IL-12 and IL-10 production are differentially regulated by phosphatidylinositol 3-kinase in mast cells

The cellular mechanisms that directly regulate the production of pro- and anti-inflammatory cytokines after lipopolysaccharide (LPS) stimulation in mast cells are currently unresolved. The aim of this study was to clarify the role of phosphatidylinositol 3-kinase (PI3K) in the production of IL-12 and IL-10 in mouse bone marrow-derived mast cells (BMMCs), stimulated with Escherichia coli-derived LPS. LPS activates the PI3K signalling pathway; analysis of cytokine production following LPS stimulation of BMMCs revealed that inhibition of the PI3K pathway differentially regulated IL-10 and IL-12 syntheses. IL-12 production was enhanced, whereas IL-10 levels were suppressed. Inhibition of LPS-mediated activation of the PI3K pathway resulted in a pronounced reduction of NF-κB activity that was dependent on IκBα phosphorylation. These findings demonstrate a regulatory function for PI3K in modulating IL-10 and IL-12 production in mast cells and provide insight into how engagement of the PI3K pathway affects the induction of key immunoregulatory cytokines that control both qualitative and quantitative aspects of early inflammation.

SU-E-J-119: Comparative Evaluation of Respiratory Motion-Corrected Cone-Beam CT Images Derived from Treatment-Day Vs. Simulation-Day Respiration-Correlated CT Scans

PURPOSE

Respiration-induced motion artifacts in cone-beam CT (CBCT) can be corrected using a model of patient motion obtained from respiration-correlated CT (RCCT). This approach assumes that respiration-induced organ deformations at simulation, when RCCT scans are normally acquired, are still valid at treatment. The purpose of this study is to compare lung tumor image quality in motion-corrected CBCT images derived from treatment-day RCCT(tx) to simulation-day RCCT(sim) patient images.

METHODS

In an IRB-approved study, lung cancer patients receive an RCCT at simulation, and an RCCT, gated CBCT and 1-minute CBCT at one treatment session. CBCT projections from the 1-minute scan are sorted according to breathing amplitude from an external monitor and reconstructed and warped to obtain a motion-corrected MC-CBCT at end expiration. Motion correction uses a model adapted from either RCCT(tx) or RCCT(sim), thus obtaining MC-CBCT(tx) and MC-CBCT(sim) images respectively. A gated CBCT, in which gantry rotation and projection acquisition occur within a gate at end expiration, serves as ground truth for comparison. Quality of MC-CBCT images is evaluated from tumor-to-background contrast ratio (TBCR) values measured by delineating the tumor and annular volume around it on the gated CBCT then transferring the contours and aligning them to each MC-CBCT.

RESULTS

TBCR is found tobe lower in MC-CBCT(sim) images, relative to MC-CBCT(tx), in four out of five patients with mean 21% reduction in a range 9-39%. In the remaining case, where there was no change in TBCR, tumor motion observed in the RCCT was small (2mm). Tumor motion extent relative to diaphragm is observed to change between RCCT(tx) and RCCT(sim) scans.

CONCLUSIONS

Preliminary results indicate that deformation patterns in lung do change between simulation and treatment. Such variations may reduce the validity of using simulation data for motion-corrected CBCT at treatment. The findings require confirmation with larger numbers of patients. NIH/NCI award R01 CA126993, research grant from Varian Medical Systems.

An efficacy analysis for nasopharyngeal carcinoma screening of different screening intervals

OBJECTIVE

To evaluate the impact of different screening intervals on screening for nasopharyngeal carcinoma (NPC).

METHODS

A Markov model was constructed, based on the natural history of NPC. The 5-year mortality rate of NPC was the major measurement to evaluate the efficacies of 16 screening strategies. Parameters for the model were derived from published literature.

RESULTS

Screening reduced the 5-year mortality rate for NPC by 20.4 - 43.3%, compared with the equivalent rate without screening. The 5 year mortality rate and the NPC pick-up rate with strategy A1 (annual screening) were 23.6% and 83.9%, respectively. Compared with strategy A1, strategy B1 (annual screening for seropositive subjects; biennial screening for seronegative subjects) had a similar 5-year mortality rate (24.0%) and a slightly smaller NPC pick-up rate (81.7%), but led to a 39.3% reduction in total screenings. Compared with all other strategies excluding strategy A1, strategy B1 achieved the lowest 5-year mortality rate and the largest NPC pick-up rate.

CONCLUSIONS

Strategy B1 had the highest efficacy for NPC screening.

Mode-dependent effect of high-frequency electrical stimulation of the anterior thalamic nucleus on amygdala-kindled seizures in rats

Deep brain stimulation (DBS) is an emerging treatment of epilepsy. Anterior nucleus of the thalamus (ANT) is considered to be an attractive target due to its close connection to the limbic structures and wide regions of neocortex. The present study aimed to investigate the effects of high frequency stimulation (HFS) targeting the ANT on amygdala-kindled seizures in Wistar rats in two different stimulation modes i.e. pre-treatment and post-treatment stimulations, mimicking the scheduled and responsive stimulations in clinical use respectively. When fully-kindled seizures were achieved by daily amygdala kindling (1 s train of 1 ms pulses at 60 Hz), HFS (15 min train of 100 μs pulses at 150 Hz and 450-800 μA) was applied in two modes for 10 days. Bilateral post-treatment with HFS reduced the incidence of generalized seizures and the mean behavioral seizure stage and shortened average afterdischarge duration (ADD) and generalized seizure duration (GSD), while bilateral pre-treatment with HFS resulted in a similar but much weaker inhibition of seizures. On the other hand, we also found the two stimulation modes both increased the afterdischarge threshold (ADT) and the differences of current intensity between ADT and generalized seizure threshold (GST) i.e. Δ(GST-ADT). However, Δ(GST-ADT) increased by at least 20 μA in bilateral post-treatment group, while less in bilateral pre-treatment group. Additionally, unilateral post-treatment with HFS failed to inhibit seizures. Our data show that anti-epileptic effect of bilateral post-treatment with HFS of ANT is much stronger than that of bilateral pre-treatment HFS, indicating bilateral responsive stimulation might be more appropriate for clinical anti-epileptic treatment of ANT HFS.

The probiotic Bacillus licheniformis ameliorates heat stress-induced impairment of egg production, gut morphology, and intestinal mucosal immunity in laying hens

We investigated the effect of a 12-d exposure to 34°C plus dietary inclusion of the probiotic Bacillus licheniformis on the egg production, gut morphology, and intestinal mucosal immunity of laying hens. Ninety-six commercial hens (Hy-Line Brown) at the age of 60 wk were randomly allocated to 4 groups. After a period of laying rate adjustment (14 d), all the hens were subjected to 2 temperature treatments (12 d). Birds in 1 group were raised at 21°C and fed a basal diet, and birds in the other 3 groups were raised at 34°C and fed a basal diet supplemented with 0, 10(6), or 10(7) cfu of B. licheniformis per gram of feed, respectively. Rearing at 34°C depressed egg production and feed intake (P < 0.05). Compared with birds kept at 21°C, birds kept at 34°C had elevated serum levels of tumor necrosis factor-α (d 6), IL-1 (d 6 and 12), and corticosterone (d 6); decreased villus height (ileum: d 6; cecum: d 6 and 12) and ratio of villus height to crypt depth (ileum: d 6; cecum: d 6 and 12); fewer intraepithelial lymphocytes (ileum: d 6; cecum: d 6) and IgA-secreting cells (ileum: d 6; cecum: d 6 and 12); and more mast cells (ileum: d 6; cecum: d 6 and 12; P < 0.05). The number of goblet cells in the cecum increased at d 6 in heat-treated birds, and then deceased at d 12 (P < 0.05). Moreover, morphological examination showed injury to the villi of birds kept at 34°C. In general, inclusion of 10(7) cfu/g of B. licheniformis in the diet of heat-stressed hens was effective in overcoming the observed decline in egg production and feed intake, restoring the impaired villus structure, and sustaining a balanced mucosal immune response. Therefore, the probiotic B. licheniformis may be useful for ameliorating the adverse influence of heat on the egg production and gut health of laying hens.

Artemisiae capillaris herba induces prolonged survival of fully cardiac allografts and generates regulatory cells in mice

Inchingorei-san (TJ-117), a 6-component herbal medicine, is used in Japan for the treatment of vomiting, urticaria, and liver and kidney disorders with few side effects. In this study we investigated the effect of TJ-117 on alloimmune responses in murine cardiac allograft transplantation. CBA (H2(k)) mice underwent transplantation of a C57BL/6 (B6, H2(b)) heart with oral administration of TJ-117 (or 1 component of TJ-117) from the day of transplantation for 7 days. CBA recipients given 1 g/kg/d of TJ-117 showed prolonged B6 allograft survival (median survival time [MST], 23 days). Naive CBA mice rejected B6 cardiac grafts acutely (MST, 7 days). Moreover, Artemisiae capillaris herba (ACH; 1g/kg/d) 1 component of TJ-117, significantly prolonged B6 allograft survival (MST, > 100 days). However, the other 5 components of TJ-117 were individually less effective than TJ-117 or ACH. ACH also suppressed splenocyte proliferation and interferon-γ production. Secondary CBA recipient showed prolonged survival of B6 hearts after treatments with whole splenocytes from primary ACH-treated CBA recipients carrying B6 cardiac allografts for 30 days (MST, >50 days). Flow cytometry studies showed increased CD4(+)CD25(+)Foxp3(+) regulatory cells in transplant recipients given ACH. In conclusion, ACH, 1 component of TJ-117, as well as TJ-117 induced hyporesponsiveness to fully allogeneic cardiac allografts with generation of CD4(+)CD25(+)Foxp3(+) regulatory cells.

SLICC/ACR damage index independently associated with left ventricular diastolic dysfunction in patients with systemic lupus erythematosus

Left ventricular (LV) diastolic dysfunction has been reported in both active and inactive systemic lupus erythematosus (SLE) patients without clinical evidence of cardiovascular disease. However, the relationship between the long-term inflammatory burden reflected by the SLICC/ACR damage index and LV diastolic function has not been studied. Eighty-two SLE patients and 82 controls matched for age, sex, body mass index, blood pressure and heart rate underwent echocardiography with tissue Doppler imaging (TDI). LV diastolic function was estimated by the myocardial early diastolic velocity (E') at the lateral annulus. There were 51 patients (62.2%) with nephritis, 23 patients (28.0%) with hypertension, 21 patients (25.6%) with vasculitis, 16 patients (19.5%) with pulmonary hypertension, 4 patients (4.9%) with cerebrovascular disease and 2 patients (2.4%) with diabetes mellitus. Sixty-two patients (75.6%) were taking prednisone and 35 patients (42.7%) used a immunosuppressant. Forty-five patients (54.8%) had active disease and suffered from disease-related end-organ damage. Patients with SLICC/ACR damage index ≥1 had more evidence of LV diastolic dysfunction with lower lateral annulus E' (9.6 ± 3.4 vs 12.9 ± 3.5 cm/s, p < 0.001) than those without. In addition, the proportion of patients with abnormal LV myocardial relaxation (defined as lateral E' < 10.0 cm/s) (51.1% vs 16.2%, χ(2) = 10.8, p = 0.001) were significantly higher. Multivariate analysis showed that the SLICC/ACR damage index ≥1 was independently associated with LV diastolic dysfunction (OR = 3.80, 95%CI: 1.21-11.95, p = 0.023) after adjusting for hypertension, disease duration and medical therapy. This may suggest that the overall inflammatory burden in SLE, as reflected by SLICC/ACR damage index, is associated with the development of diastolic dysfunction in SLE patients.

Genome-wide association studies for hematological traits in swine

Improving immune capacity may increase the profitability of animal production if it enables animals to better cope with infections. Hematological traits play pivotal roles in animal immune capacity and disease resistance. Thus far, few studies have been conducted using a high-density swine SNP chip panel to unravel the genetic mechanism of the immune capability in domestic animals. In this study, using mixed model-based single-locus regression analyses, we carried out genome-wide association studies, using the Porcine SNP60 BeadChip, for immune responses in piglets for 18 hematological traits (seven leukocyte traits, seven erythrocyte traits, and four platelet traits) after being immunized with classical swine fever vaccine. After adjusting for multiple testing based on permutations, 10, 24, and 77 chromosome-wise significant SNPs were identified for the leukocyte traits, erythrocyte traits, and platelet traits respectively, of which 10 reached genome-wise significance level. Among the 53 SNPs for mean platelet volume, 29 are located in a linkage disequilibrium block between 32.77 and 40.59 Mb on SSC6. Four genes of interest are located within the block, providing genetic evidence that this genomic segment may be considered a candidate region relevant to the platelet traits. Other candidate genes of interest for red blood cell, hemoglobin, and red blood cell volume distribution width also have been found near the significant SNPs. Our genome-wide association study provides a list of significant SNPs and candidate genes that offer valuable information for future dissection of molecular mechanisms regulating hematological traits.

Utilization of lightflecks by seedlings of five dominant tree species of different subtropical forest successional stages under low-light growth conditions

We selected five typical tree species, including one early-successional species (ES) Pinus massoniana Lamb., two mid-successional species (MS) Schima superba Gardn. et Champ. and Castanopsis fissa (Champ. ex Benth.) Rehd. et Wils. and two late-successional species (LS) Cryptocarya concinna Hance. and Acmena acuminatissima (BI.) Merr et Perry., which represent the plants at three successional periods in Dinghushan subtropical forest succession of southern China. Potted seedlings of the five species were grown under 12% of full sunlight for 36 months. The ES and MS showed the slowest and fastest responses to lightflecks, respectively, which correlated with the rate of stomatal opening. In contrast to P. massoniana and C. concinna, the other three species exhibited a high induction loss. Early-successional species showed the lowest specific leaf area and chlorophyll content, the highest photosynthetic capacity (A(max)) and respiratory carbon losses (R(d)). Compared with ES and MS, LS showed lower A(max) and R(d). The five tree species showed a similar chlorophyll a/b ratio after long-term low-light adaptations. On the other hand, LS had a relatively higher de-epoxidation state to protect themselves from excess light during lightflecks. Our results indicated that (i) slower responses to lightflecks could partially explain why ES species could not achieve seedling regeneration in low-light conditions; (ii) fast responses to lightflecks could partially explain why MS species could achieve seedling regeneration in low-light conditions; and (iii) smaller respiratory carbon losses might confer on the LS species a competitive advantage in low-light conditions.

Evaluation of deformable image registration and a motion model in CT images with limited features

Deformable image registration (DIR) is increasingly used in radiotherapy applications and provides the basis for a previously described model of patient-specific respiratory motion. We examine the accuracy of a DIR algorithm and a motion model with respiration-correlated CT (RCCT) images of software phantom with known displacement fields, physical deformable abdominal phantom with implanted fiducials in the liver and small liver structures in patient images. The motion model is derived from a principal component analysis that relates volumetric deformations with the motion of the diaphragm or fiducials in the RCCT. Patient data analysis compares DIR with rigid registration as ground truth: the mean ± standard deviation 3D discrepancy of liver structure centroid positions is 2.0 ± 2.2 mm. DIR discrepancy in the software phantom is 3.8 ± 2.0 mm in lung and 3.7 ± 1.8 mm in abdomen; discrepancies near the chest wall are larger than indicated by image feature matching. Marker's 3D discrepancy in the physical phantom is 3.6 ± 2.8 mm. The results indicate that visible features in the images are important for guiding the DIR algorithm. Motion model accuracy is comparable to DIR, indicating that two principal components are sufficient to describe DIR-derived deformation in these datasets.

Multivesicular exocytosis in rat pancreatic beta cells

AIMS/HYPOTHESIS

To establish the occurrence, modulation and functional significance of compound exocytosis in insulin-secreting beta cells.

METHODS

Exocytosis was monitored in rat beta cells by electrophysiological, biochemical and optical methods. The functional assays were complemented by three-dimensional reconstruction of confocal imaging, transmission and block face scanning electron microscopy to obtain ultrastructural evidence of compound exocytosis.

RESULTS

Compound exocytosis contributed marginally (<5% of events) to exocytosis elicited by glucose/membrane depolarisation alone. However, in beta cells stimulated by a combination of glucose and the muscarinic agonist carbachol, 15-20% of the release events were due to multivesicular exocytosis, but the frequency of exocytosis was not affected. The optical measurements suggest that carbachol should stimulate insulin secretion by ∼40%, similar to the observed enhancement of glucose-induced insulin secretion. The effects of carbachol were mimicked by elevating [Ca(2+)](i) from 0.2 to 2 μmol/l Ca(2+). Two-photon sulforhodamine imaging revealed exocytotic events about fivefold larger than single vesicles and that these structures, once formed, could persist for tens of seconds. Cells exposed to carbachol for 30 s contained long (1-2 μm) serpentine-like membrane structures adjacent to the plasma membrane. Three-dimensional electron microscopy confirmed the existence of fused multigranular aggregates within the beta cell, the frequency of which increased about fourfold in response to stimulation with carbachol.

CONCLUSIONS/INTERPRETATION

Although contributing marginally to glucose-induced insulin secretion, compound exocytosis becomes quantitatively significant under conditions associated with global elevation of cytoplasmic calcium. These findings suggest that compound exocytosis is a major contributor to the augmentation of glucose-induced insulin secretion by muscarinic receptor activation.

Establishing a new electrical conduction pathway by anastomosis of the right auricle and right ventricle assisted by mesenchymal stem cells in a canine model

BACKGROUND

Electronic pacemakers are the primary treatment of complete atrioventricular (AV) block, but their use is associated with many complications. The aim of the present study was to create an alternative treatment for these patients.

MATERIALS AND METHODS

Mesenchymal stem cells (MSCs) isolated from the bone marrow of a 3-month-old dog were cultured in vitro. The MSCs were labeled with 4', 6-diamidino-2-phenylindole (DAPI) before transplantation. We anastomosed the right auricle and right ventricle in 24 dogs, and transplanted labelled MSCs into the anastomotic area of 8 dog hearts. Using immunostaining we assessed survival and differentiation of the implanted cells at 8 weeks posttransplantation. Electrocardiography confirmed the secondary electrical conduction pathway.

RESULTS

The ventricular current was captured by the electronic pacemaker in 21 dogs. Compared with the control group (surgery alone), pacemaker stimulus current was significantly less in the MSC group (surgery+MSCs).

CONCLUSIONS

Anastomosis of the right auricle and right ventricle assisted by MSCs may be a new treatment for patients with complete AV block in the future.

An intelligent multi-restart memetic algorithm for box constrained global optimisation

In this paper, we propose a multi-restart memetic algorithm framework for box constrained global continuous optimisation. In this framework, an evolutionary algorithm (EA) and a local optimizer are employed as separated building blocks. The EA is used to explore the search space for very promising solutions (e.g., solutions in the attraction basin of the global optimum) through its exploration capability and previous EA search history, and local search is used to improve these promising solutions to local optima. An estimation of distribution algorithm (EDA) combined with a derivative free local optimizer, called NEWUOA (M. Powell, Developments of NEWUOA for minimization without derivatives. Journal of Numerical Analysis, 28:649-664, 2008), is developed based on this framework and empirically compared with several well-known EAs on a set of 40 commonly used test functions. The main components of the specific algorithm include: (1) an adaptive multivariate probability model, (2) a multiple sampling strategy, (3) decoupling of the hybridisation strategy, and (4) a restart mechanism. The adaptive multivariate probability model and multiple sampling strategy are designed to enhance the exploration capability. The restart mechanism attempts to make the search escape from local optima, resorting to previous search history. Comparison results show that the algorithm is comparable with the best known EAs, including the winner of the 2005 IEEE Congress on Evolutionary Computation (CEC2005), and significantly better than the others in terms of both the solution quality and computational cost.

Novel brain targeting prodrugs of naproxen based on dimethylamino group with various linkages

As a preventive and treatment drug for Alzheimer's disease (AD), naproxen's clinical application is hampered by its limited distribution in the brain. To increase the delivery of naproxen across the blood-brain barrier (BBB), 3 prodrugs (P1, P2 and P3) of naproxen were synthesized through either ester bond or amido bond using the dimethylamino moiety as a brain-targeting ligand. The in vitro release of naproxen from the 3 prodrugs was studied in PBS, rat plasma and brain homogenate. P3 with an amido bond appeared to be highly stable in all incubation media, whereas P1 and P2 with ester bonds were partially hydrolyzed in alkaline environment and brain homogenate to yield the parent drug. After i. v. administration to rats, the brain concentration of total naproxen (summation of released and bound naproxen, TN) of P1, P2 and P3 groups were 28.81, 24.51 and 15.54 times greater than that of the control naproxen group at 5 min, respectively, and the brain AUC0-t were 6.94, 10.06 and 6.70 times greater than that of the control naproxen group. In addition, the Cmax of TN in the brain after the administration of prodrugs with ester bonds (P1 and P2) was higher than that of the amide prodrug (P3). The results highlighted the possibility of brain delivery of naproxen using prodrug strategies based on the brain-targeting ligand with dimethylamino moiety, in which the linkage between drug and targeting group might play an important role in modulating the in vivo behaviors of these prodrugs.

Integration of proteomics into systems biology of cancer

Deciphering the complexity and heterogeneity of cancer, benefits from integration of proteomic level data into systems biology efforts. The opportunities available as a result of advances in proteomic technologies, the successes to date, and the challenges involved in integrating diverse datasets are addressed in this review.

Ribosomal protein S14 unties the MDM2-p53 loop upon ribosomal stress

The MDM2-p53 feedback loop is crucially important for restricting p53 level and activity during normal cell growth and proliferation, and is thus subjected to dynamic regulation in order for cells to activate p53 upon various stress signals. Several ribosomal proteins, such as RPL11, RPL5, RPL23, RPL26 or RPS7, have been shown to have a role in regulation of this feedback loop in response to ribosomal stress. Here, we identify another ribosomal protein S14, which is highly associated with 5q-syndrome, as a novel activator of p53 by inhibiting MDM2 activity. We found that RPS14, but not RPS19, binds to the central acidic domain of MDM2, similar to RPL5 and RPL23, and inhibits its E3 ubiquitin ligase activity toward p53. This RPS14-MDM2 binding was induced upon ribosomal stress caused by actinomycin D or mycophenolic acid. Overexpression of RPS14, but not RPS19, elevated p53 level and activity, leading to G1 or G2 arrest. Conversely, knockdown of RPS14 alleviated p53 induction by these two reagents. Interestingly, knockdown of either RPS14 or RPS19 caused a ribosomal stress that led to p53 activation, which was impaired by further knocking down the level of RPL11 or RPL5. Together, our results demonstrate that RPS14 and RPS19 have distinct roles in regulating the MDM2-p53 feedback loop in response to ribosomal stress.

Enzymatic synthesis oF L-tryptophan from D,L-2-amino-delta2-thiazoline-4-carboxylic acid and indole by Pseudomonas sp. TS1138 L-2-amino-delta2-thiazoline-4-carboxylic acid hydrolase, S-carbamyl-L-cysteine amidohydrolase, and Escherichia coli L-tryptophanase

L-Tryptophan (L-Trp) is an essential amino acid. It is widely used in medical, health and food products, so a low-cost supply is needed. There are 4 methods for L-Trp production: chemical synthesis, extraction, enzymatic synthesis, and fermentation. In this study, we produced a recombinant bacterial strain pET-tnaA of Escherichia coli which has the L-tryptophanase gene. Using the pET-tnaA E. coli and the strain TS1138 of Pseudomonas sp., a one-pot enzymatic synthesis of L-Trp was developed. Pseudomonas sp. TS1138 was added to a solution of D,L-2-amino-delta2-thiazoline-4-carboxylic acid (DL-ATC) to convert it to L-cysteine (L-Cys). After concentration, E. coli BL21 (DE 3) cells including plasmid pET-tnaA, indole, and pyridoxal 5'-phosphate were added. At the optimum conditions, the conversion rates of DL-ATC and L-Cys were 95.4% and 92.1%, respectively. After purifying using macroporous resin S8 and NKA-II, 10.32 g of L-Trp of 98.3% purity was obtained. This study established methods for one-pot enzymatic synthesis and separation of L-Trp. This method of producing L-Trp is more environmentally sound than methods using chemical synthesis, and it lays the foundations for industrial production of L-Trp from DL-ATC and indole.

Predictors of remission with placebo using an integrated study database from patients with major depressive disorder

OBJECTIVE

To identify predictors of remission with placebo treatment in double-blind randomized controlled trials (RCTs) in major depressive disorder (MDD).

METHOD

A total of 1017 placebo-treated patients with baseline Hamilton Depression rating scale (HAMD) total ≥15 from eight duloxetine RCTs were included. Remission was defined as endpoint (7-8 weeks) HAMD total ≤7. Data were randomly split into training data (N = 813, 80%) for model selection and test data (N = 204, 20%) for validation. Logistic regression and classification and regression tree (CART) methods were used to identify predictors of remission. Predictive accuracy of models was assessed by Receiver Operator Characteristic (ROC) curves.

RESULTS

Baseline predictors for remission with placebo consistently identified with the logistic regression and CART analysis were less severe depressive symptoms (based on HAMD core symptoms), younger age, less anxiety (based on HAMD anxiety/somatization), and shorter current MDD episode duration. Associated cut-off values from the CART method characterized patient groups according to their remission likelihood. However, the predictive accuracy was modest for both methods with areas under the ROC curve of 0.6-0.65 based on test data.

CONCLUSION

The derived models, although of limited value for predicting remission in individual patients, may be useful for adjusting for placebo effects in clinical trials.