From MIF-1 to endomorphin: the Tyr-MIF-1 family of peptides

The Tyr-MIF-1 family of small peptides has served a prototypic role in the introduction of several novel concepts into the peptide field of research. MIF-1 (Pro-Leu-Gly-NH(2)) was the first hypothalamic peptide shown to act "up" on the brain, not just "down" on the pituitary. In several situations, including clinical depression, MIF-1 exhibits an inverted U-shaped dose-response relationship in which increasing doses can result in decreasing effects. This tripeptide also can antagonize opiate actions, and the first report of such activity also correctly predicted the discovery of other endogenous antiopiate peptides. The tetrapeptide Tyr-MIF-1 (Tyr-Pro-Leu-Gly-NH(2)) not only shows antiopiate activity, but also considerable selectivity for the mu-opiate binding site. Tyr-W-MIF-1 (Tyr-Pro-Trp-Gly-NH(2)) is an even more selective ligand for the mu receptor, leading to the discovery of two more Tyr-Pro tetrapeptides that have the highest specificity and affinity for this site. These are the endomorphins: endomorphin-1 is Tyr-Pro-Trp-Phe-NH(2) and endomorphin-2 is Tyr-Pro-Phe-Phe-NH(2). Tyr-MIF-1 proved, contrary to the then prevailing dogma, that peptides can be saturably transported across the blood-brain barrier by a quantifiable transport system. Unexpectedly, the Tyr-MIF-1 transporter is shared with Met-enkephalin. In the era in which it was doubtful whether a peripheral peptide could exert CNS effects, the Tyr-MIF-1 family of peptides also explicitly showed that they can exert more than one central action that persists longer than their half-lives in blood. These peptides clearly illustrate that the name of a peptide restricts neither its actions nor its conceptual implications.

Resveratrol enhances proliferation and osteoblastic differentiation in human mesenchymal stem cells via ER-dependent ERK1/2 activation

In the present study, we investigated the in vitro effect of resveratrol (RSVL), a polyphenolic phytoestrogen, on cell proliferation and osteoblastic maturation in human bone marrow-derived mesenchymal stem cell (HBMSC) cultures. RSVL (10(-8)-10(-5) M) increased cell growth dose-dependently, as measured by [(3)H]-thymidine incorporation, and stimulated osteoblastic maturation as assessed by alkaline phosphatase (ALP) activity, calcium deposition into the extracellular matrix, and the expression of osteoblastic markers such as RUNX2/CBFA1, Osterix and Osteocalcin in HBMSCs cell cultures. Further studies found that RSVL (10(-6)M) resulted in a rapid activation of both extracellular signal-regulated kinase 1/2 (ERK1/2) and p38 mitogen-activated protein kinase (MAPK) signaling in HBMSCs cultures. The effects of RSVL were mimicked by 17beta-estrodial (10(-8) M) and were abolished by estrogen receptor (ER) antagonist ICI182780. An ERK1/2 pathway inhibitor, PD98059, significantly attenuated RSVL-induced ERK1/2 phosphorylation, consistent with the reduction of cell proliferation and osteoblastic differentiation as well as expression of osteoblastic markers. In contrast, SB203580, a p38 MAPK pathway blocker, blocked RSVL-induced p38 phosphorylation, but resulted in an increase of cell proliferation and a more osteoblastic maturation. These data suggest that RSVL stimulates HBMSCs proliferation and osteoblastic differentiation through an ER-dependent mechanism and coupling to ERK1/2 activation.

The fasting polypeptide FGF21 can enter brain from blood

FGF21 recently has been proposed as a missing link in the biology of fasting, raising the question of whether it directly reaches the brain. We used multiple time-regression analysis to quantify the influx rate of this polypeptide across the blood-brain barrier (BBB), size-exclusion chromatography to examine degradation, capillary depletion to differentiate entry into brain parenchyma from retention in the microvasculature, and measurement of efflux rate to determine a possible confounding effect on measurement of entry. FGF21 was 94% intact in serum and 75% in brain 10 min after intravenous bolus delivery. Its influx rate was 0.23+/-0.12 microl/g-min, nearly four times faster than that of the vascular marker albumin. At 10 min, about 0.5% of the administered FGF21 was present in a gram of brain tissue. Of this, 70% reached the parenchyma of the brain. Co-injection of excess FGF21 failed to inhibit the influx, showing a lack of saturation. Efflux, which occurred at the same rate as the bulk reabsorption of cerebrospinal fluid, also was not saturable. In summary, FGF21 shows significant, non-saturable, unidirectional influx across the BBB.

Urocortin and the brain

Urocortin is a member of the corticotropin-releasing hormone (CRH) family of peptides. In the brain, its potent suppression of food intake is mediated by CRH receptors (CRHR). Urocortin also participates in the regulation of anxiety, learning, memory, and body temperature, and it shows neuroprotection. This review will summarize the location of urocortin-producing neurons and their projections, the pharmacological evidence of its actions in the CNS, and information acquired from knockout mice. Urocortin interacts with leptin, neuropeptide Y, orexin, and corticotropin in the brain. Also produced by the GI tract, heart, and immune cells, urocortin has blood concentrations ranging from 13 to 152 pg/ml. Blood-borne urocortin stimulates the cerebral endothelial cells composing the blood-brain barrier and crosses the blood-brain barrier by a unique transport system. Overall, urocortin acts on a broad neuronal substrate as a neuromodulator important for basic survival.

Nesfatin-1 crosses the blood-brain barrier without saturation

Nesfatin-1 is an 82 amino acid peptide that suppresses food intake after intracerebroventricular injection. Nesfatin-1 and its precursor NUCB2 were identified by subtraction cloning in cell lines of both neuronal and adipocytic origin. This provides a strong basis for studies to determine how peripherally derived nesfatin-1 permeates the blood-brain barrier (BBB) to participate in its CNS actions and whether pharmacological delivery by the peripheral route is feasible. In this study, nesfatin-1 remained stable in blood at least 20 min after intravenous injection and permeated the BBB by a non-saturable mechanism. The influx rate of nesfatin-1 after intravenous delivery was 0.27+/-0.11 microl/g-min, and 0.3% of nesfatin-1 reached brain parenchyma 10 min after injection. The lack of saturation of influx was shown by use of excess unlabeled nesfatin-1 in multiple-time regression analysis, capillary depletion, and in situ brain perfusion. After intracerebroventricular injection, nesfatin-1 had a half-time disappearance of 23.8 min, which was not significantly different from that of albumin. This indicates that nesfatin-1 exited the brain by bulk absorption of cerebrospinal fluid without a specific efflux transport system. We conclude that the permeation of nesfatin-1 is a non-saturable process in either the blood-to-brain or brain-to-blood direction. Thus, the limited penetration under physiological conditions does not limit the pharmacological delivery of this satiety peptide as a potential therapeutic agent.

Opposing effects of proteasomes and lysosomes on LIFR: modulation by TNF

The blood-brain barrier (BBB), a communicating interface for inflammation, transports cytokines through its endothelial cells. This study shows how tumor necrosis factor alpha (TNF) regulates the expression of the leukemia inhibitor factor receptor (LIFR) gp190 in RBE4 cells. The high expression of LIFR was rapidly downregulated by the proinflammatory agents lipopolysaccharide, TNF, and LIF. Downregulation by TNF affected LIFR endocytosis and lysosomal degradation, preceding decreased LIFR mRNA. Lysosomal inhibitors reversed the rapid disappearance of LIFR, whereas inhibition of the ubiquitin-proteasome pathway did not. Rather, blockade of proteasome activity, as well as inhibition of NFkappaB activation, reduced the basal expression of LIFR. Thus, NFkappaB activity and proteasome degradation of IkappaB stabilized LIFR and prevented its rapid lysosomal degradation. By a non-NFkappaB-mediated mechanism, TNF facilitated LIFR degradation and reduced LIFR activation indicated by pStat3. The novel opposite effects of proteasomes and lysosomes in controlling receptor expression shows the functional implications and interactions of circulating inflammatory cytokines in acutely modulating BBB activity.

TNF reduces LIF endocytosis despite increasing NFkappaB-mediated gp130 expression

To examine how the proinflammatory cytokine tumor necrosis factor alpha (TNF) modulates the response of cerebral microvessels to other cytokines, we used rat cerebral microvessel endothelial RBE4 cells to simulate the in vitro blood-brain barrier (BBB). The gp130 receptor, which is shared by the interleukin (IL)-6 family of cytokines, showed specific upregulation by TNF. TNF treatment (5 ng/ml for 30 min to 24 h) increased gp130 at both the levels of transcription and protein expression. The stability of gp130 protein was mediated by NFkappaB activity, as the inhibitors quinazoline and MG132 not only blocked the increase induced by 6 h of TNF treatment, but also reduced its basal level of expression. By contrast, the lysosomal inhibitor chloroquine and the extracellular regulated kinase inhibitor U0126 showed no effect. Despite the increase of gp130, TNF caused a significant reduction in the cell binding and endocytosis of leukemia inhibitory factor (LIF), another proinflammatory cytokine that binds to the gp130 co-receptor and its unique gp190 receptor. This is consistent with our previous findings that TNF reduces gp190 expression and Stat3 activation. Thus, TNF stimulation results in decreased responsiveness of RBE4 cells to LIF, indicating complex regulatory interactions of cytokines at the BBB.

Differential role of TNF receptors in cellular trafficking of intact TNF

BACKGROUND/AIMS

Although ligand signaling and degradation within the cell have received much attention, few studies have quantified the role of receptors on the transcytosis of ligand into and out of the cell in intact form. Accordingly, we determined the differential role of the two receptors for tumor necrosis factor alpha (TNFR1, TNFR2) on cellular transcytosis.

METHODS

TNFR1 and TNFR2 were overexpressed in HEK293 cells by transient transfection. Cell surface binding, endocytosis, and exocytosis of (125)I-TNF were quantified. Degradation was determined by acid precipitation and size-exclusion chromatography.

RESULTS

TNFR1- mediated uptake of TNF was faster than TNFR2-mediated uptake of TNF. TNFR2, however, exhibited greater capacity, leading to a higher percentage release of TNF into the exocytosis medium. Rather than being degraded, most of the TNF inside the cell remained intact for 1 h. Both receptors exerted protective roles against degradation, but there was no cooperativity between them.

CONCLUSION

The effects of TNFR1 and TNFR2 in shepherding TNF across the cell illustrate the differential roles of receptors on the cellular trafficking of the ligand in intact form so as to facilitate its biological effects.

Surfactant-mediated growth revisited

The x-ray structure analysis of the oxygen-surfactant-mediated growth of Ni on Cu(001) identifies up to 0.15 monolayers of oxygen in subsurface octahedral sites. This questions the validity of the general view that surfactant oxygen floats on top of the growing Ni film. Rather, the surfactant action is ascribed to an oxygen-enriched zone extending over the two topmost layers. Surface stress measurements support this finding. Our results have important implications for the microscopic understanding of surfactant-mediated growth and the change of the magnetic anisotropy of the Ni films.

Unexpected amplification of leptin-induced Stat3 signaling by urocortin: implications for obesity

Cooperativity among ingestive peptides reflects attempts by the body to finely control its weight. Urocortin, like leptin, is a potent suppressor of food intake, and they interact at the blood-brain barrier (BBB). After injection into the hypothalamus, urocortin can stimulate the release of leptin in the periphery. It is not known, however, whether urocortin, known to signal through adenylate cyclase and elevate cAMP, can potentiate signal transducer and activator of transcription (Stat) 1 and 3 signaling known to mediate the actions of leptin. We examined the interactions between urocortin and leptin signaling in two cellular systems: HEK293 cells and cerebral microvessel endothelial RBE4 cells, a model of the BBB. Both cell lines have low basal levels of CRHR1 and CRHR2 (receptors for urocortin) and ObRs (receptors for leptin). The cells were cotransfected with the receptors and luciferase reporters to determine the level of Stat1 or Stat3 activation 6 h after treatment with leptin, urocortin, or both. Urocortin induced significant Stat3 but not Stat1 activation, mediated by either CRHR1 or CRHR2. Leptin signaling by ObRb caused a large increase of both Stat1 and Stat3, and this was significantly potentiated by the addition of urocortin, being more robust for Stat3 than Stat1. The interactions of leptin and urocortin were not reciprocal, as leptin failed to further increase urocortin-mediated cAMP production. By unexpectedly potentiating leptin signaling through Stat, urocortin amplifies the cellular response of leptin. This novel phenomenon suggests that urocortin can play an important compensatory role during leptin resistance in obesity.

Mitogen-activated protein kinase signalling pathways triggered by the hepatitis C virus envelope protein E2: implications for the prevention of infection

OBJECTIVE

Hepatitis C virus (HCV) is a major pathogenic factor of liver diseases. During HCV infection, interaction of the envelope protein E2 of the virion, with target cells, is a crucial process for viral penetration into the cell and its propagation. We speculate that such interaction may trigger early signalling events required for HCV infection.

MATERIALS AND METHODS

Human liver cell line L-02 was treated with HCV E2. The kinase phosphorylation levels of mitogen-activated protein kinase (MAPK) signalling pathways in the treated cells were analyzed by Western blotting. The proliferation of the E2-treated cells was evaluated by MTT assay.

RESULTS

HCV E2 was shown to be an efficient activator for MAPK pathways. Levels of phosphorylation of upstream kinases Raf-1 and MEK1/2 were seen to be elevated following E2 treatment and similarly, phosphorylation levels of downstream kinases MAPK/ERK and p38 MAPK also increased in response to E2 treatment, and specificity of kinase activation by E2 was confirmed. E2-induced MAPK/ERK activation was inhibited by the MEK1/2 inhibitor U0126 in a concentration-dependent manner. Blockage of relevant cellular receptors reduced activation of Raf-1, MEK1/2, MAPK/ERK and p38 MAPK by E2, indicating efflux of the E2 signal from extracellular to the intracellular spaces. Thus, kinase cascades of MAPK pathways were continuously affected by E2 presence. Moreover, enhancement of cell proliferation by E2 appeared to be associated with the dynamic phosphorylation of MAPK/ERK and p38 MAPK.

CONCLUSION

These results suggest that MAPK signalling pathways triggered by E2 may be a potential target for prevention of HCV infection.

Tumor necrosis factor and stroke: role of the blood-brain barrier

The progression and outcome of stroke is affected by the intricate relationship between the blood-brain barrier (BBB) and tumor necrosis factor alpha (TNFalpha). TNFalpha crosses the intact BBB by a receptor-mediated transport system that is upregulated by CNS trauma and inflammation. In this review, we discuss intracellular trafficking and transcytosis of TNFalpha, regulation of TNFalpha transport after stroke, and the effects of TNFalpha on stroke preconditioning. TNFalpha can activate cytoprotective pathways by pretreatment or persistent exposure to low doses. This explains the paradoxical observation that transport of this proinflammatory cytokine improves the survival and function of hypoxic cells and of mice with stroke. The dual effects of TNFalpha may be related to differential regulation of TNFalpha trafficking downstream to TNFR1 and TNFR2 receptors. As we better understand how peripheral TNFalpha affects its own transport and modulates neuroregeneration, we may be in a better position to pharmacologically manipulate its regulatory transport system to treat stroke.

Convergent trafficking pattern of leptin after endocytosis mediated by ObRa-ObRd

The cellular effects of leptin are dependent on the receptor subtypes that mediate the signaling and fate of endocytosed leptin inside the cells. In this study, we examined the differences in receptor expression, endocytosis, intracellular degradation, and exocytosis of a trace amount of leptin in cells overexpressing ObRb and short forms of the leptin receptor. The relative contribution of proteasomes and lysosomes in the intracellular fate of leptin was also determined. There were three unusual findings: (1) all receptor subtypes could mediate the binding and endocytosis of leptin, although ObRb was expressed at a lower level than ObRa, ObRc, and ObRd after transient transfection. This indicates that ObRb can be a transporting receptor. (2) Once internalized, the intracellular degradation pattern and exocytosis of leptin were independent of the receptor subtype. (3) Endocytosed leptin could remain intact for at least 1 h. This stability was further enhanced by inhibition of lysosomal activity. Thus, the intracellular pool of intact leptin may allow prolonged biological functions for this adipokine.

Adipokines and the blood-brain barrier

Just as the blood-brain barrier (BBB) is not a static barrier, the adipocytes are not inert storage depots. Adipokines are peptides or polypeptides produced by white adipose tissue; they play important roles in normal physiology as well as in the metabolic syndrome. Adipokines secreted into the circulation can interact with the BBB and exert potent CNS effects. The specific transport systems for two important adipokines, leptin and tumor necrosis factor alpha, have been characterized during the past decade. By contrast, transforming growth factor beta-1 and adiponectin do not show specific permeation across the BBB, but modulate endothelial functions. Still others, like interleukin-6, may reach the brain but are rapidly degraded. This review summarizes current knowledge and recent findings of the rapidly growing family of adipokines and their interactions with the BBB.

TNFalpha trafficking in cerebral vascular endothelial cells

Using small tags, we tracked the pathway of tumor necrosis factor (TNF)alpha across cerebral vascular endothelial cells. In cerebral microvessel derived RBE4 cells, (125)I-TNFalpha had rapid endocytosis within the first 20 min and showed substantial exocytosis in the intact form. Biotinylated TNFalpha was detected at different time points after endocytosis by streptavidin-Quantum dots which showed its time-dependent colocalization with intracellular organelles. In mice, electron microscopic autoradiography after intravenous injection of (125)I-TNFalpha showed its transcytosis, as signals emerged on the abluminal side of the endothelial cells and reached brain parenchyma. The vesicular trafficking of TNFalpha reflects the immunomodulatory potential of peripheral cytokines for the CNS.

Mahogany, blood-brain barrier, and fat mass surge in AVY mice

Avy/agouti (Avy) mice have late onset obesity related to overexpression of agouti signaling protein (ASP) in the hypothalamus. As mahogany modulates the actions of ASP, we tested the transport of mahogany peptide across the blood-brain barrier (BBB). The brain uptake of mahogany peptide was significantly higher in young Avy mice, and it preceded the surge of fat mass quantified by nuclear magnetic resonance. The results suggest a role of accelerated BBB transport in the epigenetics of Avy mice.

Models of total and presumed wildlife sources of fecal coliform bacteria in coastal ponds

Models that accurately predict fecal coliform bacteria (FCB) concentrations, one of the most widely used measures of estuarine water quality, are needed to improve land use decision-making. Rapidly occurring changes in coastal land uses and the influence on water quality increases the urgency of having improved decision tools. For this study, samples were collected monthly from six coastal ponds, two tidal creeks and four shallow water wells for up to 212 years. These data were used along with other measures of environmental conditions and land classes within each watershed to construct quantitative relationships between combinations of variables and both total and presumed wildlife sources of FCB. Linear regression, bootstrapping and generalized additive modeling that incorporates both linear and nonlinear terms were used. Results of repeated simultaneous sampling on the same tide stage of ponds and downstream estuarine creeks suggest that most FCB come from wildlife and that the ponds effectively remove these bacteria except immediately following heavy rainfall. Predictive models for concentrations of total and presumed wildlife bacteria are provided along with simple measures to estimate watershed boundaries. It is proposed that these tools can be used to minimize impacts on receiving water body quality. The models can be used to test alternative development approaches within coastal watersheds similar to that found in the southeastern USA coastal zone as well as to evaluate specific proposed landscape alterations.

Soluble receptor inhibits leptin transport

Evidence both from mice and cultured cells suggests an important role of soluble leptin receptors in obesity and leptin signaling. However, the direct effects of soluble receptors on leptin uptake by cells are not clear. This study shows that soluble leptin receptors antagonize the permeation of leptin across the mouse blood-brain barrier by reducing the binding and endocytosis of leptin. This is illustrated by analysis of radioactively labeled and fluorescent-tagged leptin in normal mice and in cultured cells overexpressing various forms of leptin receptors. Three constructs of soluble leptin receptors were generated in this study: ObRe (805 aa), ObR839, and ObR852. (125)I-leptin was injected intravenously and its influx rate from blood to brain determined by multiple-time regression analysis. Pre-incubation with ObR839 caused a significant reduction of leptin influx across the blood-brain barrier. Endocytosis assays and fluorescent image analysis further showed that ObRe, ObR839, and ObR852 failed to mediate leptin internalization and trafficking within the cells. Instead, these soluble receptors inhibited surface binding and endocytosis of leptin. Thus, we provide novel direct evidence both in vivo and in vitro that soluble receptors of leptin serve as antagonists of the transport of leptin.

TNF activates P-glycoprotein in cerebral microvascular endothelial cells

BACKGROUND/AIMS

Multidrug resistance proteins (MDRs, including P-glycoproteins) are efflux pumps that serve important biological functions but hinder successful drug delivery to the CNS. Many chemotherapeutic agents, anti-epileptics, anti-HIV drugs, and opiates are substrates for MDRs. Therefore, understanding the regulation of MDRs in the endothelial cells composing the blood-brain barrier has therapeutic implications.

METHODS

We used microarray, real time RT-PCR, Western blotting, and uptake of vinblastine by RBE4 cerebral endothelial cells to test the effects of tumor necrosis factor alpha (TNF) on the expression and functions of P-glycoprotein (MDR1).

RESULTS

The proinflammatory cytokine TNF specifically induced the expression and enhanced the function of MDR1 in RBE4 cells. The persistent upregulation of MDR1 mRNA was shown by cDNA microarray at 6, 12, and 24 h after TNF treatment. This was confirmed by real-time RT-PCR between 2 and 24 h. MDR1 protein expression was increased 6 to 24 h after TNF treatment and resulted in a significant reduction in the cellular uptake of (3)H-vinblastine.

CONCLUSION

The drug efflux transporter in cerebral endothelial cells can be upregulated by TNF. This suggests that adjunctive anti-TNF treatment has novel therapeutic potential in conditions such as brain cancer, epilepsy, neuroAIDS, and chronic pain.

Corticotropin-releasing hormone receptor (CRHR)1 and CRHR2 are both trafficking and signaling receptors for urocortin

Transport of urocortin, a potent satiety peptide, occurs at the blood-brain barrier of the mouse. Endocytosis of urocortin by the cerebral microvessel endothelial cells composing the blood-brain barrier is a rate-limiting step of this transport, but the cellular mechanisms involved have not been fully elucidated. The presence of both CRH receptors R1 and R2 in isolated cerebral microvessels shown in this study suggested that both subtypes might mediate urocortin transport. The roles of these two receptors in the endocytosis and signal transduction of urocortin were tested by overexpression studies in human embryonic kidney 293 cells. Both receptors led to a significant increase of binding and endocytosis of radiolabeled urocortin. CRHR1-mediated urocortin endocytosis was blocked by astressin (antagonist for both CRHRs), whereas CRHR2-mediated urocortin endocytosis was also blocked by antisauvagine 30 (selective CRHR2beta antagonist). Chlorpromazine, filipin, and nystatin had no effect on urocortin endocytosis, indicating the lack of significant involvement of clathrin or caveolae membrane microdomains. Both CRHR1 and CRHR2 were able to mediate the ligand-induced increase of cAMP production, suggesting that the overexpressed receptors were biologically active. Elevation of intracellular cAMP by forskolin or dibutyryl-cAMP, however, did not show acute modulation of the binding and endocytosis of urocortin. Despite the substantial intracellular degradation of endocytosed urocortin in cells overexpressing either CRHR1 or CRHR2, intact urocortin could be exocytosed during the 1-h study interval. We conclude that both CRHR1 and CRHR2 play a facilitatory role in the non-clathrin-, non-caveolae-mediated endocytosis and intracellular signal transduction of this potent peptide.

Gamma glutamyl transpeptidase is a dynamic indicator of endothelial response to stroke

Gamma glutamyl transpeptidase (gammaGT) is enriched at the apical surface of the cerebral capillaries that constitute the blood-brain barrier (BBB). This study tested the effects of hypoxia and inflammation on gammaGT activity in mice after stroke induced by transient cerebral artery occlusion (tMCAO) and in cultured cerebral microvessel endothelial cells. In microvessel-enriched preparations from mice after tMCAO, gammaGT activity was higher than in the sham controls in both ipsilateral and contralateral hemispheres from 12 h to 5 days after stroke, but lower at later time points (10-15 days). To identify the roles of different cytotoxic and stimulatory signals in this event, we further studied the dynamic changes of gammaGT activity in rat brain endothelial (RBE4) cells. Tumor necrosis factor alpha and lipopolyssachride significantly increased gammaGT activity in a time-dependent manner, an effect not seen after re-oxygenation. Such endothelial activation correlated with reduced total cellular ATP production. Thus, hypoxia and inflammatory stimulation appeared to have opposite effects on endothelial function. With the co-existence of inflammation and hypoxia in the brain after ischemic stroke, dynamic changes of gammaGT activity reflect evolving changes of endothelial function.

State-level adjusted ESRD incident rates: use of observed vs model-predicted category-specific rates

Because of differences in case-mix across states, state-level case-mix-adjusted end-stage renal disease (ESRD) incident rates are reported in each United States Renal Data System Annual Data Report to make the across-state comparisons valid. The adjusted rates were estimated by the direct adjustment method, a widely used method for adjusted event rate calculation, based on observed category-specific ESRD incident rates in each state (called the observation-based method). However, when some adjusting categories in a state are small, the adjusted rate and the standard error for this state as estimated by this method may be inaccurate. This report proposes a model-based method that can overcome the disadvantages of the observation-based method and can be extended to continuous adjusting variables. National ESRD incident data and national population data from 1990 to 1999 were used. State-level adjusted ESRD incident rates were estimated by both the observation- and the model-based methods. For the model-based method, a Poisson regression model was used to estimate category-specific ESRD incident rates. For large-population states, both observation- and model-based methods produced similar estimates for adjusted ESRD incident rates. For small-population states, however, the observation-based method produced year-to-year estimates of adjusted ESRD incident rates that varied considerably and also had very large standard errors. In contrast, the model-based method produced stable estimates. The model-based method can overcome the disadvantages of the observation-based method for estimating state-level adjusted ESRD incident rates, especially for small states.

Reciprocal interactions of insulin and insulin-like growth factor I in receptor-mediated transport across the blood-brain barrier

Although the blood-brain barrier limits free passage of peptides and proteins from the peripheral circulation to the central nervous system, specific transport systems for insulin and IGF-I have been identified. To further determine whether insulin and IGF-I share the same transport system, and if not, whether the two transport systems interact with each other, we performed multiple-time regression analysis in mice after iv injection and in situ brain perfusion of these peptides. Insulin and IGF-I caused reciprocal inhibition of each other's transport, although the effect of insulin was detected only by the in situ brain perfusion system. The interaction took place mainly at the step of cell surface binding as seen in cultured rat brain endothelium 4 brain microvessel endothelial cells. Further studies in 3T3 cells stably overexpressing the insulin receptor showed that the sharing of the transport systems was only partial. We conclude that insulin and IGF-I are mainly transported by their own transport systems, but a small amount can enter the brain by their "noncognate" transporters. The redundancy of their transport systems illustrates the regulatory function of the blood-brain barrier and reflects the importance of blood-borne insulin and IGF-I in the central nervous system.

Permeation of hepatocyte growth factor across the blood-brain barrier

Hepatocyte growth factor (HGF), mainly produced and acting in the periphery, attenuates cerebral ischemia-induced cell death and thus shows therapeutic potential in CNS regeneration. Accordingly, we tested its ability to permeate the blood-brain barrier (BBB). HGF was stable in the circulating blood of adult mice for up to 20 min, as HPLC showed intact (125)I-HGF in both serum and brain homogenate. Multiple time regression analysis revealed a rapid blood-to-brain influx rate of 0.38 +/- 0.07 microl/g min, faster than might be expected for a protein of this size. Although excess unlabeled HGF failed to inhibit of the influx of (125)I-HGF in mice, the use of a higher dose of unlabeled HGF in cellular uptake studies showed the presence of saturable endocytosis. Furthermore, capillary depletion studies showed that about 32% of the HGF present in brain entered the parenchymal compartment in contrast to the 11% entrapped in endothelial cells 10 min after intravenous bolus injection. The amount of HGF that crossed the BBB in intact form was substantial and could be physiologically important in the CNS.