Identification and characterization of pig embryo microRNAs by Solexa sequencing

MicroRNAs (miRNAs) are a class of small, non-coding RNAs of approximately 22 nucleotides in length that regulate gene expression by binding to the 3'-untranslated regions of target mRNAs. It is now clear that miRNAs are involved in many biological processes, including proliferation, differentiation and regulation of gene expression during early embryonic development. The miRBase 16.0 (2010) shows that there are 175, 673, 408 and 1048 annotated miRNAs for Caenorhabditis elegans, Mus musculus, Rattus norvegicus and Homo sapiens, respectively. However, there are only 211 miRNAs described for Sus scrofa. In particular, the full set of miRNAs and their expression patterns are still poorly understood in the embryo. Therefore, we combined Solexa sequencing with computational techniques to analyse the sequences and relative expression levels of S. scrofa miRNAs at embryonic day 33 (E33). Of the distinct miRNAs identified, 76 previously known miRNAs and 194 candidate miRNAs were identified in head, and 77 known miRNAs and 130 predicted candidate miRNAs were identified in organ region. Furthermore, we performed additional investigation for identifying the potential target mRNAs using PicTar and TargetScan. Concurrent function analysis suggested that highly expressed miRNAs are mostly involved in the development of nerves, cerebrum, muscle and organs. Our results provide useful information for the investigation into embryonic miRNAs of pig and provide a valuable resource for investigators interested in the regulation of embryonic development in pigs and other animals.

The impact of prior radiotherapy on fatal complications after self-expandable metallic stents (SEMS) for malignant dysphagia due to esophageal carcinoma

The esophageal stent has been demonstrated to serve as a safe and effective palliative treatment for advanced inoperable esophageal carcinoma. However, the safety of esophageal stents in patients with prior radiotherapy (RT) remains debated. This article aims to investigate the impact of prior RT on the incidence of fatal complications after self-expandable metallic stents for palliation of malignant dysphagia because of esophageal carcinoma. Between January 2007 and July 2010, 93 patients with malignant dysphagia because of esophageal carcinoma underwent placement of self-expandable metallic stents in our hospital. Patients were retrospectively separated into two groups: patients with RT before stent placement (RT group, n=57) and patients with no treatment before stent placement (no RT group, n=35).The median survival after stent placement was 77 days (7-842 days) in the RT group and 246 days (15-878 days) in the no RT group. Improvement in dysphagia score was similar in both groups. The fatal complications included fatal gastrointestinal hemorrhage and uncontrolled pneumonia. The incidence of fatal gastrointestinal hemorrhage and uncontrolled pneumonia were 28.1% and 5.7% (P=0.009), 28.1% and 5.7% (P=0.009), respectively. Logistic regression analysis showed a significant interaction between prior RT and fatal gastrointestinal hemorrhage (relative risk 7.82, 95% confidence interval 1.54-39.61; P=0.013). Mortality of massive hemorrhage was 5.7% (2/35), 0% (0/4), 12.5% (3/24), and 44.8% (13/29), respectively, in patients who received 0, 1Gy∼49Gy, 50Gy∼60Gy, and >60Gy (χ(2) =17.761; P=0.000). Logistic regression analysis disclosed prior RT did not significantly increase the risk of uncontrolled pneumonia (relative risk 1.47, 95% confidence interval 0.21-10.12; P=0.697).

Socioeconomic status and children with intellectual disability in China

BACKGROUND

Intellectual disability (ID) accounts for 70% of all disabilities among children in China's Second National Sampling Survey on Disability. Although studies have shown a relationship between social class and ID in children, none have investigated the association of socioeconomic variables in Chinese children with mild or severe ID.

METHODS

Data for children aged 0-6 years with and without ID were abstracted from the Second National Sampling Survey on Disability in China, conducted in 2006. Crude odds ratios showed the effect of sociodemographic factors on mild and severe ID. Adjusted odds ratios (OR(a) ) (95% confidence intervals) estimated the independent effects of these factors.

RESULTS

For both mild and severe ID, risk of having ID increased with male sex, birth to a woman aged 35 years and older, lower maternal education, mother's older age at delivery, lower income and rural residence. After age, gender and parent disability were controlled, mothers aged 35 years and older were more likely to have a child with ID: mild ID, OR(a) 1.47 (1.15-1.88); severe ID, OR(a) 1.32 (1.00-1.73). There was an approximate increasing monotonic risk of severe ID with increasing socioeconomic disadvantage: lowest income, OR(a) 3.00 (2.19-4.12); low income, OR(a) 2.28 (1.63-3.19); lower middle income, OR(a) 1.72 (1.27-2.33); middle income, OR(a) 1.73 (1.28-2.36).

CONCLUSIONS

There is a significant relationship between sociodemographic factors and ID. Similar patterns were found for both mild and severe ID. Recommendations are given for preventing ID in Chinese children.

Metabolite detection of pancreatic carcinoma by in vivo proton MR spectroscopy at 3T: initial results

PURPOSE

The authors sought to identify metabolic features of pancreatic carcinoma by in vivo proton magnetic resonance (MR) spectroscopy at 3 Tesla.

MATERIALS AND METHODS

Forty healthy volunteers and 40 patients with pancreatic carcinoma confirmed by histopathology underwent T2-weighted imaging for localisation of the single voxel. Respiration-triggered (1)H MR spectroscopy was used to detect metabolites in normal pancreas and cancerous tissue. All spectral data were processed with SAGE software. Unsuppressed water at 4.7 ppm was used as an internal reference to determine metabolite concentrations. Each ratio among the different peak areas was statistically evaluated between normal pancreas and pancreatic carcinoma.

RESULTS

The following five groups of spectra were detected: unsaturated fatty acids (-CH = CH-) at 5.4 ppm; residual water at 4.7 ppm; choline metabolites at 3.2 ppm; unsaturated fatty acids (-CH2-CH = CH-) or a combination of N-acetylaspartate (NAA), N-acetylaspartylglutamate (NAAG), glutamine, glutamate, macromolecules and unsaturated fatty acids (-CH2-CH = CH-) at 2.0 ppm and lipids at 1.3 ppm. Ratio of lipids to unsuppressed water in normal pancreas was statistically greater than that in pancreatic cancer (p=0.004). Ratio of choline to unsuppressed water in normal pancreas was statistically greater than that in pancreatic cancer (p=0.0001). Ratio of fatty acids (-CH = CH-) to lipids in normal pancreas was statistically lower than that in pancreatic cancer (p=0.006).

CONCLUSIONS

Compared with normal pancreas, pancreatic carcinoma has a higher ratio of fatty acids (-CH = CH-) to lipids and lower ratios of lipids to unsuppressed water and choline to unsuppressed water at 3T.

The incidence and risk factors of invasive fungal infection after haploidentical haematopoietic stem cell transplantation without in vitro T-cell depletion

In recent years, we have successfully established a novel method of haploidentical haematopoietic stem cell transplantation (HSCT) without in vitro T-cell depletion. This study was aimed at analysing the incidence and risk factors of invasive fungal infection (IFI) with this transplantation method. The study comprised 291 patients who had undergone haploidentical HSCT from 1 January 2007 to 31 December 2008. IFI was diagnosed according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group 2002 criteria, and only proven or probable cases of IFI were regarded as true cases. A total of 39 patients were documented as having IFI, including four proven cases and 35 probable cases. The median time of diagnosis was 26 days (range: 6-405 days) after transplantation. The cumulative incidence rates of IFI at 40 days, 1 year, 2 years and 3 years after transplantation were 8.25%, 13.1%, 13.4% and 13.4%, respectively. Multivariate analysis identified platelet engraftment time (>17 days) (p 0.027; hazard ratio (HR) 2.432; 95% CI 1.105-5.355), a high risk of underlying disease (p 0.001; HR 2.916; 95% CI 1.515-5.611) and grade III-IV acute graft-versus-host disease (p 0.019; HR 2.407; 95% CI 1.154-5.022) as risk factors for IFI. The incidence rates of IFI in patients with no, one, two or three risk factors at 3 years after transplantation were 4.48%, 7.86%, 29.6% and 23.1%, respectively. In conclusion, IFI is an important complication following haploidentical HSCT without in vitro T-cell depletion.

Two novel HLA-A alleles: HLA-A*31:01:09 and HLA-A*33:30

The HLA-A*31:01:09 differs from the closest allele HLAA*31:01:02 by a C to T silent substitution at position 447 in exon 3. The HLA-A*33:30 differs from the closest allele HLA-A*33:03:01 by a single nucleotide substitution at position 453 in exon 3, leading to a change of Arg 131 Cys.

The expression of CXCR4 and its relationship with matrix metalloproteinase-9/vascular endothelial growth factor in esophageal squamous cell cancer

Esophageal cancer (EC) is a highly aggressive neoplasm with poor prognosis. The main reason for this disappointing outcome is the strong behavior of esophageal cancer cell's invasion and metastasis. CXC chemokine receptor 4 (CXCR4) was found to be expressed in many tumors and significantly correlated with invasion, angiogenesis, metastasis, and prognosis. In the present study, we investigated the expressions of CXCR4, matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor (VEGF) in esophageal squamous cell cancer (ESCC) and analyzed the relationship among the three proteins. Sections of paraffin-embedded tissues were obtained from 127 patients with ESCC undergoing esophagectomy at Zhongshan Hospital, Fudan University in 2005. The CXCR4, MMP-9, and VEGF expressions in EC tissues were evaluated according to the immunohistochemical staining area and intensity. The correlations between patients' prognosis and covariates were analyzed by Kaplan--Meier method (univariate analysis) and Cox regression (multivariate analysis). The overall expression rate of CXCR4, MMP-9, and VEGF was 88.2%, 93.7%, and 79.5%, respectively. CXCR4 expression was significantly associated with tumor grade, tumor size, tumor depth, regional lymph node metastasis, and tumor, node, metastasis (TNM) stage (P < 0.05). MMP-9 expression was significantly associated with age and tumor grade (P < 0.05). VEGF expression was significantly associated with tumor grade, tumor depth, and TNM stage (P < 0.05). CXCR4 expression was positively correlated with MMP-9 expression (P < 0.01, r= 0.365) and VEGF expression (P < 0.01, r= 0.380). However, there was no significant correlation between MMP-9 and VEGF expression (P > 0.05). In univariate analysis, CXCR4 expression, tumor size, tumor depth, lymph node metastasis, and TNM stage were correlated with patients' prognosis (P < 0.05); in multivariate analysis, tumor size and lymph node metastasis were the independent factors of poor prognosis. CXCR4 was highly expressed in ESCC and correlated with MMP-9, VEGF, clinicopathological features and prognosis. We speculated CXCR4 play an important role during the progression of this disease and there might be some regulatory mechanism existing between CXCR4 and MMP-9/VEGF in ESCC.

Celecoxib inhibits β-catenin-dependent survival of the human osteosarcoma MG-63 cell line

Cyclo-oxygenase (COX)-2 inhibitors may exert antitumour effects through COX-2-independent mechanisms. This study investigated the effects of the COX-2 inhibitor celecoxib on the viability of the human osteosarcoma MG-63 cell line and its β-catenin signalling pathway. Cell viability and apoptosis were examined in celecoxib-treated cells or after β-catenin knockdown in vitro. Analyses were performed to detect glycogen synthase kinase (GSK)-3β, phosphorylated GSK-3β, β-catenin, c-Myc and cyclin D1 proteins, and mRNA levels of β-catenin, c-Myc and CCND1 (encoding cyclin D1). β-Catenin was shown to be required for MG63 cell survival and celecoxib exerted an inhibitory effect on the viability of cultured MG-63 cells in a time- and dose-dependent manner. β-Catenin protein decreased in the cytosol and nucleus following celecoxib treatment (from 6 h after initiation of treatment onwards; lowest protein levels were reached at > 72 h). Significant reductions in β-catenin, c-Myc and CCND1 mRNA were observed. Celecoxib inhibited MG-63 cell viability, possibly by activating GSK-3β and inhibiting β-catenin-dependent gene transcription, suggesting a role for celecoxib in osteosarcoma treatment.

Glycine and a glycine dehydrogenase (GLDC) SNP as citalopram/escitalopram response biomarkers in depression: pharmacometabolomics-informed pharmacogenomics

Major depressive disorder (MDD) is a common psychiatric disease. Selective serotonin reuptake inhibitors (SSRIs) are an important class of drugs used in the treatment of MDD. However, many patients do not respond adequately to SSRI therapy. We used a pharmacometabolomics-informed pharmacogenomic research strategy to identify citalopram/escitalopram treatment outcome biomarkers. Metabolomic assay of plasma samples from 20 escitalopram remitters and 20 nonremitters showed that glycine was negatively associated with treatment outcome (P = 0.0054). This observation was pursued by genotyping tag single-nucleotide polymorphisms (SNPs) for genes encoding glycine synthesis and degradation enzymes, using 529 DNA samples from SSRI-treated MDD patients. The rs10975641 SNP in the glycine dehydrogenase (GLDC) gene was associated with treatment outcome phenotypes. Genotyping for rs10975641 was carried out in 1,245 MDD patients in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, and its presence was significant (P = 0.02) in DNA taken from these patients. These results highlight a possible role for glycine in SSRI response and illustrate the use of pharmacometabolomics to "inform" pharmacogenomics.

Multivariate models to detect genomic signatures for a class of drugs: application to thiopurines pharmacogenomics

Often, analysis for pharmacogenomic studies involving multiple drugs from the same class is completed by analyzing each drug individually for association with genomic variation. However, by completing the analysis of each drug individually, we may be losing valuable information. When studying multiple drugs from the same drug class, one may wish to determine genomic variation that explains the difference in response between individuals for the drug class, as opposed to each individual drug. Therefore, we have developed a multivariate model to assess whether genomic variation impacts a class of drugs. In addition to determine genomic effects that are similar for the drugs, we will also be able to determine genomic effects that differ between the drugs (that is, interaction). We will illustrate the utility of this multivariate model for cytotoxicity and genomic data collected on the Coriell Human Variation Panel for the class of anti-purine metabolites (6-mercaptopurine and 6-thioguanine).

Catechol O-methyltransferase pharmacogenomics and selective serotonin reuptake inhibitor response

We applied a systematic pharmacogenetic approach to investigate the role of genetic variation in the gene encoding catechol O-methyltransferase (COMT) in individual variation in selective serotonin reuptake inhibitor (SSRI) response among depressed patients. In all, 23 single-nucleotide polymorphisms (SNPs) in COMT were genotyped using DNA from the Sequenced Treatment Alternatives to Relieve Depression (STAR(*)D) study (N=1914). One SNP, rs13306278, located in the distal promoter region of COMT, showed significant association with remission in White non-Hispanic (WNH) subjects (P=0.038). Electromobility shift assay for rs13306278 showed alternation in the ability of the variant sequence to bind nuclear proteins. A replication study was performed using samples from the Mayo Clinic Pharmacogenetics Research Network Citalopram/Escitalopram Pharmacogenomic study (N=422) that demonstrated a similar trend for association. Our findings suggest that novel genetic markers in the COMT distal promoter may influence SSRI response phenotypes.

The role of fibroblast Tiam1 in tumor cell invasion and metastasis

The co-evolution of tumors and their microenvironment involves bidirectional communication between tumor cells and tumor-associated stroma. Various cell types are present in tumor-associated stroma, of which fibroblasts are the most abundant. The Rac exchange factor Tiam1 is implicated in multiple signaling pathways in epithelial tumor cells and lack of Tiam1 in tumor cells retards tumor growth in Tiam1 knock-out mouse models. Conversely, tumors arising in Tiam1 knock-out mice have increased invasiveness. We have investigated the role of Tiam1 in tumor-associated fibroblasts as a modulator of tumor cell invasion and metastasis, using retroviral delivery of short hairpin RNA to suppress Tiam1 levels in three different experimental models. In spheroid co-culture of mammary epithelial cells and fibroblasts, Tiam1 silencing in fibroblasts led to increased epithelial cell outgrowth into matrix. In tissue-engineered human skin, Tiam1 silencing in dermal fibroblasts led to increased invasiveness of epidermal keratinocytes with premalignant features. In a model of human breast cancer in mice, co-implantation of mammary fibroblasts inhibited tumor invasion and metastasis, which was reversed by Tiam1 silencing in co-injected fibroblasts. These results suggest that stromal Tiam1 may play a role in modulating the effects of the tumor microenvironment on malignant cell invasion and metastasis. This suggests a set of pathways for further investigation, with implications for future therapeutic targets.

Active biomonitoring of complex pollution in Taihu Lake with Carassius auratus

Carassius auratus bred in clean water were selected to conduct active biomonitoring (ABM) exposures in Meiliang and Gong bays in the northern polluted area of Taihu Lake. The biotransformation enzymes 7-ethoxyresorufin-O-deethylase (EROD) and glutathione S-transferase (GST), antioxidant enzymes glutathione peroxidase (GP(X)), reduced glutathione (GSH) content and superoxide dismutase (SOD) and lipoperoxidation (as TBARS) in liver were determined as biomarkers during the field exposure period. At the same time, the contents of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and heavy metals in the surface sediments of biomonitoring sites were measured. The total PAH concentrations ranged from 248.8 to 375.9microgkg(-1) dry weight, PCB from 1.26 to 2.41microgkg(-1), OCP from 0.15 to 2.06microgkg(-1), and heavy metal from 126.3 to 210.0mgkg(-1). The results indicate that complex pollution by persistent organic pollutants and heavy metals is present in the northern end of Taihu Lake and the in situ exposed organisms were stressed. Moreover, Meilaing Bay is a more stressful place to fish living there. The integrated biomarker response (IBR) was calculated by combining different biomarkers to single value, which can be used to describe the toxically-induced stress level of populations in different areas. Pollutant concentrations were displayed as star plots and compared to IBR star plots. There was a visual correlation between the PCB gradient and the OCP gradient measured in the sediments and the IBR variation.

Transplanted bone morphogenetic protein/poly(lactic-co-glycolic acid) delayed-release microcysts combined with rat micromorselized bone and collagen for bone tissue engineering

This study was designed to optimize the preparation of delayed-release microcysts containing bone morphogenetic protein 2 (BMP-2) combined with poly(lactic-co-glycolic acid) (PLGA) and to investigate their osteogenic properties when combined with rat autologous micromorselized bone and collagen. Rat autologous micromorselized bone, collagen and BMP-2/PLGA delayed-release microcysts were implanted in various combinations into the rat gluteus maximus muscle sack model. The following post-operative measurements were made: general observations of the implant site, histological observations, osteogenesis measurements and alkaline phosphatase activity. Autologous micromorselized bone combined with collagen and BMP-2/PLGA delayed-release microcysts demonstrated significantly superior osteogenic properties than any of the other combinations of these three components. These findings suggest that micromorselized bone combined with collagen and BMP-2/PLGA delayed-release microcysts could reduce the quantity of BMP-2 and autologous bone required for these procedures, making their use feasible in human bone restoration.

A novel HLA-DRB1*120204 allele found in a Chinese individual

The HLA-DRB1*120204 allele differs by a single synonymous nucleotide change from the DRB1*120201 allele at position 203 in exon 2 from C to G.

Predictive values of clinical and pathological parameters for malignancy of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) possess a wide spectrum of biological properties, from indolent to highly aggressive. In this study, we evaluated a set of clinical and pathological parameters for their predicative values for malignancy of GISTs by retrospective reviews of tumor specimens and their relevant medical records from 840 patients. All GIST cases were first assigned as malignant if they met any of the following criteria: gross spreads, including liver metastassis and/or peritoneal dissemination, microscopic spreads, including lymph node metastasis, infiltrations to vascular, fat, nerve and muscularis mucosal tissues, or relapse. The remaining cases were recorded as biological behavior uncertain. This initial assignment revealed a set of five morphological features to be associated with malignancy. They were: mitotic counts greater than 10 per 50HPFs (P<0.0001), muscularis propria infiltration (P<0.0001), coagulative necrosis (P<0.0001), perivascular growth pattern (P=0.005), and severe nuclear atypia (P=0.014). Therefore, a new classification system, including criteria of 2 gross spreads, 5 microscopic spreads, and 5 histopathological parameters was developed. All the GIST cases were re-classified into a group of 485 malignant tumors, and a group of 355 nonmalignant tumors. Patient follow-up data revealed 5-year disease-free and overall survival rates as high as 99.3% and 100% for the nonmalignant group, but low rates of 43.9% and 59.7% for the malignant group. These results demonstrated a correlation of the new classification with clinical outcomes. Therefore, this set of 12 parameters has predictive values for malignancy of GISTs, and is potentially useful in the grading of the tumors.

Analysis of signal pathway activation in hepatocellular carcinoma: Association with clinical outcomes to sorafenib in Chinese patients

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Background: The pathogenesis of hepatocellular carcinoma invovles multi-stage development of molecular aberrations affecting signaling pathways that regulate cancer growth and progression. Treatment strategies have focused on inhibition of the Ras effector pathway with inhibitors of Raf, such as sorafenib in HCC. Greater understanding of the cellular response to sorafenib is needed to tailor targeted therapy for individual patients and identify those more likely to benefit. Methods: We performed immunohistochemistry on a tissue microarray of tumor and adjacent liver tissue from 40 HBV-infected HCC patients who were treated with sorafenib, and 20 normal liver. We compared the levels of 8 signaling proteins including growth factor receptors (PDGFRa, VEGFR1, VEGFR2, VEGFR3, c-kit, c-met, IGF-R, EGFR), tumor suppressors (PTEN) and their downstream phosphorylated (p-) signal transducers (p-RAF, p-MEK1/2, p-ERK1/2; PI3K, p-AKT, NFkB, axin, β-catenin,p-GSK3β, p-mTOR, p-S6, p-70S6K, p-JNK, p-SRC, p-STAT3, c-fos, c-jun) in cancer cells and endothelial cells of HCC to those in non-neoplastic liver. Results: The overall profiles of signalling protein expression levels, activation states and subcellular distribution in HCC cells and endothelial cells were distinguishable from non-neoplastic hepatocytes. The ERK pathway activation was correlated with low level of nuclear β-cat and high level of p-mTOR (p<0.05). Long survival (>6m) patients were characterized by high level of nuclear pERK and low level of p-AKT, p-GSK3β (p<0.05) in tumor cells. The high microvessel density and the presence of micrometastases correlated with high level of VEGFR, p-ERK and p-SRC in endothelial cells. Conclusions: Sorafenib may affect signalling through the Ras/Raf/MAPK/ERK pathway. HBV-related HCC patients with. overactivation of signal transduction cascade MAPK/ERK and PI3K/AKT pathways in tumor cells and/or endothelial cells may benefit from the targeted treatment.

No significant financial relationships to disclose.

The patterns of care studies for operable breast cancer in China

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Background: To present the results of clinical practices for operable breast cancer (BC) in the developed areas of China during the past decade. Methods: Four academic levels of radiotherapy (RT) departments, located in the Southeast coast of China, were selected. A pattern of care study, about women with operated BC and post-operative RT during 1999 and 2006, was conducted. The recruited samples were evaluated for their medical files completeness at first. For qualified documentations, data collected included patient characteristics, clinical and pathologic features, and treatment course received. Frequencies and corresponding percentages were calculated and analyzed for comparisons between 1999 and 2006. Results: 97 in 1999 and 271 in 2006 were identified as qualified files. Patient's diagnosis median age were 48 (1996) and 46 (2006) years. The clinical staging with I, II, and III (UICC 1997) were in 11%, 69%, 13% of 1999 patients and 15%, 74%, 7% of the 2006. The pathological characteristics were clearly defined in 78% (1999) and 84% (2006), but hormonal receptors and Her2neu were performed in 59% and 0% in the 1999 vs. 73% (p < 0.05) and 1% in 2006 survey. As type and extent of surgery and RT, the percentage of conservative treatment was increased from 4% in 1999 to 12% in 2006 (p< 0.05), postmastectomy RT was done for all the others. The time interval from operation to initiation of RT were longer in 2006, the mean was delayed from 23.8 to 43.4 days. The axillary operation pattern including lymph node dissection, level I/II dissection, and sentinel lymph node biopsy (SLNB), were documented in 61%, 24%, and 8% of patients in 2006. For patients of 1999, no SLNB was performed and 16% with level I/II operation (p< 0.05). Systemic chemotherapy (CT) and/or hormonal therapy were used in 74% (1999) and 98% (2006) of patients respectively (p< 0.05). Anthracyclines and paclitaxel-based CT regimens use significantly increased between 1999 and 2006 (31% vs. 52% and 12% vs. 36%). Conclusions: The practice patterns established in this study provide a baseline data. The present results demonstrate a low level of compliance with Western guidelines of clinical practices with current BC standards and continued improvement in many categories. Establishment and widespread use of international guidelines in China are desirable.

No significant financial relationships to disclose.

Endogenous activated protein C signaling is critical to protection of mice from lipopolysaccaride-induced septic shock

SUMMARY BACKGROUND

Activated protein C (APC) is known to protect animals from sepsis. Endogenous protein C is important in protection. It is unknown whether the cytoprotective or anticoagulant properties of protein C (PC) are responsible for the protective effect of endogenous PC.

OBJECTIVE

To determine if signaling by endogenous activated protein C contributes to survival in sepsis.

METHODS

We used an immunochemical approach to either block all of the known activities of protein C using mAb MPC1609 or, alternatively, selectively block the anticoagulant activity of activated protein C while sparing some of its cytoprotective activities using mAb MAPC1591.

RESULTS

MPC1609 blocked APC binding to endothelium whereas MAPC1591 enhanced binding. MPC1609 prevented APC protection of endothelial barrier function whereas MAPC1591 did not. Injection of MPC1609, but not MAPC1591, with a sublethal dose of lipopolysaccharide (LPS) caused lethality. At 18 h, the mice injected with MPC1609 plus LPS had much higher interleukin-6 (IL-6) levels than mice injected with LPS alone or LPS plus MPC1591. In these mice treated with LPS plus MPC1609, higher blood urea nitrogen (BUN) and creatinine levels suggested that an acute renal failure might contribute to a slow clearance of IL-6.

CONCLUSIONS

These studies demonstrate for the first time that cytoprotective activities of APC, and not the anticoagulant activity, is required for protection in this sepsis model. Similar anti-human antibodies may prove useful in clinical conditions such as trauma and hemophilia where cytoprotection is desirable, but the anticoagulant activity of endogenous activated protein C may contribute to bleeding.

Up-regulated renal expression of TNF-α signalling adapter proteins in lupus glomerulonephritis

The role of tumour necrosis factor (TNF-α) signalling adapters in lupus nephritis (LN) is poorly understood. This study investigated renal expression of TNF-α and TNF signalling adapter proteins, including TNF receptor-associated death domain protein (TRADD), receptor-interacting protein (RIP) and TNF receptor-associated factor-2 (TRAF-2) in patients with LN. The renal expression of proliferating cell nuclear antigen (PCNA) and CD68 was also measured. The study showed that glomerular and tubular expression of TNF-α, TRADD, RIP and TRAF-2 was significantly up-regulated in class III and IV LN in which the intense staining was observed on the crescents, proximal and distal tubules and interstitial mononuclear cells. The number of PCNA-positive cells and CD68-positive cells (macrophages) was increased obviously in class III and IV LN. There was a correlation between the expression levels of TNF-α, TRADD, RIP, TRAF-2 and the number of PCNA-positive or CD68-positive cells and active index of renal pathology. These findings suggest that TNF-α and TNF-α adapters in patients with LN play a role in immunopathogenic injury via transmitting abnormal cell proliferating and proinflammatory signals. The findings have provided further insights into the role of TNF-α and its adapter proteins in the pathogenesis of LN and have important therapeutic implications.

Murine bone marrow mesenchymal stem cells cause mature dendritic cells to promote T-cell tolerance

Bone mesenchymal stem cells (BMSC) are attractive not only in regenerative medicine, but also for the treatment of autoimmune diseases and graft-versus-host disease. BMSC also play a role in enabling alloantigen tolerance. An in-depth mechanistic understanding of this phenomenon of tolerance could lead to novel cell-based therapies for autoimmune disease. We demonstrate here that co-culture of mature dendritic cells (DC) with BMSC in a transwell system (BMSC-DC) downregulated expression of the maturation marker, CD83 and CD80/86 co-stimulatory molecules on DC, while increasing their endocytic activity. This resulted in defective antigen presentation and co-stimulatory capacity of mature DC. Functionally, BMSC-DC have impaired T-cell stimulatory activity in a mixed lymphocyte reaction and orchestrate a shift from predominantly pro-inflammatory T-helper (Th)-1 to anti-inflammatory Th2 cells. While the expression of MHC II, CD80 and CD86 were upregulated on BMSC co-cultured with DC, these BMSC lacked the ability to stimulate T-cell proliferation. Taken together, these data suggest that the interaction between BMSC and DC modulates the immunoregulatory function of these cells in a coordinated manner, effectively skewing the immune response towards T-cell tolerance.