A human anti-CD40 monoclonal antibody, 4D11, for kidney transplantation in cynomolgus monkeys: induction and maintenance therapy

Blockade of CD40-CD154 signaling pathway is an attractive strategy to induce potent immunosuppression and tolerance in organ transplantation. Due to its strong immunosuppressive effect shown in nonhuman primate experiments, anti-CD154 monoclonal antibodies (mAbs) have been tried in clinical settings, but it was interrupted by unexpected thromboembolic complications. Thus, inhibition of the counter molecule, CD40, has remained an alternative approach. In the previous preliminary study, we have shown that 4D11, a novel fully human anti-CD40 mAb, has a fairly potent immunosuppressive effect on kidney allograft in nonhuman primates. In this study, we aimed to confirm the efficacy and untoward events of the 2-week induction and 180-day maintenance 4D11 treatments. In both, 4D11 significantly suppressed T-cell-mediated alloimmune responses and prolonged allograft survival. Addition of weekly 4D11 administration after the induction treatment further enhanced graft survival. Complete inhibition of both donor-specific Ab and anti-4D11 Ab productions was obtained only with higher-dose maintenance therapy. No serious side effect including thromboembolic complications was noted except for a transient reduction of hematocrit in one animal, and decrease of peripheral B-cell counts in all. These results indicate that the 4D11 appears to be a promising candidate for immunosuppression in clinical organ transplantation.

Characteristic changes in coronary artery at the early hyperglycaemic stage in a rat type 2 diabetes model and the effects of pravastatin

BACKGROUND AND PURPOSE

Diabetes is a risk factor for the development of coronary artery disease but it is not known whether the functions of endothelium-derived nitric oxide (NO) and endothelium-derived hyperpolarizing factor (EDHF) in coronary arteries are altered in the early stage of diabetes. Such alterations and the effects of pravastatin were examined in left anterior descending coronary arteries (LAD) from Otsuka Long-Evans Tokushima Fatty (OLETF) rats (type 2 diabetes model) at the early hyperglycaemic stage [vs. non-diabetic Long-Evans Tokushima Otsuka (LETO) rats].

EXPERIMENTAL APPROACH

Isometric tension, membrane potential and superoxide production were measured, as were protein expression of NAD(P)H oxidase components and endothelial NO synthase (eNOS).

KEY RESULTS

Superoxide production and the protein expressions of both the nicotinamide adenine dinucleotide (phosphate) [NAD(P)H] oxidase components and eNOS were increased in OLETF rats. These changes were normalized by pravastatin administration. Not only acetylcholine (ACh)-induced endothelial NO production but also functions of endothelium-derived NO [from (i) the absolute tension induced by epithio-thromboxane A(2) (STA(2)) or high K(+); (ii) enhancement of the STA(2)-contraction by a nitric oxide synthase (NOS) inhibitor; and (iii) the ACh-induced endothelium-dependent relaxation of high K(+)-induced contraction] or EDHF [from (iv) ACh-induced endothelium-dependent smooth muscle cell hyperpolarization and relaxation in the presence of a NOS inhibitor] were similar between LETO and OLETF rats [whether or not the latter were pravastatin-treated or -untreated].

CONCLUSIONS AND IMPLICATIONS

Under conditions of increased vascular superoxide production, endothelial function is retained in LAD in OLETF rats at the early hyperglycaemic stage, partly due to enhanced endothelial NOS protein expression. Inhibition of superoxide production may contribute to the beneficial vascular effects of pravastatin.

Superfluorescent pulsed emission from biexcitons in an ensemble of semiconductor quantum dots

Picosecond time-resolved photoluminescence from biexcitons in CuCl quantum dots (QDs) embedded in a NaCl matrix has been measured using an optical Kerr gate method. Ultrafast pulsed emission from the biexciton states was observed for the first time, only under resonant two-photon excitation of biexcitons. This implies that complete population inversion between the biexciton and exciton states is necessary in order to trigger the pulsed emission. In addition, the nature of the dependence of the time profiles of the pulsed emission on the excitation intensity reveals that the peak intensity is directly proportional to the square of the number of excited QDs. We conclude that this phenomenon is caused by superfluorescence, that is, the cooperative spontaneous radiative decay of many isolated excited states coupled by a resonant electromagnetic wave. Such a phenomenon has been observed for the first time in an ensemble of semiconductor QDs in this study. The results presented in this paper show that it is possible to control the microscopic coherent dynamics of electronic excited states in a QD ensemble.

Effect of atorvastatin on microRNA 221 / 222 expression in endothelial progenitor cells obtained from patients with coronary artery disease

BACKGROUND

Endothelial progenitor cells (EPCs) play an important role in the maintenance of vascular integrity. Lipid lowering therapy (LLT) with statins may contribute to biologically relevant activities including the proliferation of endothelial cells. The physiological role of microRNA (miR)-221/222, a newly discovered class of small RNA, is closely linked to the proliferation of endothelial cells. We therefore investigated whether LLT with statins might affect miR-221/222 expression in EPCs obtained from patients with coronary artery disease (CAD).

MATERIALS AND METHODS

This study included 44 patients with stable CAD and 22 subjects without CAD (non-CAD). Patients with CAD were randomized to 12 months of LLT with atorvastatin (10 mg day(-1)) or pravastatin (10 mg day(-1)). EPCs were obtained from peripheral blood at baseline and after 12 months of statin therapy. Levels of miR-221/222 in EPCs were measured by real-time RT-PCR.

RESULTS

Levels of miR-221/222 were significantly higher in the CAD group than in the non-CAD group (P < 0.01). Levels of miR-221/222 were weakly negatively correlated with EPC number in the CAD group. After 12 months of therapy, changes in lipid profiles were greater in the atorvastatin group than in the pravastatin group. LLT with atorvastatin markedly increased EPC numbers and decreased miR-221/222 levels (all P < 0.05), whereas LLT with pravastatin did not change EPC numbers or miR-221/222 levels.

CONCLUSIONS

This study demonstrates that LLT with atorvastatin increases EPC numbers and decreases miR-221/222 levels in patients with CAD, possibly contributing to the beneficial effects of LLT with atorvastatin in this disorder.

Odontogenic potential of post-natal oral mucosal epithelium

A bioengineered tooth would provide a powerful alternative to currently available clinical treatments. Previous experiments have succeeded in bioengineering teeth using tooth germs from animal embryos. However, the ultimate goal is to develop a technology which enables teeth to be regenerated with the use of autologous cells. To pursue this goal, we re-associated the palatal epithelium from young mice with the odontogenic dental mesenchyme and transplanted the re-associated tissues into mouse kidney capsules. Morphologically defined teeth were formed from the re-associated cultured palatal epithelial cell sheets from mice aged up to 4 wks, but no tooth was formed when the palatal epithelium from mice after 2 days of age was directly re-associated. Our results demonstrated that post-natal non-dental oral mucosal epithelium can be used as a substitute for dental epithelium, and that epithelial cell sheet improves the ability of the oral epithelium of older mice to differentiate into dental epithelium.

[Sweet's syndrome after off-pump coronary artery bypass grafting]

We report a 73-year-old man with myelodysplastic syndrome (MDS) who developed Sweet's disease after off-pump coronary artery bypass grafting (OPCAB). Coronary angiography showed severe 3 vessel disease. We conducted OPCAB on triple vessels using bilateral internal thoracic artery and saphenous vein grafts. He had a high fever and rubor around the median skin incision on 5 postoperative day. Skin biopsy demonstrated acute febrile neutrophilic dermatitis (Sweet's disease). The cutaneous lesions improved gradually by corticosteroids. A careful attention should be paid postoperatively in a patient with hematological disorders such as MDS, aplastic anemia, and malignancy.

Relationship between Joint National Committee-VI classification of hypertension and ambulatory blood pressure in patients with hypertension diagnosed by casual blood pressure

BACKGROUND

White-coat hypertension has been diagnosed arbitrarily based on different criteria. In 1997, the Joint National Committee-VI (JNC-VI) reported a new classification of hypertension and strongly emphasized the importance of ambulatory blood pressure (ABP) monitoring. The report pronounced normal ABP values for the first time.

HYPOTHESIS

The study's aim was to clarify the relationship between casual blood pressure (BP) and ABP of patients with essential hypertension in each stage of JNC-VI classification, and the prevalence of white-coat hypertension diagnosed by using JNC-VI normal ABP criteria.

METHODS

Ambulatory blood pressure was monitored non-invasively in 232 patients with essential hypertension whose casual BP was > or = 140/90 mmHg. The patients were classified according to JNC-VI classification, and their casual BP was compared with ABP. The criterion of white-coat hypertension was defined as casual BP > or = 140/90 mmHg with normal ABP according to JNC-VI criteria (< 135/85 during daytime and < 120/75 during nighttime).

RESULTS

Mean ABP increased as the stage advanced, and the differences between casual BP and ABP also increased. There were considerable overlaps in the distribution of ABP among stages. The prevalence of white-coat hypertension was 13% overall: 30% of the patients with isolated systolic hypertension, 19% of those in stage 1, 10% in stage 2, and 4% in stage 3.

CONCLUSIONS

Classification of hypertension based on casual BP may not always correspond in severity to that based on ABP. Ambulatory blood pressure monitoring recommended by JNC-VI is very useful for the evaluation of hypertension to differentiate white-coat hypertension from true hypertension.

Effect of Perospirone on p300 Electrophysiological Activity and Social Cognition in Schizophrenia: A Three-dimensional Analysis with (s)loreta

The purpose of this study was to determine if perospirone, a second generation antipsychotic drug and partial agonist at serotonin-5-HT1A receptors, enhances electrophysiological activity, such as event-related potentials (ERPs), in frontal brain regions, as well as cognitive function in subjects with schizophrenia. P300 current source images were obtained by means of standardized low resolution brain electromagnetic tomography (sLORETA) before and after treatment with perospirone for 6 months. Perospirone significantly increased P300 current source density in the left superior frontal gyrus, and improved positive symptoms and performance on the script tasks, a measure of verbal social cognition. Perospirone also tended to enhance verbal learning memory in patients with schizophrenia. There was a significant correlation between the changes in P300 amplitudes on the left frontal lead and those in social cognition. These results suggest the changes in three-dimensional distribution of cortical activity, as demonstrated by sLORETA, may mediate some of the actions of antipsychotic drugs. the distinct cognition-enhancing profile of perospirone may be related to its actions on 5-HT1A receptors.

Advancement in singing ability using The YUBA Method in patients with cochlear implants

CONCLUSION

Although overall improvement was not so dramatic due to a lack of retention, session by session advancement of matching pitch for targeted MIDI (Musical Instrument Digital Interface) sound was predominantly obvious. It was proved that The YUBA Method worked to improve singing ability for patients with cochlear implants.

OBJECTIVES

This study sought to verify whether or not the Yuba theory and method improved the singing ability of patients with cochlear implants.

SUBJECTS AND METHODS

Based on diagnosis, the instructor experimented to improve matching pitch of singing for three patients with cochlear implants using The YUBA Method. The mean fundamental frequencies and standard deviation of singing were then compared with before and after instructions to patients. The instruction was given for over 40 days at the University of Tokyo Hospital.

RESULTS

For each patient, the mean fundamental frequencies of their singing approached the mean MIDI specified frequencies as references for tests done in all three songs. Overall, the SD between fundamental frequencies of their singing and reference MIDI sounds became smaller.

The expression of TNF-alpha converting enzyme at the site of ruptured plaques in patients with acute myocardial infarction

BACKGROUND

Tumour necrosis factor-alpha (TNF-alpha) converting enzyme (TACE) plays an essential role in the TNF-alpha shedding process, which could affect the outcome of acute myocardial infarction (AMI). However, it remains unclear whether it originates from the ruptured plaque or represents a systemic process. This study analysed TACE-mediated TNF-alpha shedding at the site of ruptured plaques in AMI patients and compared them with a systemic mechanism.

MATERIALS AND METHODS

The study included 60 patients with AMI who underwent percutaneous coronary intervention (PCI) and 21 patients with stable angina pectoris (SA). Local samples from the site of plaque were taken from AMI using aspiration catheter treatment. Systemic samples were also taken from the aorta in all patients with AMI and SA.

RESULTS

Systemic levels of TACE and TNF-alpha were higher in AMI patients than in SA patients. In AMI patients, these levels were higher in local samples than in systemic samples. A positive correlation was seen between local TACE and TNF-alpha levels in AMI patients. Thrombus material removed from the ruptured plaque showed immunostainings of TACE and TNF-alpha in infiltrating macrophages. By six months follow-up study, local TACE levels remained the only significant independent predictors of adverse cardiac events in AMI patients.

CONCLUSIONS

This study demonstrates that local expression of TACE is related to TNF-alpha shedding at the site of ruptured plaques in AMI patients. In addition, local TACE expression at the site of ruptured plaques may play an important role in poor outcomes in patients with AMI.

Essential elements in the coding region of mRNA for translation of ColE2 Rep protein

Translation initiation of mRNA encoding the plasmid-specified initiator protein (Rep) required for initiation of the ColE2 plasmid DNA replication is fairly efficient in Escherichia coli despite the absence of a canonical Shine-Dalgarno sequence. Although a GA cluster sequence exists upstream the initiation codon, its activity as the SD sequence has been shown to be very inefficient. Deletion analyses have shown that there are sequences important for the Rep translation in the regions upstream the GA cluster sequence and downstream the initiation codon. To further define regions important for translation of the Rep mRNA, a set of the ColE2 rep genes bearing single-base substitution mutations in the coding region near the initiation codon was generated and their translation activities examined. We showed that translation of the Rep mRNA was reduced by some of these mutations in a region ranging at least 70 nucleotides from the initiation codon in the coding region, indicating the presence of translation enhancer(s) outside the translation initiation region which is covered by the ribosome bound to the initiation codon. Some of them seem to be essential and specific for translation of the ColE2 Rep mRNA due to the absence of a canonical SD sequence.