426. The role of sperm mitochondria in the process of epididymal maturation

On leaving the testis, spermatozoa can neither swim nor achieve fertilisation of the oocyte. These functional properties are acquired as spermatozoa engage a process of post-testicular maturation in the epididymis. Research into the biochemical basis of sperm maturation has revealed that this process is associated with activation of sperm mitochondria. Immature spermatozoa from the caput epididymis displayed a low mitochondrial membrane potential (MMP) whereas mature spermatozoa from the caudal epididymis actively maintained a high MMP. Moreover mitochondrial generation of reactive oxygen species could be triggered by antimycin in mature caudal epididymal spermatozoa but not in immature cells recovered from the caput epididymis. The molecular mechanisms responsible for regulating mitochondrial function were reversible since washing the cells free of epididymal fluid allowed immature spermatozoa to acquire a high MMP while incubating mature caudal cells in caput epididymal fluid, suppressed MMP. These results strongly suggested that fluid from the caput epididymis contains a mitochondrial inhibitor and that activation of mitochondrial activity is due to the removal or inactivation of this inhibitor during epididymal transit. The causative factor is not species specific because incubation of ejaculated human spermatozoa in murine epididymal fluid effectively suppressed their MMP. Caput epididymal fluid was fractionated using FPLC and each of the fractions was tested for their bioactivity. A major protein band with a molecular mass ~150 kDa was present in the active fraction. Further characterisation of this reversible mitochondrial inhibitor may reveal the mechanisms by which epididymal spermatozoa control mitochondrial function during maturation. It may also contribute to our understanding of human male infertility and potentially serve as a novel target for male fertility regulation.

Prototype single step lateral flow technology for detection of avian influenza virus and chicken antibody to avian influenza virus

A rapid and effective lateral flow assay (LFA) for detection of avian influenza virus (AIV) was developed. For antigen capture, the assay used monoclonal antibody specific for a conserved nuclear protein (NP) epitope, immobilized on a cellulose acetate matrix, in conjunction with a second NP monoclonal antibody chemically linked to either coloured latex beads or colloidal gold particles contained in a sample pad for detection. Virus sample added to the sample pad flowed into the trapping antibody to form a visible band as well as a second, control band further along the acetate strip. The control band consisted of recombinant protein A/G, also immobilized on the matrix. A second LFA for detection of chicken antibody to AIV was developed where NP antigen was immobilized on the matrix with recombinant protein A/G immobilized as a control band. Latex beads or colloidal gold particles to which monoclonal anti-chicken antibody was attached, were used as the indicator system.

Interleukin-18 gene polymorphisms and haplotypes in patients with oral lichen planus: a study in an ethnic Chinese cohort

Interleukin (IL)-18, a proinflammatory cytokine, induces T-helper 1 differentiation and cytotoxic T-lymphocyte functions, both of which have been proposed in the pathogenesis of oral lichen planus (OLP) - an oral disease resembles oral mucosal graft-versus-host disease (GVHD) both clinically and histologically. The aim of this study was to evaluate the association of single nucleotide polymorphisms (SNPs) in the IL18 gene on the chromosome 11q22 in patients with OLP. Four SNPs of the IL18 gene at positions -137G/C (rs187238), -607C/A (rs1946518), -656G/T (rs1946519), and 1248A/G (rs189667) were analyzed in 151 patients with OLP and 143 normal controls using polymerase chain reaction-sequence-specific primers method, and the serum level of IL-18 protein was determined by enzyme-linked immunosorbent assay (ELISA). The data revealed that there is a significant difference in IL18-607 genotype distributions between the patient group and the control group (P < 0.001), and the polymorphism -137G/C also appears to be statistically associated with the more severe erosive subtype (eOLP) (P = 0.023). The identified polymorphisms at the IL-18 promoter region (i.e. -137GG) are likely to exert positive effect on the production of IL-18 protein in OLP, as detected by ELISA. Using phase software, four haplotypes were deduced from the two polymorphisms -607C/A and -137G/C, named haplotypes I to IV, and the haplotypes I, II, and IV are significantly associated with OLP (P < 0.001). Our data suggest that the identified IL18 polymorphisms may be associated with the pathogenesis of OLP in this Chinese cohort by upregulation of IL-18 production in vivo.

A novel HLA-DRB1 allele, DRB1*0832, identified by sequence-based typing method

Human leukocyte antigen-DRB1*0832 may have arisen by gene conversion from a DRB1*080302 backbone, leading to amino acid changes at codons 26, 28, 30, 32, 37, and 38.

HLA-DQB1*0317 is a novel allele with an unusual DR-DQ haplotype

HLA-DQB1*0317 may have arisen by gene conversion from the DQB1*030302 backbone, leading to one amino acid change from Leu to Gly at codon 26.

Safety of erlotinib in TRUST, a phase IV trial in patients with advanced non-small cell lung cancer (NSCLC): Initial results from the East/South East (E/SE) Asian subgroup

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Background: Erlotinib significantly improved survival versus placebo and was well tolerated in patients (pts) with previously treated advanced NSCLC in the phase III BR.21 study (Shepherd et al. N Engl J Med 2005;353;123–32). TRUST, an open-label, multicenter study was initiated to provide erlotinib access to pts with advanced NSCLC. Here we report data for E/SE Asian pts. Methods: Eligible pts had failed 1–2 prior standard chemotherapy (CT) regimens, or were unsuitable for CT. Erlotinib 150 mg/day p.o. was given until disease progression/unacceptable toxicity. NCI CTC v3.0 was used to grade toxicities. Results: At data cut-off of 20/11/06, 885 pts were included in the analysis: n= Taiwan 297, mainland China 248, Hong Kong 160, South Korea 146, Thailand 30, Indonesia 2, Malaysia 2. Median age was 61yrs (range 22–95). Pt characteristics (%): male/female 55/45, ECOG PS 0/1/2/3 15/67/14/4, stage IIIb/IV 20/79, adenocarcinoma/other 68/32, erlotinib as 1st/2nd/3rd/other line therapy 11/55/33/<1, never/ever smoker 52/47 (no data <1). 83% pts experienced rash, of which 9% was grade (gr)3/4. Safety data forms were available for 598 pts; 54% had at least one adverse event (AE).104 pts (17%) had a treatment (tx)-related unexpected adverse event (AE) but no single AE occurred in >3% pts and only 3% were ≥gr3. Serious tx-related AEs were experienced by 19 pts (3%); 17 were gr3/4, most commonly gastrointestinal (n=6). One pt had suspected tx-related interstitial lung disease (gr2); the patient continued tx. 18 pts (3%) withdrew due to a tx-related event; 11 were gr3/4, most commonly gastrointestinal (n=4) and respiratory (idiopathic pulmonary fibrosis n=1, pneumonitis n=2). 76 pts (13%) required dose reduction due to a tx-related event (13%), mainly due to rash (n=57). 83% pts received erlotinib for >4 weeks. Efficacy will be presented. Conclusions: The results reported here for E/SE Asian pts in the TRUST study confirm in a community setting the good tolerability observed with erlotinib in clinical trials. Importantly, erlotinib was generally well tolerated and so could be administered at full tx dose to most pts.

[Table: see text]

Fluorescence in situ hybridization (FISH) subgroup analysis of TRIBUTE, a phase III trial of erlotinib plus carboplatin and paclitaxel in NSCLC

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Background: TRIBUTE was a phase III, placebo-controlled study of patients with previously untreated advanced NSCLC. Patients received erlotinib (E) (150 mg/d) or placebo, plus a course of 6 cycles of carboplatin and paclitaxel (CP), followed by maintenance E monotherapy (for those in the CP+E arm who were responding to treatment). 1,059 patients were randomized and treated (526 E; 533 placebo). There were no significant differences in OS, RR, or TTP between the two arms. In subgroup analyses of the pivotal 2nd line trial (BR21) of E in patients with relapsed NSCLC in which E significantly increased median survival (HR=0.71, p <0.0001), patients who scored positively for increased EGFR copy number by fluorescence in situ hybridization (FISH) exhibited prolonged OS (HR=0.44, p=0.008). Here we report on a similar subgroup analysis for TRIBUTE. Methods: FISH analysis was performed on all available tissue samples. FISH+ samples had a high level of polysomy (=four copies of the gene in =40% of cells), or gene amplification (presence of tight gene clusters, gene/chromosome per cell ratio =2, or =15 copies of the genes per cell in =10% of analyzed cells). Results: FISH analysis was successfully performed on 245 patients (121 E, 124 placebo). Outcome in the placebo patients from this subgroup was better than the overall population, suggesting that this subgroup may not be representative. Of the 100 patients (41%) that were FISH+, 33 had amplification and 67 had high polysomy. In FISH+ patients, OS was similar between those treated with CP+E and those treated with CP alone. However, FISH+ patients in the CP+E arm experienced a decrease in RR compared to those in the CP alone arm, and had a marginally significant longer TTP (HR=0.59, 0.35–0.99). The benefit in TTP appeared after approximately 6 months, during the maintenance portion of the trial. Conclusions: In this retrospective analysis, FISH+ did not predict survival benefit in TRIBUTE. A longer TTP, but a lower RR, was observed in the FISH+ patients. The lower RR in the CP+E arm in this group, taken together with the improved TTP during maintenance therapy, suggests that a non-concurrent combination approach (CP followed by E) warrants further investigation.

No significant financial relationships to disclose.

A novel HLA-A2 variant, A*9203, identified by sequence-based typing

HLA-A*9203, found in Taiwan using sequence-based typing method, was identical to HLA-A*0207 in exon 3 but differed in exon 2 by five nucleotide substitutions at positions 240-282 corresponding to three amino acid changes at codons 62, 66 and 70. Since this substitution motif is also seen in A*11 and A*03, it is likely that a gene conversion event from A*11 or A*03 to a A*0207 backbone may have been the process used in generating HLA-A*9203.

Linear and nonlinear EEG indexes in relation to the severity of coma

Glascow's coma scale (GCS) is a clinical standard for assessing the severity of coma in intensive care units (ICUs). The EEG monitoring can be on-line work, soon responds to the change in the brain wave, and allows long-term continuous monitoring of brain activity. In this paper, several EEG parameters, including spectral possession distribution and nonlinear description (approximate entropy and Lempel-Ziv complexity) were used to assess the capability of EEG indexes for the severity of coma. Our results demonstrated that all EEG parameters are moderately related to the GCS, with the Spearman statistical correlation of 0.62-0.71 between the spectral possession distribution and the GCS and 0.62-0.66 between nonlinear measures and the GCS. The moderate correlation between EEG parameters and the GCS implies the possibility of the EEG-derived index to reveal the neurological status of patients in coma.

Impacts of diabetes and hypertension on the risk of hospitalization among less educated people

Coexisting hypertension increases the morbidity and mortality associated with diabetes, and may be more so in less educated people. We analysed data from 49 904 Canadians 40-64 years of age who participated in the Canadian Community Health Survey, 2000-2001. Multiple classification analysis was used to adjust for covariates. Population weight and design effect of the survey were taken into account in the analysis. The association between hypertension and hospitalization varied according to diabetes and education. The adjusted difference in hospitalization incidence attributable to hypertension was significantly higher for the lower education group than the higher education group, and such a pattern tended to be more pronounced among diabetic people. The adjusted incidence difference attributable to hypertension was higher in the diabetic group (8.8, 95% confidence interval (CI): 4.6, 13.0%) than in the non-diabetic group (4.6, 95% CI: 3.6, 5.6%) for people with low education, but was similar for those with well-educated people. Possible reasons for the modifying effect of education on the relationship among hypertension, diabetes and hospitalization were discussed.

Alloimmunization among patients with transfusion-dependent thalassemia in Taiwan

The development of erythrocyte alloantibodies complicates transfusion therapy in patients with thalassemia. However, no data are available on the frequency of erythrocyte alloimmunization in patients with transfusion-dependent thalassemia in Taiwan. We analysed the clinical and transfusion records of 30 individuals (15 females and 15 males; mean age, 20 years; range, 4-31 years) with thalassemia who had regular transfusions for periods ranging from 0.5 to 20 years. Of the 30 patients, 28 who had beta-thalassemia major and two who had Hb H disease (alpha thalassemia), 11 (37%) were found to carry alloantibodies. All alloantibodies were clinically significant specificities, including four cases of anti-E, two of anti-E + c, two of anti-'Mi(a)', one of anti-'Mi(a)' + E, one of anti-D and one of anti-S. Alloimmunization to erythrocyte antigens is a frequent complication in transfusion-dependent thalassemia.

A novel HLA-B allele, B*5612, identified by sequence-based typing method

HLA-B*5612, found in Taiwan using sequence-based typing method, was identical to HLA-B*5502 in exon 2 but differed in exon 3 by 10 nucleotide substitutions at positions 353-420 leading to five amino acid change at codon 94, 95, 97, 103 and 116. As this sequence motif was not found in the Asian population, it is likely that HLA-B*5612 is the product of a complex mechanism of implying a dual gene conversion event.