Isolated v-lesion represents a benign phenotype of vascular rejection of the kidney allograft - a retrospective study

While the detrimental impact of the humoral acute vascular rejection (AVR) phenotype is recognized, the prognostic significance of isolated v-lesion (IV) remains unclear. In this retrospective single-centre study, AVR was found in 98 of 1015 patients (9.7%) who had undergone kidney transplantation in 2010-2014, with donor-specific antibodies (DSA) evaluated in all of them. The outcome of four AVR phenotypes was evaluated during median follow-up of 59 months; in 25 patients with IV, 18 with T-cell-mediated vascular rejection (TCMVR), 19 with antibody-mediated vascular rejection (AMVR) and 36 with suspected antibody-mediated rejection (sAMVR). AVR was diagnosed mainly by for-cause biopsy (81%) early after transplantation (median 19 POD) and appeared as mild-grade intimal arteritis. IV occurred in low-sensitized patients after the first transplantation (96%) in the absence of DSA. IV responded satisfactorily to treatment (88%), showed no persistence of rejection in surveillance biopsy, and had stable graft function, minimal proteinuria and excellent DCGS (96%). Contrary to that, Kaplan-Meier estimate of 3-year DCGS of AMVR was 66% (log-rank = 0.0004). Early IV represents a benign phenotype of AVR with a favourable outcome. This study prompts further research to evaluate the nature of IV before considering any change in the classification and management.

Plant poisonings in children in the Czech Republic, 1996-2001

Ingestion of or exposure to potentially poisonous plants is a relatively common presenting complaint in hospital paediatric departments, especially amongst toddlers. We present a retrospective study conducted to review the hospital admissions following acute childhood poisoning with plants in the Czech Republic over a 6-year period from 1996 to 2001. Six university hospital paediatric departments and two local hospital paediatric departments were involved in the study. Information and complete data on the cases were collected on the basis of all hospital medical records and internal hospital database outcomes. A total of 174 plant exposures were analysed to tabulate the list of top species involved in plant poisonings. The aims were to provide classification according to agent frequency, clinical presentations, severity of symptoms expressed, affected age groups and gender of patients and to evaluate the treatment according to patient outcome. The most frequent ingestions were of thorn apple seeds (14.9%), followed by dumb cane exposures (11.5%) and common yew (9.8%). Thorn apple, dumb cane, golden chain and raw beans caused the most serious symptoms. There were no fatalities reported out of the reviewed medical records. Complete data on plant poisoning in children from all over the territory of the Czech Republic are not available; however, we believe that the frequency of causes and the rank of plant species commonly involved are properly reflected in our study.

ZIP7-mediated intracellular zinc transport contributes to aberrant growth factor signaling in antihormone-resistant breast cancer Cells

Antiestrogens such as tamoxifen are the mainstay of treatment for estrogen receptor-positive breast cancer. However, their effectiveness is limited by the development of endocrine resistance, allowing tumor regrowth and progression. Importantly, in vitro MCF7 cell models of acquired tamoxifen resistance (TamR cells) display an aggressive, invasive phenotype in which activation of epithelial growth factor receptor/IGF-I receptor/Src signaling plays a critical role. In this study, we report that TamR cells have increased levels of zinc and zinc transporter, ZIP7 [solute carrier family 39 (zinc transporter) member 7, also known as SLC39A7], resulting in an enhanced response to exogenous zinc, which is manifested as a greatly increased growth factor receptor activation, leading to increased growth and invasion. Removal of ZIP7, using small interfering RNA, destroys this activation of epithelial growth factor receptor/IGF-I receptor/Src signaling by reducing intracellular zinc levels. Similarly, it also blocks the activation of HER2, -3, and -4. These data suggest that intracellular zinc levels may be a critical factor in determining growth factor responses and that the targeting of zinc transporters may have novel therapeutic implications. We show that ZIP7 is a critical component in the redistribution of zinc from intracellular stores to the cytoplasm and, as such, is essential for the zinc-induced inhibition of phosphatases, which leads to activation of growth factor receptors. Removal of ZIP7 therefore offers a means through which zinc-induced activation of growth factor receptors may be effectively suppressed and provides a mechanism of targeting multiple growth factor pathways, increasing tumor kill, and preventing further development of resistance in breast cancer.