Cancer vaccines for non-small-cell lung cancer

Lung cancer is globally the second most common form of cancer in both men and women and the single largest cause of cancer-related mortality in the world. It is a disease with poor prognosis and the survival statistics have scarcely improved since historical times. The advent of targeted therapies has caused an incremental increase in survival figures. Nevertheless, significant progress in treatment outcomes need to be achieved before any perceptible improvement in overall survival of lung cancer patients becomes evident. The use of active-specific immunotherapy or cancer vaccines for the treatment of lung cancer is still in its infancy. Nevertheless several cancer vaccines have demonstrated clinical effects and improvements in overall survival in phase II and phase III trials and several more clinical trials are currently ongoing. This review summarizes the recent developments in NSCLC vaccines.

Development of a dendritic cell-based vaccine for chronic lymphocytic leukemia

Evidence for the existence of CLL-specific antigens recognized by the immune system can be gathered from the observation that many patients display monoclonal or oligoclonal expansions and skewed repertoire of T cells. In vitro functional studies have shown that tumor-specific T-cells are able to lyse the leukemic cells. Antileukemic cellular immunity may be boosted in vivo using dendritic cell-based immunotherapy. Our preclinical studies provide evidence that DC that had endocytosed apoptotic CLL cells (Apo-DC) were superior to fusion hybrids, tumor lysate or RNA in eliciting antileukemic T-cell responses in vitro. We have validated a method for enriching the small number of monocyte precursors present in the peripheral blood of CLL patients and utilize them for generating individualized, Apo-DC cellular vaccines. In most cases, a minimum of 50 x 10(6) Apo-DC could be generated, beginning with immunomagnetically enriched monocytes from a single leukapheresis product containing at least 1% CD14+ cells. Cryopreservation and thawing did not affect the phenotype or the T cell stimulatory function of Apo-DC. A phase I/II, open label clinical trial examining the feasibility, safety and immunogenicity of Apo-DC vaccination has been initiated. CLL patients receive 10(7) Apo-DC for at least five immunizations and monitored clinically and immunologically for 52 weeks. Three cohorts are accrued stepwise. Cohort I receives Apo-DC alone; Cohort II: Apo-DC+ repeated doses of low-dose GM-CSF; Cohort III: low-dose cyclophosphamide followed by Apo-DC + GM-CSF.

Ultrasound-assisted extraction of capsaicinoids from peppers

The development of a rapid, reproducible and simple method of extraction of the majority capsaicinoids (nordihydrocapsaicin, capsaicin, dihydrocapsaicin, homocapsaicin and homodihydrocapsaicin) present in hot peppers by the employment of ultrasound-assisted extraction is reported. The study has covered four possible solvents for the extraction (acetonitrile, methanol, ethanol and water), the optimum temperature for extraction (10-60 degrees C), the extraction time (2-25 min), the quantity of sample (0.2-2 g), and the volume of solvent (15-50 mL). Under the optimum conditions of the method developed, methanol is employed as solvent, at a temperature of 50 degrees C and an extraction time of 10 min. The repeatability and reproducibility of the method (R.S.D.<3%) have been determined. The capsaicinoids extracted have been analysed by HPLC with fluorescence detection and using monolithic columns for the chromatographic separation. The method developed has been employed for the quantification of the various capsaicinoids present in different varieties of hot peppers cultivated in Spain.

Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry

This population-based study reveals clinical and epidemiologic characteristics of hospitalised osteoporosis-related vertebral fractures and indicates an association with a substantial hospital burden in Spain. These data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements.

INTRODUCTION

Vertebral fractures (VF) are recognised as the most frequent complication of osteoporosis. Our objective was to determine the clinico-epidemiological characteristics and health-care burden of hospitalised VF in Spain.

METHOD

From the 2002 National Hospital Discharge Register, records for all osteoporosis-related VF in the Spanish population aged >or=30 years and over were retrieved. Diagnostic categories included the ICD-9-CM codes 805 and 733.xx. Population data were drawn from the National Statistics Institute.

RESULTS

In total, 7,100 records were eligible for analysis. According to Deyo-adapted Charlson index, 62% of cases had no associated comorbidity. VF were the cause of hospitalisation in 52% of cases. Overall in-hospital mortality was 3.5%. Men had higher adjusted mortality than women. Mean hospital stay was 11.4+/-0.2 days. Identified cases amounted to a hospitalisation rate of 2.76 cases per 10,000 population aged >or=30 years. Direct inpatient hospital costs exceeded 41 million euros and accounted for 0.078% of Spanish expenditure on hospitalisations and specialised care in 2002.

CONCLUSIONS

The national discharge database reveals epidemiological features of hospitalised osteoporosis-attributable VF and indicates an association with a substantial hospital burden in Spain. Our data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements.

Opinión de los médicos españoles sobre el síndrome de intestino irritable: Resultados de un estudio utilizando el método Delphi

INTRODUCTION

lack of evidence in most clinical situations regarding irritable bowel syndrome (IBS) enhances the importance of an expert s opinion, which will guide management and even the concept underlying the disease.

OBJECTIVE

to delve into the knowledge and degree of agreement on main clinical skills for this syndrome among physicians involved in its management.

MATERIAL AND METHOD

two rounds of a Delphi survey were conducted on 100 physicians: general practitioners (GPs) and gastroenterologists. The questionnaire evaluated agreement among participants in some aspects regarding the definition, diagnosis, and treatment of IBS.

RESULTS

fifty-five percent of participants completed the two-round survey. Agreement was achieved regarding the definition of typical symptoms and red flags characterizing IBS. Although there was no consensus regarding the appropriate management of patients without alarm symptoms, the performance of a colonoscopy on any patient presenting red flags was suggested. Patients were thought to require a wider examination when older than 40. A well defined line of IBS treatment was not found, albeit most physicians tended to choose it depending on the main complaint.

CONCLUSION

interviewed physicians showed adequate theoretical knowledge of IBS, but lack of uniformity on diagnosis and treatment approach reflects the controversial day-by-day management of this syndrome.

Strain rate imaging: data acquisition and postrocessing

Several studies already demonstrated the clinical relevance of strain rate imaging. Unfortunately, so far only few echolaboratories are using this technique in their clinical practice. This is mainly due to the lack of information on how to perform a standard strain rate imaging study. Thus, the aim of the present review is to provide the bases and methodology to perform a correct strain rate study.

Determination of trans-resveratrol in grapes by pressurised liquid extraction and fast high-performance liquid chromatography

A study has been made of the extraction of trans-resveratrol from grapes using pressurised liquids (PLE); for this, the first stage was to determine the stability of this compound during extractions at different temperatures (50, 100, 150 degrees C), with quantitative recoveries being obtained up to 150 degrees C. By employing solid-phase extraction (SPE) it was possible to retain this compound and separate it from other interfering substances present in the grape. The method developed comprises a sequential extraction of the sample adsorbed (0.5g) on a polystyrene-divinylbenzene based sorbent in the extraction chamber, first with water at 40 degrees C and 40atm of pressure (three cycles of 5min), and then with methanol at 150 degrees C and 40atm (three cycles of 5min). The trans-resveratrol content of the methanolic extract is determined by means of liquid chromatography. A rapid (5min) chromatographic method employing a monolithic column, with fluorescence detection, has been developed; for this, the conditions for detection of the compound were optimised (excitation at 310nm and emission at 403nm). The analytical parameters of the method of chromatographic analysis developed have been calculated: linear range (0.11-2.75mg/L), detection limit (0.003mg/L), quantification limit (0.004mg/L). Using this method, three varieties of grape have been analysed and the concentration of trans-resveratrol in these has been determined.

Generation of DC-based vaccine for therapy of B-CLL patients. Comparison of two methods for enriching monocytic precursors

BACKGROUND

The generation of Ag-loaded DC under good manufacturing practice (GMP) conditions is logistically challenging and further compounded when the starting precursors need to be purified from B-CLL patients who have overwhelming numbers of circulating B-CLL cells and decreased numbers of monocytes.

METHODS

We have previously demonstrated that DC with endocytosed B-CLL apoptotic bodies are powerful stimulators of anti-leukemic T cells. In this study we compared counterflow elutriation and immunomagnetic separation for enriching monocyte precursors, and evaluated the feasibility of generating DC from B-CLL patients and the effects of cryopreservation.

RESULTS

Monocyte yield from a single leukapheresis product of a B-CLL patient varied from 1 x 108 to 10 x 108 total cells, from which 40-200 x 106 mature DC could be produced. Adequate numbers of monocytes could not be enriched from one patient with 0.2% monocytes in the leukapheresis product, and the target of 50 x 106 DC was barely achieved in another patient with 0.9% monocytes in the pheresed cells. These results suggested that successful production of DC is dependent on a minimum frequency of 1% CD14(+) monocytes in the leukapheresis product. Cryopreservation of tumor cell-loaded DC yielded a recovery rate of 86+/-4.4% upon thawing, with a total viability of 90+/-2.8%. Most importantly, cryopreserved Ag-loaded DC retained their morphology, phenotype and function.

DISCUSSION

The results demonstrate that adequate numbers of functional DC required for clinical therapy can be generated from patients who have >1% of CD14(+) monocytes in the leukapheresis product. Moreover, Ag-loaded DC can be cryopreserved and recovered without significant change in phenotype or function.

Determination of phenolics in cosmetic creams and similar emulsions

A new method for the analysis of phenolics in cosmetic creams has been developed, based on a systematic study of the extractability of five phenolic compounds from such emulsions. A solid-liquid extraction using ultrasound was applied as a prior stage to the chromatographic determination of phenolics in the extracts. Three solvents, hexane, methanol and water, were used as extracting agents. These solvents permit both the de-emulsification of the creams and the extraction of phenolics. A factorial fractional experimental design was developed to analyse the influence in the extraction process of five different extraction variables: ultrasound horn, temperature, extracting volume, cycle and amplitude of ultrasounds. Graphic analysis of results revealed the variables with most influence in the extraction, as well as the interactions between the variables. Finally, the influence of the extraction time and the sample quantity were also studied. With this new method, phenolics can be extracted from silicone-based cosmetic creams in 10 min, using 50 degrees C as extraction temperature. RSDs (n=6) calculated ranged from 1.5% for ferulic acid to 6.5% for epicatechin. Recoveries of between 88.9% for gallic acid and 98.4% for caffeic acid were obtained.

[Chorea in hemodialysis: Is chorea just a neurological syndrome or is it related to uremia or dialysis?]

Chronic renal failure and haemodialysis patients are prone to develop encephalopathy. The causes of encephalopathy are often unclear. Clinical signs of encephalopathy in the uraemic patient often overlap with several other affections causing neurological disorders. Whenever basal ganglia are anatomically involved, movement disorders arise, including chorea. Some acute and chronic neurological syndromes associated with chronic uraemia have consistently been reported (uraemic encephalopathy, dialysis disequilibrium syndrome, dialysis dementia, nephroangiosclerosis neuropathy and ageing neuropathy). Other clinical conditions in which neurological involvement exists are not so frequent in both haemodialysis patients and in the general population (Wernicke's encefalopathy, Creutzfeldt-Jacob disease). Because of the non specific symptoms and the very heterogeneous aetiology, a careful physical examination should be performed in haemodialysis patients with clinical signs of encephalopathy and the main metabolic alterations should be sought; moreover, central nervous system imaging examination is often appropriate. In case of basal ganglia anatomical involvement, supported by findings of imaging techniques, it is necessary to evaluate individual causes of encephalopathy by means of more accurate tests including analysis of cerebro-spinal fluid, measurement of plasma levels of vitamin B components and laboratory tests searching for more uncommon diseases such as Huntington's chorea and Wilson's disease.

[Helicobacter pylori: cagA analysis and vacA genotyping in Chile. Detection of a s2/m1 strain]

BACKGROUND

The genes cagA and vacA encode H pylori virulence factors.

AIM

To genotype these genes in H pylori strains isolated from patients with upper gastrointestinal symptoms.

MATERIAL AND METHODS

We studied 50 patients who underwent an upper gastrointestinal endoscopy, with positive culture for H pylori. Detection of cagA and vacA genotyping was done using polymerase chain reactions.

RESULTS

The gene cagA was detected in 19 samples (38%). Signal sequences s1 and s2 of vacA gene were detected in 16 samples each (32%). There was simultaneous amplification of s1 and s2 in 6 samples and they were not detected in 9 samples. The middle region of vacA was m1 in 9 samples, m2 in 29 samples and there was simultaneous amplification of m1 and m2 in 12 samples. In 16 samples (32%), more than one type of signal sequence or medial region was detected. Of those patients in whom vacA was the only genotype detected, 15 were s2/m2, 7 were s1/m1, 4 were s1/m2 and 1 was s2/m1.

CONCLUSIONS

In these patients, the infection with cagA- H pylori strains, predominates, the prevalence of infection with s1 or s2 strains is similar and the predominant medial region is m2.

Gastric permeability is not increased in children colonized by CagA-positive strains of Helicobacter pylori

BACKGROUND

Sucrose permeability has been used as a marker to detect gastric lesions in children. As CagA status of Helicobacter pylori is an important factor in determining the evolution of the gastric lesion, CagA-positive strains being more frequently associated with severe mucosal lesions, the aim of this study was to determine the prevalence of CagA-positive strains in Helicobacter pylori-colonized children and to evaluate whether the sucrose permeability test might discriminate between colonization by CagA-positive or negative strains.

PATIENTS AND METHODS

A series of 38 children (11.1+/-3.6 years) who required upper endoscopy for diagnostic purposes were included in the study. Endoscopy was carried out after the sucrose permeability test, and gastric biopsies were obtained for histologic examination, Helicobacter pylori detection by Giemsa staining and CLO-test, and determination of CagA status of the colonizing Helicobacter pylori strains by polymerase chain reaction.

RESULTS

Helicobacter pylori was detected in 26 subjects (68.4%) and of these, 16 (61.5%) were colonized by CagA-positive strains. The intensity of the histologic findings was significantly associated with the presence of Helicobacter pylori and with CagA status of the infecting strains (chi2=21.2, p=0.0017). However no significant difference in the urinary excretion of sucrose between children not colonized and children with CagA- negative or positive strains was observed (0.027% [0.012-0.035%]; 0.027% [0.016-0.047%] and 0.026% [0.016-0.038], median [range], respectively; Kruskal-Wallis analysis of variance F=0.75, p=0.69).

CONCLUSIONS

These results indicate that in Chile, about 60% of the Helicobacter pylori infected children are colonized by CagA-positive strains, in association with more intense lesions of the gastric mucosa, but that gastric permeability to sucrose does not discriminate between colonization by CagA-negative and positive strains of Helicobacter pylori.

Evaluation of a tetracycline-inducible promoter in Staphylococcus aureus in vitro and in vivo and its application in demonstrating the role of sigB in microcolony formation

An inducible promoter system provides a powerful tool for studying the genetic basis for virulence. A variety of inducible systems have been used in other organisms, including pXyl-xylR-inducible promoter, the pSpac-lacI system, and the arabinose-inducible P(BAD) promoter, but each of these systems has limitations in its application to Staphylococcus aureus. In this study, we demonstrated the efficacy of a tetracycline-inducible promoter system in inducing gene expression in S. aureus in vitro and inside epithelial cells as well as in an animal model of infection. Using the xyl/tetO promoter::gfp(uvr) fusion carried on a shuttle plasmid, we demonstrated that dose-dependent tetracycline induction, as measured by bacterial fluorescence, occurred in each of the above environments while basal activation under noninduced conditions remained low. To ascertain how the system can be used to elucidate the genetic basis of a pathogenic phenotype, we cloned the sigB gene downstream of the inducible promoter. Induction of SigB expression led to dose-dependent attachment of the tested strain to polystyrene microtiter wells. Additionally, bacterial microcolony formation, an event preceding mature biofilm formation, also increased with tetracycline induction of SigB.

sigma(B) activity in Staphylococcus aureus is controlled by RsbU and an additional factor(s) during bacterial growth

Two genes of the sigB operon, rsbU and rsbV, were deleted in an rsbU(+) strain (FDA486) to evaluate the contribution of these two genes to sigma(B) activity in Staphylococcus aureus. The sigma(B) protein level and the transcription of two sigma(B)-dependent promoters (sigB and sarA P3 transcripts) were analyzed in the constructed mutants. A deletion of the first gene (rsbU) within the sigB operon led only to a partial reduction in sigma(beta) activity. A deletion of the second gene (rsbV) resulted in a more dramatic reduction in the sigma(B) protein level and its activity than did the deletion of rsbU, thus indicating that RsbV can be activated independent of RsbU. In the parental strain, the sigma(B)-dependent transcript initiated upstream of rsbV was 28-fold higher than the sigma(A)-dependent transcript originating from the rsbU promoter. The level of the sigma(B)-dependent transcript decreased up to 50% in the rsbU mutant and up to 90% in the rsbV mutant compared with the transcript in the wild type. The yellow pigment of S. aureus colonies, a sigma(B)-dependent phenotype, was partially reduced in the rsbU and rsbV mutants, whereas alpha-hemolysin was increased. Additionally, the sarA P3 promoter activity of the parental strain was induced to a higher level in response to pH 5.5 than was that of the rsbU or rsbV mutant, indicating that RsbU is the major activator of the sigma(B) response to acid stress. Using a tetracycline-inducible system to modulate the expression of RsbW, we progressively repressed pigment production, presumably by reducing the free sigma(B) level. Collectively, our data indicated that RsbU and RsbV in S. aureus contributed to different levels of sigma(B) protein expression and varying sigma(B) activities. Although RsbV can activate sigma(B) independent of RsbU, RsbU remains the major activator of sigma(B) during acid stress.

Epstein-Barr virus in gastric carcinoma is associated with location in the cardia and with a diffuse histology: a study in one area of Chile

Epstein-Barr virus (EBV) has been associated with the most common form of stomach neoplasms, the gastric carcinoma (GC). The presence of EBV-encoded small RNAtype-1 (EBER-1), a marker for EBV infection was analyzed by in situ hybridization (ISH) in 185 formalin-fixed and paraffin-embedded cases of GC from a high risk region. We found 31 (16.8%) EBV-positive cases with no relationship to age. Although male predominance (19% in males and 12.5% in females) was observed, the gender difference did not achieve statistical significance. Odds ratio (OR) for cardia location was 5.4 (95% CI 1.7-17.3) when antrum was used as referent category and the effects of gender and age were taken into account. The proportion of EBV-positive cases in diffuse histology was higher than intestinal type (OR = 4.8, 95% CI = 2.0-11.1). Our findings are contrary to a previously accepted hypothesis, that high-risk countries for GC have low rates of EBV-associated GC. In addition, our findings regarding location, histology and weak male predominance are different from what has been described in Asian and European countries, but similar to those described in Mexico and Mexican descendants living in the U.S. suggesting unique characteristics of EBV-associated GC in Latin-America.

Extracellular fibrinogen-binding protein, Efb, from Staphylococcus aureus blocks platelet aggregation due to its binding to the alpha-chain

Extracellular fibrinogen-binding protein (Efb) secreted by Staphylococcus aureus has previously been shown to contribute to pathogenesis in a rat wound infection model. Also antibodies against Efb exhibited a protective effect in a mouse mastitis model. The interaction between Efb and fibrinogen is divalent, with one binding site within the N-terminal repeat region in Efb and one at the C terminus. In this study we show that the distal D domain of fibrinogen contains at least one of the binding domains recognized by Efb. Efb stimulates fibrinogen binding to ADP-activated platelets. Furthermore, Efb inhibits ADP-induced, fibrinogen-dependent platelet aggregation in a concentration-dependent manner. This implies that Efb modifies platelet function by amplifying a non-functional interaction between fibrinogen and platelets. Efb recognizes the A alpha-chain of the D fragment of fibrinogen. The RGD sequence on the A alpha-chain is located close to the region recognized by Efb and contains a putative binding site for the platelet integrin GPIIb/IIIa receptor complex involved in platelet aggregation.

Stability of phenolic compounds during extraction with superheated solvents

The stability of nine phenolic compounds in the extraction with superheated methanol at different temperatures (40, 50, 100 and 150 degrees C) has been tested. The evolution of the same compounds in boiling methanol (65 degrees C) in contact with air was also determined. All the assayed phenolic compounds were stable under the extraction conditions with the exception of catechin and epicatechin (recoveries: 87.4% for catechin and 86.0% for epicatechin at 150 degrees C and 94.1% for epicatechin at 100 degrees C). Phenolic compounds kept at the boiling point of methanol (65 degrees C) showed lower recoveries: gentisic acid (85.5%), syringic aldehyde (92.8%), catechin (63.7%) and epicatechin (63.4%). Extraction with superheated solvents was also applied to the extraction of phenolic compounds from solid wastes of the winemaking process.

Supercritical fluid extraction of 5-hydroxymethyl-2-furaldehyde from raisins

An extraction method based on supercritical CO(2) has been developed for the analysis of 5-hydroxymethyl-2-furaldehyde in raisins. To optimize extraction variables, a fractional factorial experimental design was applied. Six extraction variables were optimized. The organic modifier used for increasing the extraction fluid solvating power was the most important factor. Methanol as organic modifier produced 10-fold higher recoveries of 5-hydroxymethyl-2-furaldehyde than ethyl acetate. The efficiency of the organic modifier in the static extraction phase was compared with using it in the dynamic extraction phase. Repeatability of the analysis method was evaluated, which resulted in an RSD of <5%. 5-Hydroxymethyl-2-furaldehyde was quantified in raisins, and the concentration was found to be 0.128 mg/g of raisin.

Supercritical fluid extraction of grape glycosides

Supercritical fluid extraction with methanol-modified CO(2) was used to extract glycosides from grapes. An optimization design involving 12 extraction variables was applied to achieve quantitative recoveries. The most important factor was the amount of organic modifier, a consequence of the high degree of glycoside polarity. By the proposed method, the total time of analysis can be decreased relative to that required for more conventional extractions. The full method can also be automated.

Antibody responses in patients with staphylococcal septicemia against two Staphylococcus aureus fibrinogen binding proteins: clumping factor and an extracellular fibrinogen binding protein

We analyzed the serum antibody responses against two Staphylococcus aureus fibrinogen binding proteins, the cell-bound clumping factor (Clf) and an extracellular fibrinogen binding protein (Efb). The material consisted of 105 consecutive serum samples from 41 patients suffering from S. aureus septicemia and 72 serum samples from healthy individuals. An enzyme-linked immunosorbent assay (ELISA) was developed. Healthy individuals showed variable levels of antibodies against the studied antigens, and cutoff levels (upper 95th percentile) against these antigens were determined. No correlation was seen between serum antibody levels against Clf and Efb. In acute-phase samples 27% of patients showed positive antibody levels against Clf and 10% showed positive levels against Efb, while in convalescent-phase samples 63% (26 of 41) showed a positive serology against Clf and 49% (20 of 41) showed a positive serology against Efb. Antibody levels against Efb were significantly lower in the acute-phase sera than in sera from healthy individuals (P = 0. 002). An antibody response against Clf was most frequent in patients suffering from osteitis plus septic arthritis and from endocarditis (80% positive). The antibody response against Efb appeared to develop later in the course of disease. A possible biological effect of measured antibodies was demonstrated with the help of an inhibition ELISA, in which both high-titer and low-titer sera inhibited the binding of bacteria to fibrinogen. In conclusion, we have demonstrated in vivo production of S. aureus fibrinogen binding proteins during deep S. aureus infections and a possible diagnostic and prophylactic role of the corresponding serum antibodies in such infections.

Fractional extraction of compounds from grape seeds by supercritical fluid extraction and analysis for antimicrobial and agrochemical activities

White grape seeds were subjected to sequential supercritical fluid extraction. By increasing the polarity of the supercritical fluid using methanol as a modifier of CO(2), it was possible to fractionate the extracted compounds. Two fractions were obtained; the first, which was obtained with pure CO(2), contained mainly fatty acids, aliphatic aldehydes, and sterols. The second fraction, obtained with methanol-modified CO(2), had phenolic compounds, mainly catechin, epicatechin, and gallic acid. The fractions were bioassayed. Antimicrobial activities were checked on human pathogens, and a high degree of activity was obtained with the lipophilic fraction. Agrochemical activities on phytopathogenic fungi and activities on the etiolated wheat coleoptile bioassay were also checked. The more polar fraction was active in the latter bioassay.

Functional studies of a fibrinogen binding protein from Staphylococcus epidermidis

A gene encoding a fibrinogen binding protein from Staphylococcus epidermidis was previously cloned, and the nucleotide sequence was determined. A portion of the gene encompassing the fibrinogen binding domain has now been subcloned in an expression-fusion vector. The fusion protein can bind to fibrinogen in a capture enzyme-linked immunosorbent assay and can be purified by fibrinogen affinity chromatography. This protein can completely inhibit the adherence of S. epidermidis to immobilized fibrinogen, suggesting that the adherence of S. epidermidis to fibrinogen is mainly due to this protein. Antibodies against this fibrinogen binding protein were also found to efficiently block the adherence of S. epidermidis to immobilized fibrinogen. Despite homology with clumping factors A and B from S. aureus (cell surface-associated proteins binding to fibrinogen), binding involved the beta chain of fibrinogen rather than the gamma chain, as in clumping factor A.

Extraction of polyphenolic compounds from grape seeds with near critical carbon dioxide

A new analytical method using near critical carbon dioxide to extract polyphenolic compounds from white grape seeds has been developed. Carbon dioxide density, organic modifier, percentage of modifier, and extraction temperature were optimized utilizing an experimental design. Gallic acid, catechin, and epicatechin were the main phenolic compounds detected in the HPLC chromatogram of each extract. Recovery and reproducibility of catechin from grape seed was calculated. Under optimized conditions recovery was estimated to be 79% with a RSD equal to 7.3%. Results from the supercritical fluid method were compared with results obtained via liquid-solid extraction using methanol-water.

[Immunoglobulin rearrangement in the differential diagnosis of primary gastric lymphoma]

BACKGROUND

The traditional methods to distinguish Chronic Follicular Gastritis and Primary Gastric Lymphoma do not allow an adequate definitive diagnosis in a significant number of cases. The molecular Biology diagnostic methods are based on the rearrangement of immunoglobulin genes. The polymerase chain reaction (PCR) specifically amplifies this rearrangement and allows molecular analysis of minimal tissue samples obtained with endoscopical biopsies.

AIM

To test the usefulness of this PCR method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma.

MATERIAL AND METHODS

We analyzed the endoscopical biopsies of six Chronic Follicular Gastritis cases and eight surgically treated Primary Gastric Lymphoma cases, six with the correct diagnosis in the endoscopical biopsies and two with a diagnosis of Chronic Follicular Gastritis.

RESULTS

A policlonal immunoglobulin rearrangement was found in the six cases with Chronic Follicular Gastritis. A monoclonal arrangement was found in 5 of 6 biopsies with the diagnosis of Primary Gastric Lymphoma. The same monoclonal rearrangement was observed in the two biopsies incorrectly diagnosed as Chronic Follicular Gastritis.

CONCLUSIONS

PCR analysis of immunoglobulin rearrangement is a useful method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma.

Adherence of Staphylococcus aureus is enhanced by an endogenous secreted protein with broad binding activity

A novel mechanism for enhancement of adherence of Staphylococcus aureus to host components is described. A secreted protein, Eap (extracellular adherence protein), was purified from the supernatant of S. aureus Newman and found to be able to bind to at least seven plasma proteins, e.g., fibronectin, the alpha-chain of fibrinogen, and prothrombin, and to the surface of S. aureus. Eap bound much less to cells of Staphylococcus epidermidis, Streptococcus mutans, or Escherichia coli. The protein can form oligomeric forms and is able to cause agglutination of S. aureus. Binding of S. aureus to fibroblasts and epithelial cells was significantly enhanced by addition of Eap, presumably due to its affinity both for plasma proteins on the cells and for the bacteria.

Identification of functional domains in Efb, a fibrinogen binding protein of Staphylococcus aureus

Staphylococcus aureus produces and secretes a protein, Efb, that binds to fibrinogen, seems to be required for virulence, and may benefit the microorganism by delaying wound healing. Interactions of Efb with fibrinogen are influenced by divalent metal cations, including Ca2+. Increasing concentrations of Ca2+ increased the binding of fibrinogen to immobilized Efb, whereas binding of Efb to immobilized fibrinogen was decreased with increasing Ca2+ concentration. Studies with synthetic peptides showed that peptides from the carboxyl terminal half of Efb bound to soluble fibrinogen and enhanced the binding of fibrinogen to Efb. A peptide corresponding to a repeated sequence in the amino terminal half of the protein also bound fibrinogen and inhibited binding of fibrinogen to Efb. These results may provide clues to the biological function of Efb and aid in the rational design of agents to block the Efb fibrinogen interaction.

Multiple binding sites in the interaction between an extracellular fibrinogen-binding protein from Staphylococcus aureus and fibrinogen

Efb (previously Fib) is a fibrinogen-binding protein secreted by Staphylococcus aureus. It has previously been shown that it plays a role in a wound infection model in the rat and that antibodies against Efb reduce the number of recovered bacteria from the mammary glands in a mouse mastitis model. Efb binds to the alpha-chain of fibrinogen and does not participate in bacterial adherence to fibrinogen. The binding of Efb to fibrinogen is divalent, with one binding site within the two repeat regions in Efb at the N terminus and one binding site at the C terminus. The divalent binding nature leads to precipitation of Efb-fibrinogen complex when the proteins are added to each other at a 1:1 molar ratio. The interaction between Efb and fibrinogen is strongly enhanced by Ca2+ or Zn2+ but not by Mg2.

Lack of the extracellular 19-kilodalton fibrinogen-binding protein from Staphylococcus aureus decreases virulence in experimental wound infection

A mutant deficient for the 19-kDa extracellular fibrinogen-binding protein (Fib) from Staphylococcus aureus has been constructed. The gene was inactivated by allele replacement. A 2.0-kb fragment from transposon Tn4001 carrying the gene for gentamicin resistance was inserted into the gene encoding Fib (fib). The genotype was verified by PCR analysis, and the loss of Fib was demonstrated by Western blotting (immunoblotting). The mutation has not altered the ability of the strain to bind to fibrinogen or fibronectin compared with that of the isogenic parental strain, FDA486. The mutant, designated K4.3, was compared with strain FDA486 in a wound infection model in rats. Sixty-eight percent of the rats challenged with parental strain FDA486 developed severe clinical signs of wound infection, whereas only 29% of the animals challenged with isogenic mutant K4.3 showed severe symptoms (P < 0.01). The weight loss of animals infected with the wild type was also significantly different from that of animals infected with the mutant strain. The result demonstrates that the extracellular 19-kDa fibrinogen-binding protein from S. aureus contributes to the virulence in wound infection and delays the healing process.

[Poor digestion of lactose. Its definition, prevalence in Mexico, and its implications in milk consumption]

We review the studies that have been carried out in Mexico related to prevalence of lactase deficiency. We also describe a study carried out in three regions of Mexico with different consumption of milk (Northern, Central & Southeastern), comprising 960 individuals of ages ranging from 1 to 99 years. They were evaluated in a double blind study in order to determine the prevalence of lactose maldigestion with habitual dosis of milk. Each subject received two treatments: a) 240 or 360 mL of intact milk according to age, and b) the same amount of milk but with the lactose hydrolyzed (> 90% hydrolyzed). The participants were classified as digesters or maldigesters of lactose using the hydrogen breath test. The prevalence of maldigesters was higher in the Central (30%) and Southeastern (22%) regions than in the Northern one (9%, p < 0.01). The prevalence increased with age from 4.5% (< 3 years), 13.6% (3 to 5.9), 20.8% (6 to 12.9), 21.8% (13 to 17.9) and 32.9% in adults. Lactose maldigestion affected consumption marginally.

[Lactose intolerance. Its definition, its prevalence in Mexico, and its implications in milk consumption]

In this document we describe some aspects of lactose and milk intolerance, discuss the results of studies carried out previously in Mexico, and report an investigation whose objective was to quantify the impact of lactose intolerance on the habitual consumption of milk in an open population. The prevalence of lactose intolerance and its effect on the consumption of milk was studied in three regions of Mexico. The design of the study was prospective, randomized, double-blind and crossover. The presence of milk intolerance was investigated in 960 subjects with ages between 6 months and 99 years who, as a function of age, received 240 or 360 mL of intact milk and the same amount of hydrolyzed milk. We quantified the consumption of milk and the presence of symptoms after ingesting the tested milk. Seven percent manifested symptoms with the intact milk but only 2% with the hydrolyzed milk (p < 0.001). The presence of symptoms in the intolerant subjects was significantly associated with a lower consumption of milk in comparison with the tolerant individuals (p < 0.001). On the other hand, the consumption of milk appeared to be only marginally associated with the intolerance and its symptoms. We conclude that lactose intolerance does not appear to be a major factor in determining milk consumption in Mexican healthy populations.

Insertional inactivation of the gene for collagen-binding protein has a pleiotropic effect on the phenotype of Staphylococcus aureus

This report describes phenotypical changes caused by the insertional inactivation of the gene for the collagen-binding protein in Staphylococcus aureus PH100. Insertional inactivation resulted in reductions in the amount of fibronectin-binding protein in PH100 and the ability of intact cells to aggregate in the presence of fibronectin. However, the capacity of PH100 to adhere to immobilized fibronectin remained the same.

[Anatomopathological study of 86 gastric adenomas. Experience in 14 years]

AIM

To analyze the clinical presentation, pathological aspect and treatment of gastric adenomas.

PATIENTS AND METHODS

Retrospective analysis of 75 patients aged 26 to 88 years in whom a gastric adenoma was diagnosed.

RESULT

Seventy one patients had elevated endoscopical lesions and two had depressed or flat lesions. Ninety percent of lesions were located in the gastric antrum. Pathological study detected 6 focal carcinomas within the adenomas and 5 concomitant carcinomas located elsewhere in the stomach. Fifty four patients were subjected to endoscopical resection. Among patients with focal carcinomas, a gastrectomy was performed in four and endoscopical resection in two.

CONCLUSIONS

Gastric adenomas must be considered in the differential diagnosis of gastric elevated lesions and may be confused in early gastric cancer. There is a histological resemblance between adenomas and gastric dysplasia described by several authors though only in our cases and in the Japanese literature the adenoma is referred to as mostly a polypoid sessile lesion.

Effects of intravenous digoxin on pulmonary venous and transmitral flows in patients with chronic heart failure of different degrees

Acute effects of digoxin on diastole were evaluated noninvasively by combining data simultaneously obtained by Doppler echocardiograms (echo-Doppler) of transmitral and pulmonary venous flow curves in 38 patients with dilated and failing hearts, who had been stable for at least 7 days before the study. According to the resting ejection fraction (EF), patients were subdivided into Group 1 (EF < 30%: n = 20, mean EF values 23 +/- 8%) and Group 2 (EF > or = 30%: n = 18, mean EF values 40 +/- 3%). Significant differences were observed at rest between the two groups in both transmitral (shorter deceleration time and isovolumic relaxation time and increased peak E and E/A ratio in Group 1 vs. Group 2) and transpulmonary (reduced systolic forward component and systolic fraction of the flow curves in Group 1 compared with Group 2 and control subjects) parameters. Digoxin (1 mg subdivided into two doses, each infused over a 15-min period with 2 h between the doses) significantly modified the diastolic profile in Group 1 patients in the absence of statistically relevant changes in EF: a significant decrease of transmitral peak E (from 76 +/- 17 to 60 +/- 15 cm/s, p < 0.05) and E/A ratio (from 2.5 +/- 1 to 1.6 +/- 0.6; p < 0.05) and a significant lengthening of deceleration time (from 115 +/- 20 to 160 +/- 18 ms; p < 0.05) were detected.(ABSTRACT TRUNCATED AT 250 WORDS)