5 reduced morbidity and mortality in vivo, in a mouse model of endotoxin-induced septic shock. Collectively, the data suggest that DAL-PEG-DK5 is a promising therapeutic compound for sepsis.

ESC expert statement on the effects on mood of the natural cycle and progestin-only contraceptives

Hormonal fluctuations during the natural cycle, as well as progestins used for hormonal contraception, can exert effects on mood especially in vulnerable women. Negative effects of levonorgestrel-releasing intrauterine contraception on mood are rare.

A reliability study of the new Back Strain Monitor based on clinical trials

A new Back Strain Monitor (BSM) device has been developed in order to measure, record and analyze movements of the lower back. The purpose of this study was to examine the inter-tester and the intra-tester reliability of the movement measurements given by the BSM accelerometers, and compare it with the reliability of two other conventional measurement methods: the Double Inclinometer method (DI) and the Modified-Modified Schober (MMS) method. The clinical studies included 23 participants (16 males, 7 females) with no recent history of lower back pain, who wore the device during a combination of different anatomical movements (flexion, extension, left lateral flexion and right lateral flexion of the lumber spine). The tests were conducted by three therapists (testers). The reliability results for the BSM accelerometers clearly outperform the results obtained for the DI and the MMS methods. The inter-tester reliability gives the Intra-Class Correlation (ICC) value of 0.95 for the BSM flexion, 0.89 for the DI flexion and 0.74 for the MMS. The intra-tester reliability gives the ICC value of 0.99 for BSM flexion, 0.94 for DI flexion and 0.77 for the MMS. The BSM accelerometers were highly reliable in assessing back movements, measuring these movements with less error than the DI and MMS methods.

Different roles of TiR8/Sigirr on toll-like receptor signaling in intrarenal antigen-presenting cells and tubular epithelial cells

Toll-like receptors (TLRs) exist on both myeloid and intrinsic renal cells contributing to the initiation of innate immunity during renal infection with uropathogenic Escherichia coli. Toll-interleukin 1 receptor (IL-1R) (TIR)8/SIGIRR is an orphan receptor of the TLR/IL-1R family, which suppresses TLR signaling of immune cells and is highly expressed in the kidney. Lack of TIR8/SIGIRR is associated with enhanced renal chemokine signaling upon exposure to lipopolysaccharide (LPS). This was because of TIR8/SIGIRR expression on resident intrarenal myeloid cells rather than tubular epithelial cells which express it on basolateral and luminal membranes. The lack of TIR8/SIGIRR does not enhance TLR/IL-1R signaling in tubular epithelial cells as was observed in monocytes. TIR8/SIGIRR is induced in monocytes treated with LPS or tumor necrosis factor and interferon-gamma in a dose-dependent manner but was downregulated in treated tubule epithelial cells. This cell type-specific regulation and function did not relate to mRNA splice variants but was associated with N- and O-glycosylation of the receptor in renal cells of myeloid and nonmyeloid origin. Our studies show that resident myeloid cells contribute to TLR-mediated antimicrobial immunity in the kidney and that this function is controlled by Tir8/sigirr. TIR8/SIGIRR does not suppress TLR signaling in tubular epithelial cells, which supports their role as sensors of microbial infection in the kidney.

Characterization of Splenic Glycosaminoglycans Accumulated In Vivo in Experimentally Induced Amyloid-Susceptible and Amyloid-Resistant Mice

The pathogenesis of the amyloid deposition diseases is poorly understood. The CE/J mouse, which is naturally protected from amyloid A (AA) protein amyloidosis, has provided a tool to study mechanisms that may be implicated in amyloid deposition diseases by means of comparison of findings with those in an AA-susceptible mouse strain. We have compared proteoglycan/glycosaminoglycan accumulation in vivo in amyloid-protected CE/J mouse strain and in AA-susceptible CBA/J mouse strain in homeostasis and when injected with amyloid-inducing agents. Results indicate that there is an overall increase in [(35)S]proteoglycan/glycosaminoglycan accumulation in the spleens of both strains of mice, but with a specific increase in heparan sulfate in only CBA/J mouse spleens that are rich in amyloid. Further, we report the absence of heparan sulfate in the splenic perifollicular areas of amyloid-free CE/J mouse, whereas in the amyloid-laden CBA/J mouse there is co-localization of heparan sulfate with the AA deposits. We have also examined the glycosaminoglycan disaccharide products in both these strains of mice for their sulfation positions and found no differences in the disaccharide composition of chondroitin/dermatan sulfate and heparan sulfate isolated from the control CBA/J and control CE/J mice. There were no differences in chondroitin/dermatan sulfate in both strains after experimental induction. However, analysis of the heparan sulfate disaccharides by means of capillary high-performance liquid chromatography linked to microelectrospray ionization time-of-flight mass spectrometry indicated that the disaccharide composition of the splenic heparan sulfate obtained from the treated CBA/J mice that had developed amyloid was markedly different from that obtained from the control CBA/J mice and the treated amyloid-resistant CE/J mice. These findings suggest that unique heparan sulfates play a fundamental role in the pathogenesis of amyloid.

Delayed upregulation of GABA(A) alpha1 receptor subunit mRNA in somatosensory cortex of mice following learning-dependent plasticity of cortical representations

Experience-dependent modifications of cortical representational maps are accompanied by changes in several components of GABAergic inhibitory neurotransmission system. We examined with in situ hybridization to 35S-labeled oligoprobe changes of expression of GABA(A) receptor alpha1 subunit mRNA in the barrel cortex of mice after sensory conditioning training. One day and 5 days after the end of short lasting (3 daily sessions) training an increased expression of GABA(A) alpha1 mRNA was observed at the cortical site where the plastic changes were previously found. Learning associated activation of the cerebral cortex increases expression of GABA(A) receptor mRNA after a short post-training delays.

6-O-sulfotransferase-1 represents a critical enzyme in the anticoagulant heparan sulfate biosynthetic pathway

Using recombinant retroviral transduction, we have introduced the heparin/heparan sulfate (HS) 3-O-sulfotransferase 1 (3-OST-1) gene into Chinese hamster ovary (CHO) cells. Expression of 3-OST-1 confers upon CHO cells the ability to produce anticoagulantly active HS (HS(act)). To understand how 6-OST and other proteins regulate HS(act) biosynthesis, a CHO cell clone with three copies of 3-OST-1 was chemically mutagenized. Resulting mutants that make HS but are defective in generating HS(act) were single-cell-cloned. One cell mutant makes fewer 6-O-sulfated residues. Modification of HS chains from the mutant with pure 6-OST-1 and 3'-phosphoadenosine 5'-phosphosulfate increased HS(act) from 7% to 51%. Transfection of this mutant with 6-OST-1 created a CHO cell line that makes HS, 50% of which is HS(act). We discovered in this study that (i) 6-OST-1 is a limiting enzyme in the HS(act) biosynthetic pathway in vivo when the limiting nature of 3-OST-1 is removed; (ii) HS chains from the mutant cells serve as an excellent substrate for demonstrating that 6-OST-1 is the limiting factor for HS(act) generation in vitro; (iii) in contradiction to the literature, 6-OST-1 can add 6-O-sulfate to GlcNAc residues, especially the critical 6-O-sulfate in the antithrombin binding motif; (iv) both 3-O- and 6-O-sulfation can be the final step in HS(act) biosynthesis in contrast to prior publications that concluded 3-O-sulfation is the final step in HS(act) biosynthesis; (v), in the presence of HS interacting protein peptide, 3-O-sulfate-containing sugars can be degraded into disaccharides by heparitinase digestion as demonstrated by capillary high performance liquid chromatography coupled with mass spectrometry.

PSD95 protein level rises in murine somatosensory cortex after sensory training

Proteins of the postsynaptic density are implicated in mechanisms of synaptic plasticity. We examined involvement of PSD95 and alphaCaMkII in learning-dependent plastic changes of representational maps in somatosensory cortex of mice. The barrel cortex of mice was examined following a 3 day long classical conditioning training, in which activation of facial vibrissae was linked to an aversive stimulus. This procedure produced expansion of cortical representations of vibrissae involved in the training. In subcellular fraction enriched in postsynaptic densities from the barrel cortex, it was estimated by Western blotting that the level of PSD95 increased after the training by about 50%, while the level of CaMkII remained unchanged. The results indicate involvement of PSD95 in learning-dependent cortical plasticity.

Rapid regulation of GAD67 mRNA and protein level in cortical neurons after sensory learning

Cortical representations of different modalities can be modified by sensory learning. Our previous studies in the barrel cortex showed that expansion of the cortical representation of a row of vibrissae could be induced by pairing stimulation of a row of vibrissae with a tail shock. The plastic change in cortical reactivity to the input used during the training was accompanied by increased density of GABA immunoreactive neurons in the involved row of cortical barrels. Using the same paradigm, the present study examined the pathway of GABA synthesis-expression of GAD67 mRNA and immunoreactivity of GAD67 isoenzyme in the barrel cortex of mice after sensory learning. In situ hybridization revealed that the GAD67 mRNA level was elevated in one row of barrels in the trained group as well as in controls receiving vibrissae stimulation alone. In contrast, elevation of immunoreactivity of the GAD67 protein occurred only in the trained group. The density of GABA-immunoreactive neurons in the hollows of barrels representing the row of vibrissae activated during the training was increased by 50%. These data indicated that sensory stimulation alone affected expression of the 67 kDa glutamate decarboxylase isoenzyme synthesis pathway, whereas the processes involved in cortical plasticity induced by associative learning modified this pathway additionally at the level of translation.

[Co-existence of reduced femur neck density and reduced skin thickness]

OBJECTIVE

In peri- and postmenopausal women, the association of skin thickness with bone mass is well described, and a low skin thickness is a useful predictor of osteoporosis. In this study the association between skin thickness and bone mass of femoral neck in peri- and postmenopausal women was assessed; and the potential for skin thickness as a screening test for osteoporosis evaluated.

DESIGN/METHODS

Skin thickness was measured at the arm by ultrasonography (probe 22 MHz). Bone mass was measured at the neck of femur by dual-energy X-ray absorptiometry. One hundred and three peri- and postmenopausal women were studied.

RESULT

Successive decrease of skin thickness going along with the loss of femoral neck bone mass was found. There was a statistically significant difference in skin thickness between group of females with normal bone mass and group with osteopenia (p < 0.05) and osteoporosis (p < 0.01).

CONCLUSIONS

Ultrasound skin measurement is a very simple method which can be used in the diagnostics of osteopenia and osteoporosis of the neck of femur in peri- and postmenopausal women.

[The value of skin densitometry in diagnosis of decreased bone mass in the spine of women during the period around and post-menopause]

OBJECTIVE

In peri- and postmenopausal women, the association of skin thickness with bone mass is well described, and a low skin thickness is a useful predictor of osteoporosis. In this study the association between skin thickness and bone mass of lumbar spine in peri- and postmenopausal women was assessed; and the potential for skin thickness as a screening test for osteoporosis evaluated.

DESIGN/METHODS

Skin thickness was measured at the arm by ultrasonography (probe 22 MHz). Bone mass was measured at lumbar spine by dual-energy X-ray absorptiometry. One hundred and three peri- and postmenopausal women were studied.

RESULT

Successive decrease of skin thickness going along with the loss of lumbar spine bone mass was found. There was a statistically significant difference (p < 0.05) in skin thickness between group of females with normal bone mass and group with osteoporosis.

CONCLUSIONS

Ultrasound skin measurement is a very simple method which can be used in the diagnostics of osteoporosis of the lumbar spine in peri- and postmenopausal women.

Targeted disruption of cd39/ATP diphosphohydrolase results in disordered hemostasis and thromboregulation

CD39, or vascular adenosine triphosphate diphosphohydrolase, has been considered an important inhibitor of platelet activation. Unexpectedly, cd39-deficient mice had prolonged bleeding times with minimally perturbed coagulation parameters. Platelet interactions with injured mesenteric vasculature were considerably reduced in vivo and purified mutant platelets failed to aggregate to standard agonists in vitro. This platelet hypofunction was reversible and associated with purinergic type P2Y1 receptor desensitization. In keeping with deficient vascular protective mechanisms, fibrin deposition was found at multiple organ sites in cd39-deficient mice and in transplanted cardiac grafts. Our data indicate a dual role for adenosine triphosphate diphosphohydrolase in modulating hemostasis and thrombotic reactions.

[Prevention using folic acid--a good method for reduction of neural tube defects in Poland]

Incidence of neural tube defects in Poland in the 90's was 2.68 in 1000 births. The value of incidence has not been changed within last twenty years. Mortality caused by neural tube defects in Poland is much higher than in many other European countries and the United States. High rates of incidence of neural tube defects in Poland is probably caused by low utilisation of methods of secondary prevention in a group of low-risk pregnant women. Since methods of primary prevention of neural-tube defects are available; primary prevention with folic acid, should be immediately implemented in Poland.

Loudness perception and frequency discrimination in subjects with steeply sloping hearing loss: possible correlates of neural plasticity

Loudness functions and frequency difference limens (DLFs) were measured in five subjects with steeply sloping high-frequency sensorineural hearing loss. The stimuli were pulsed pure tones encompassing a range of frequencies. Loudness data were obtained using a 2AFC matching procedure with a 500-Hz reference presented at a number of levels. DLFs were measured using a 3AFC procedure with intensities randomized within 6 dB around an equal-loudness level. Results showed significantly shallower loudness functions near the cutoff frequency of the loss than at a lower frequency, where hearing thresholds were near normal. DLFs were elevated, on average, relative to DLFs measured using the same procedure in five normally hearing subjects, but showed a local reduction near the cutoff frequency in most subjects with high-frequency loss. The loudness data are generally consistent with recent models that describe loudness perception in terms of peripheral excitation patterns that are presumably restricted by a steeply sloping hearing loss. However, the DLF data are interpreted with reference to animal experiments that have shown reorganization in the auditory cortex following the introduction of restricted cochlear lesions. Such reorganization results in an increase in the spatial representation of lesion-edge frequencies, and is comparable with the functional reorganization observed in animals following frequency-discrimination training. It is suggested that similar effects may occur in humans with steeply sloping high-frequency hearing loss, and therefore, the local reduction in DLFs in our data may reflect neural plasticity.

[Prevention of neural tube defects. An important health and social problem]

Central neural system congenital malformations in the form of neural tube defects (ntd) belong to the most common diseases leading to very serious childrens' disability and mortality. As it has been calculated, the number of children affected with ntd, delivered in Poland every year is in the range of 800-1150. Children with encephalocele participate in this number in app. 50%. As it has been found, morbidity and mortality caused by the ntd remain high and stable in Poland for the last 20 years. In the view of very limited possibilities of the treatment offered by health services, prophylactic measures remain the best methods for limitation of the problem. The primary prevention of ntd was discovered in late seventies. It has been found that folic acid added to the diet of women in the reproductive age reduced number of children born with ntd by 70%. Authors present the Programme of Primary Prevention of ntd in Poland. This Programme has been incorporated in the National Programme of Health for the Nation 1996-2005.

[Territorial distribution of neural tube defects in Poland]

Neural tube defects (ntd) remain unresolved therapeutic problems, even for contemporary health services. Prophylactic measures are the best methods for limitation of the problem. In many countries, the number of children born with ntd has been reduced significantly, even in 4-5 folds. Authors found that the situation in Poland remains stable since last 20 years. Epidemiological evaluation of the ntd morbidity in Poland is very difficult. There is no National Register of Inherited Defects. Authors observed and analysed mortality and hospitalisation due to ntd in Poland, in early ninetees, and compared these data with information originated from Regional (Wielkopolska) Inherited Defects Register. It was found that ntd mortality and hospitalisation in Wielkopolska was similar to average in Poland. It has been estimated that the rate of children born with ntd in Poland, in 1995 was 2.68 per 1000 live and stillbriths (in 1972-1974 was 2.04). Especially high rates of ntd's have been found in north-eastern part of Country. Incidence of ntd's was higher in rural, than in urban population of the Country.

[Large-scale screening for early diagnosis of gestational diabetes mellitus (GDM)]

The aim of study was to evaluate incidence of GDM in Poland. All 1500 pregnant women between 24-28 week's gestation consulted in 4 centers were offered a 50 g oral glucose test (screening test). Capillary blood glucose was measured at 60 min after glucose ingestion. When blood glucose > 140 mg/dl, 75 g OGTT according to WHO criteria was performed. 241 women have abnormal screening test and in 181 cases blood glucose were at range 140-160 mg/dl, in 39 at range 160-180 and 21 were > 180 mg/dl. Only 14 women in the first group (140-160 mg/dl) have diagnosed GDM (7.7%). In second group 24 pregnant women have GDM (61.5%). Overall GDM incidence is shown to be 3.7% (57 women). The mean age for the GDM was 28.8 +/- 0.9 years compared with 26.4 +/- 0.4 years (p < 0.05) uncomplicated pregnancy.

[Non-clinical factors in decision making about cesarean section]

Increasing cesarean-section rates have focused attention on variation in the use of this procedure that appear to be not only dependent of medical indication. This suggestion has been checked on the basis of newly implemented special forms in hospitals located in some areas of Poland in 1990. Documentation of 11.813 live births (almost 100% of live births in described area) has been analysed. It has been found 13.2% cesarean-section rate and 2.0% rate of other operative deliveries. Majority of cesarean sections have been medically indicated. But it has been also found that highest level of mothers education has been directly linked with higher rates of cesarean section. This linkage has been stronger than any other association (with age, parity etc.). Poland as a country, is divided for several regions subordinated to particular hospitals. It has been found that some of the patients have been admitted not to regional hospitals. We conclude that cesarean section rate among these patients was higher than this same ratio among all other patients admitted for deliveries in these hospitals. This association cannot be accounted for by differences in maternal age, parity, birth weight etc.

[Gastric necrosis caused by incarceration in hiatal hernia]

The described case illustrates the diagnostic difficulties in incarceration of abdominal organs in diaphragmatic hiatus hernia. The absence of characteristic symptoms and sudden deterioration of the general condition are causes of delay in surgical intervention leading, sometimes, to extensive necrosis of organs. The reported patient had extensive necrosis of gastric wall due to its incarceration in diaphragmatic hiatus hernia.