Clinicopathologic Features of Oculopharyngodistal Myopathy With LRP12 CGG Repeat Expansions Compared With Other Oculopharyngodistal Myopathy Subtypes

Importance

Repeat expansion of CGG in LRP12 has been identified as the causative variation of oculopharyngodistal myopathy (OPDM). However, to our knowledge, the clinicopathologic features of OPDM with CGG repeat expansion in LRP12 (hereafter referred to as OPDM_LRP12) remain unknown.

Objective

To identify and characterize the clinicopathologic features of patients with OPDM_LRP12.

Design, Setting, and Participants

This case series included 208 patients with a clinical or clinicopathologic diagnosis of oculopharyngeal muscular dystrophy (OPDM) from January 1, 1978, to December 31, 2020. Patients with GCN repeat expansions in PABPN1 were excluded from the study. Repeat expansions of CGG in LRP12 were screened by repeat primed polymerase chain reaction and/or Southern blot.

Main Outcomes and Measures

Clinical information, muscle imaging data obtained by either computed tomography or magnetic resonance imaging, and muscle pathologic characteristics.

Results

Sixty-five Japanese patients with OPDM (40 men [62%]; mean [SD] age at onset, 41.0 [10.1] years) from 59 families with CGG repeat expansions in LRP12 were identified. This represents the most common OPDM subtype among all patients in Japan with genetically diagnosed OPDM. The expansions ranged from 85 to 289 repeats. A negative correlation was observed between the repeat size and the age at onset (r2 = 0.188, P = .001). The most common initial symptoms were ptosis and muscle weakness, present in 24 patients (37%). Limb muscle weakness was predominantly distal in 53 of 64 patients (83%), but 2 of 64 patients (3%) had predominantly proximal muscle weakness. Ptosis was observed in 62 of 64 patients (97%), and dysphagia or dysarthria was observed in 63 of 64 patients (98%). A total of 21 of 64 patients (33%) had asymmetric muscle weakness. Aspiration pneumonia was seen in 11 of 64 patients (17%), and 5 of 64 patients (8%) required mechanical ventilation. Seven of 64 patients (11%) developed cardiac abnormalities, and 5 of 64 patients (8%) developed neurologic abnormalities. Asymmetric muscle involvement was detected on computed tomography scans in 6 of 27 patients (22%) and on magnetic resonance imaging scans in 4 of 15 patients (27%), with the soleus and the medial head of the gastrocnemius being the worst affected. All 42 muscle biopsy samples showed rimmed vacuoles. Intranuclear tubulofilamentous inclusions were observed in only 1 of 5 patients.

Conclusions and Relevance

This study suggests that OPDM_LRP12 is the most frequent OPDM subtype in Japan and is characterized by oculopharyngeal weakness, distal myopathy that especially affects the soleus and gastrocnemius muscles, and rimmed vacuoles in muscle biopsy.

Displaced Intra-Articular Calcaneal Fractures: Evaluation of Clinical and Radiological Outcome Following Open Reduction and Internal Fixation with Locking Branched Calcaneal Plate

Background An introduction of the World Health Organization Surgical Safety Checklist (WHO SSC) is essential to promote surgical safety. Objective To obtain country-specific information regarding the checklist in a leading medical institution in Nepal. Method The present research was a cross-sectional study with a survey conducted among healthcare professionals working in the operation theatre at the Tribhuvan University Teaching Hospital (TUTH) in Kathmandu, Nepal. A questionnaire was distributed to 150 healthcare professionals working in the operating theatre. Responses to the questionnaire were analysed descriptively and regression analyses used to identify factors associated with awareness of the checklist. Result In total, 127 healthcare professionals participated in the study, of whom 118 (92.9%) had been aware of the WHO SSC. A substantial proportion of participants (108, 91.5%) were not satisfied with the prevailing practice whereby the checklist was not routinely used during surgery. Lack of appropriate training was the most prevalent barrier to the checklist use (72, 67.9%), followed by unwillingness of staff to use the checklist (54, 50.9%), and lack of experience (42, 39.7%). The mean score on the survey was 6.0 out of 10. Regarding the results of the regression model on survey scores, surgeons had higher scores compared to nurses (unadjusted coefficient 0.80, 95% CI 0.20-1.40). Conclusion Most of the healthcare professionals were aware of the WHO SSC, however multiple barriers to the checklist use were identified. It is important to establish an effective use of WHO SSC in the operation theatre.

CGG expansion in NOTCH2NLC is associated with oculopharyngodistal myopathy with neurological manifestations

Oculopharyngodistal myopathy (OPDM) is a rare hereditary muscle disease characterized by progressive distal limb weakness, ptosis, ophthalmoplegia, bulbar muscle weakness and rimmed vacuoles on muscle biopsy. Recently, CGG repeat expansions in the noncoding regions of two genes, LRP12 and GIPC1, have been reported to be causative for OPDM. Furthermore, neuronal intranuclear inclusion disease (NIID) has been recently reported to be caused by CGG repeat expansions in NOTCH2NLC. We aimed to identify and to clinicopathologically characterize patients with OPDM who have CGG repeat expansions in NOTCH2NLC (OPDM_NOTCH2NLC). Note that 211 patients from 201 families, who were clinically or clinicopathologically diagnosed with OPDM or oculopharyngeal muscular dystrophy, were screened for CGG expansions in NOTCH2NLC by repeat primed-PCR. Clinical information and muscle pathology slides of identified patients with OPDM_NOTCH2NLC were re-reviewed. Intra-myonuclear inclusions were evaluated using immunohistochemistry and electron microscopy (EM). Seven Japanese OPDM patients had CGG repeat expansions in NOTCH2NLC. All seven patients clinically demonstrated ptosis, ophthalmoplegia, dysarthria and muscle weakness; they myopathologically had intra-myonuclear inclusions stained with anti-poly-ubiquitinated proteins, anti-SUMO1 and anti-p62 antibodies, which were diagnostic of NIID (typically on skin biopsy), in addition to rimmed vacuoles. The sample for EM was available only from one patient, which demonstrated intranuclear inclusions of 12.6 ± 1.6 nm in diameter. We identified seven patients with OPDM_NOTCH2NLC. Our patients had various additional central and/or peripheral nervous system involvement, although all were clinicopathologically compatible; thus, they were diagnosed as having OPDM and expanding a phenotype of the neuromyodegenerative disease caused by CGG repeat expansions in NOTCH2NLC.

Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan

BACKGROUND

Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors.

AIM

Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for coronavirus disease 2019 (COVID-19).

DESIGN

Cross-sectional study using regression and correlation analysis.

METHODS

We retrieved domestic laboratory-confirmed cases, deaths and the number of RT-PCR testing for COVID-19 from 15 January to 6 April 2020 in 47 prefectures in Japan, using publicly available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis.

RESULTS

The median prefectural-level incidence and number of RT-PCR testing per 100 000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (P < 0.001) and the number of RT-PCR testing (P = 0.03); and those for RT-PCR testing were the incidence (P = 0.025), available beds (P = 0.045) and cluster infections (P = 0.034).

CONCLUSION

Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.

P827EXPLORE-J: Lipid management and 2-year long-term clinical outcome in Japanese patients with acute coronary syndrome

Background

The cardiovascular event rate in Japan is much lower than that in Western countries. However, the incidence of atherosclerotic CV disease and its burden are expected to increase in the Japanese society with rapid aging, westernization of lifestyles and metabolic derangement. An increase in patients with CAD has been remarkable in spite of various preventive measures. The positive linear correlation of LDL-C level with CAD incidence along with LDL-C lowering and CAD event reduction is established by large-scale studies in Western countries, but data in Japan are limited. EXPLORE-J, observational study, was conducted to gain insights into the relationship between LDL-C management and CV events in the Japanese ACS patients.

Purpose

The primary objective was to evaluate the status of post-ACS lipid management and CV events in Japan.

Method

ACS patients aged ≥20 years were enrolled and followed up for 2 years. The primary endpoint was the incidence proportion of major adverse cardiovascular events (MACE), including CV death (death associated with MI/stroke and other CV deaths), non-fatal ACS/stroke requiring hospitalization during the observation period. Other endpoints were medications and metabolic parameters. Additional stratified analyses of MACE incidence proportions by median LDL-C reduction category (above/below absolute or % reduction) from the first measurement after ACS to V1 (Day 1 + 14 days) was also conducted.

Result

Of the 2016 registered patients, 1944 were analyzed. The mean age and BMI were 66.0 years and 24.2 kg/m2, respectively. At 2-year follow up, the cumulative incidence proportion of MACE was 6.8%. The cumulative incidence proportions of CV death, non-fatal ACS and stroke were 0.7%, 4.5% and 1.7%, respectively. Statin, intensive statin, and ezetimibe were prescribed, respectively, to 93.6%, 8.2%, and 3.9% at V1, and 92.3%, 10.5%, and 11.6% at V5 (Day 730±30 days).

The mean LDL-C levels were 121.2, 99.4, 80.9, and 79.8 mg/dL at the first measurement after ACS, V1, V2 (Day 30±7 days) and V5, respectively. The proportions of patients who achieved LDL-C <70 and <100 mg/dL at V1 and V5 were 14.4% to 34.6% and 56.5% to 82.8%, respectively. The incidence rate of MACE was lower among patients with larger than median absolute reduction in LDL-C level than among those with smaller reduction (median −17.0 mg/dL; 5.5% vs 8.3%, p=0.0435). The same trend was observed in patients with higher LDL-C reduction rate (median −15.36%; 6.3% vs 7.6%, p=0.4302).

Kaplan-Meier estimates of MACE incidence

Conclusion

The results show the status of medical management and CV event rates in post-ACS Japanese patients. It also shows that half of the ACS patients did not achieve the recommended LDL-C levels of <70 mg/dL per guidelines, indicating the need to intensify lipid lowering therapy. To further characterize and quantify the patient population and the benefit of lipid management, we plan to conduct additional analyses with risk stratification of the population.

Acknowledgement/Funding

This study was sponsored by Sanofi and Regeneron Pharmaceuticals, Inc.

Abstract P3-10-14: Breast cancer provider delay after the 2011 triple disaster in Fukushima, Japan

Introduction

Timely diagnosis and treatment is an indispensable part of breast cancer management. Delay of this process, also known as provider delay, can result in a deteriorated prognosis of affected patients. Although it has been suggested that disasters can impact cancer care and extend provider delay, there is little information available on long-term trends of breast cancer provider delay in post-disaster settings.

So-so district of Fukushima prefecture, Japan, experienced an earthquake, tsunami and the Fukushima Daiichi Nuclear Power Plant Accident in 2011. So-so district has areas falling within the mandatory, voluntary and non-evacuation ordered zones. Due to a long-term shortage of medical staff and closure of medical institutions post-disaster, patients with breast cancer may have experienced longer provider delay in this area.

Objectives

To compare provider delay of breast cancer patients and elucidate contributing factors to delay pre- and post-disaster, in an area severely affected by Japan's 2011 triple disaster.

Methods

We retrospectively investigated data of newly diagnosed breast cancer patients who undertook first medical consultation at the two main cancer centers in the non-evacuation ordered zone of So-so district from 2005 to 2016. Sociodemographic and clinical information was collected from medical records. The main outcome measure was median (days) from first medical consultation to start of breast cancer-specific treatment, pre- and post-disaster, using Mann-Whitney U test. Multivariate linear regression was then conducted to identify any factors which contributed to extended provider delay before and after the disaster.

Results

A total of 157 pre-disaster patients and 121 post-disaster patients were included in the study. There was no significant difference in the interval of median days of first medical consultation to start of first treatment pre- and post-disaster (40 vs. 39, p=0.82). Although diagnosis was made in a shorter interval post-disaster compared to pre-disaster (11 vs. 14, p=0.01) with significantly smaller median number of biopsies (1 vs. 1, p=0.001), this post-disaster improvement in diagnostic process was offset by deferred start of treatment after diagnosis (26 vs. 22, p=0.008). Among the pre-disaster patients, cancer detection by breast cancer screening program (p&lt;0.001), being engaged in full-time job (p&lt;0.042), and number of biopsies before diagnosis (p=0.005) contributed to longer provider delay in multivariate regression. However, consultation from other medical providers (p=0.03) was the only factor which significantly contributed to extended delay post-disaster, after controlling for multiple variables.

Conclusion

There was no significant increase in provider delay among breast cancer patients post-disaster. However, a median interval of 39 days from first medical consultation to start of treatment is much longer than other high-income countries, and shows much room for improvement in future.Introduction

Timely diagnosis and treatment is an indispensable part of breast cancer management. Delay of this process, also known as provider delay, can result in a deteriorated prognosis of affected patients. Although it has been suggested that disasters can impact cancer care and extend provider delay, there is little information available on long-term trends of breast cancer provider delay in post-disaster settings.

So-so district of Fukushima prefecture, Japan, experienced an earthquake, tsunami and the Fukushima Daiichi Nuclear Power Plant Accident in 2011. So-so district has areas falling within the mandatory, voluntary and non-evacuation ordered zones. Due to a long-term shortage of medical staff and closure of medical institutions post-disaster, patients with breast cancer may have experienced longer provider delay in this area.

Objectives

To compare provider delay of breast cancer patients and elucidate contributing factors to delay pre- and post-disaster, in an area severely affected by Japan's 2011 triple disaster.

Methods

We retrospectively investigated data of newly diagnosed breast cancer patients who undertook first medical consultation at the two main cancer centers in the non-evacuation ordered zone of So-so district from 2005 to 2016. Sociodemographic and clinical information was collected from medical records. The main outcome measure was median (days) from first medical consultation to start of breast cancer-specific treatment, pre- and post-disaster, using Mann-Whitney U test. Multivariate linear regression was then conducted to identify any factors which contributed to extended provider delay before and after the disaster.

Results

A total of 157 pre-disaster patients and 121 post-disaster patients were included in the study. There was no significant difference in the interval of median days of first medical consultation to start of first treatment pre- and post-disaster (40 vs. 39, p=0.82). Although diagnosis was made in a shorter interval post-disaster compared to pre-disaster (11 vs. 14, p=0.01) with significantly smaller median number of biopsies (1 vs. 1, p=0.001), this post-disaster improvement in diagnostic process was offset by deferred start of treatment after diagnosis (26 vs. 22, p=0.008). Among the pre-disaster patients, cancer detection by breast cancer screening program (p&lt;0.001), being engaged in full-time job (p&lt;0.042), and number of biopsies before diagnosis (p=0.005) contributed to longer provider delay in multivariate regression. However, consultation from other medical providers (p=0.03) was the only factor which significantly contributed to extended delay post-disaster, after controlling for multiple variables.

Conclusion

There was no significant increase in provider delay among breast cancer patients post-disaster. However, a median interval of 39 days from first medical consultation to start of treatment is much longer than other high-income countries, and shows much room for improvement in future.

Citation Format: Ozaki A, Leppold C, Tsubokura M, Sawano T, Tsukada M, Ohira H. Breast cancer provider delay after the 2011 triple disaster in Fukushima, Japan [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-10-14.

Abstract P6-12-04: Delayed hospital visits in patients with breast cancer after the great East Japan earthquake and the subsequent Fukushima Daiichi nuclear power plant accident: A retrospective comparative analysis

Introduction

In breast cancer, delay in first presentation and self-interruption of continuous treatment are associated with lower survival. It has been suggested that risk factors for such behavioral patterns include poor social support.

Minamisoma City, located within a 30 kilometers radius from Fukushima Daiichi nuclear power plant, has experienced rapid change in social structures following the Great East Japan Earthquake and the subsequent power plant accident. There has been a mass evacuation among young and middle-aged generations for fear of potential irradiation, and this has resulted in the separation of families and friends. These changes may have resulted in a deterioration of social support for residents, which could consequently lead to changed patterns of behavior in diseases such as breast cancer.

Objectives

This study compared the behavioral patterns before and after the disasters in patients with breast cancer in Minamisoma City.

Methods

We retrospectively analyzed data from patients with breast cancer who were diagnosed from January 2008 through March 2015 in the two main cancer centers in Minamisoma City. Demographic and clinical information was extracted from medical records, including age, stage, pathological findings, treatment, and the reason for the first hospital visit. The main outcome was a change of interval from the appearance of initial symptoms to the first hospital visit before and after the disasters. We also assessed whether continuous follow-up was maintained after the disasters. We used an unpaired t-test for numerical variables and a chi-squared test for categorical variables.

Results

A total of 102 and 97 patients were diagnosed with breast cancer before and after the disasters, respectively. There were no statistically significant differences between the 2 groups concerning average age (61 years old vs. 61 years old, p=1), stage 3 or 4 cancer (18% vs. 17%, p=0.81), invasive cancer (92% vs. 93%, p=0.87) and symptomatic patients (75% vs. 74%, p=0.74), respectively. However, after the disasters, there were significant increases in the ratio of patients with more than a one-year delay from the appearance of the initial symptom to the first hospital visit (5.4% vs. 15%, p&lt;0.05). The patients with more than a one-year delay had a significantly higher ratio of advanced stage cancer compared with patients who visited a hospital earlier. Continuous follow-up was maintained in all patients diagnosed after the disasters.

Discussion

The characteristics of patients were not significantly different before and after the disasters, while the ratio of patients with more than a one-year delay of the first hospital visit significantly increased after the disasters. Although information on social capital and other sociodemographic factors was not available, we speculate that poor social support due to changed social structures after the disasters might contribute to delay in first presentation in symptomatic breast cancer patients. Further study is warranted to clarify the factors associated with delayed hospital visits, in order to establish effective health interventions in the aftermath of mass disasters.

Citation Format: Ozaki A, Tsubokura M, Nomura S, Morita T, Ochi S, Kato S, Saji S, Yokota T, Leppold C, Tanimoto T, Kami M, Tsukada M, Ohira H. Delayed hospital visits in patients with breast cancer after the great East Japan earthquake and the subsequent Fukushima Daiichi nuclear power plant accident: A retrospective comparative analysis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-12-04.

Genotyping of Edwardsiella ictaluri isolates in Japan using amplified-fragment length polymorphism analysis

AIM

The major objective of the present study was to clarify genetic relationship of isolates of Edwardsiella ictaluri in Japan, which was first found from ayu Plecoglossus altivelis in Japanese rivers in 2007.

METHODS AND RESULTS

Ten isolates of Edw. ictaluri in 2007-2008 from ayu and the 1 isolate from bagrid catfish Pelteobagrus nudiceps in Japan were subjected to amplified-fragment length polymorphism (AFLP) analysis. The strains isolated from catfish in United States (ATCC strains) or Indonesia were used as reference strains. The AFLP profiles were all the same among the isolates from Japan, while the polymorphic DNA bands were observed among the strains from United States or Indonesia. The isolates from Japan and Indonesia constituted a genogroup different from the ATCC strains on a dendrogram constructed from the AFLP profiles.

CONCLUSION

No DNA polymorphisms were found among Japanese Edw. ictaluri isolates.

SIGNIFICANCE AND IMPACT OF THE STUDY

A single clonality of the Edw. ictaluri isolates in Japan suggests the single source of the organism, and the infection in ayu is in the early stage of epidemics.

A set of polymorphic trinucleotide and tetranucleotide microsatellite markers for the Japanese flounder (Paralichthys olivaceus)

We have developed the first set of trinucleotide and tetranucleotide markers for the Japanese flounder, Paralichthys olivaceus. One hundred and sixty-seven polymorphic trinucleotide and tetranucleotide microsatellites were isolated using clones derived from two libraries. Of almost 200,000 clones analysed, 0.5% presented trinucleotide or tetranucleotide repeat regions. Among the trinucleotide repeats analysed in this study, the most frequent one was (CAG)(n) and the most common tetranucleotide repeat was (GATA)(n). The position of the new markers in the genetic linkage map was determined. Markers were evenly distributed along the P. olivaceus linkage groups, without distinction between the kinds of repeats and library of origin. The markers isolated in this study contribute significantly to the genetic linkage map of the Japanese flounder.

Construction of a novel hydroxyproline-producing recombinant Escherichia coli by introducing a proline 4-hydroxylase gene

An Escherichia coli recombinant strain producing trans-4-hydroxy-L-proline (Hyp) was constructed by introducing a proline 4-hydroxylase gene into an L-proline-producing E. coli. Plasmid pPF1, which contains a gene encoding feedback resistant gamma-glutamyl kinase (proB74), was constructed and introduced into E. coli W1485 putA. The recombinant E. coli W1485 putA/pPF1 strain produced L-proline (1.2 g/l). The proline production by W1485 putA/pPF1 was converted to Hyp production by introducing pWFH1 which contains a proline 4-hydroxylase gene. E. coli W1485 putA which harbors pWFP1 carrying the proline 4-hydroxylase gene, proB74, and proA produced 25 g/l of Hyp in 96 h. A novel biosynthetic pathway of Hyp, which has not previously been produced in E. coli, was constructed in E. coli.

Alkylphenol and bisphenol A levels in rubber products

Levels of p-t-butylphenol (PTBP), p-t-octylphenol (PTOP), p-nonylphenol (NP) and bisphenol A (BPA) in rubber products in food-contact use, infant-related use and other uses are reported. Of 60 rubber products tested, PTOP was found in three in a concentration range of 2.2-37 microgram g(-1), and NP in 15 in a concentration range of 2.6-513 microgram g(-1). PTBP and BPA were not found in any sample. PTOP and NP were not detected in any infant-related sample, regardless of the material type. In contrast, among the samples with food contact and with other uses, the percentages containing PTOP or NP were 33 and 43%, respectively. A migration test was performed on eight samples containing NP and used in food-contact environments. The migration level of NP from spatulas to n-heptane was 0.83-1.52 microgram ml(-1). The average migration rates to water, 20% ethanol and n-heptane were 0.03, 0.7 and 6.6%, respectively.

Genotoxicity of gardenia yellow and its components

Gardenia fruit (Gardenia jasminoides ELLIS) is widely used as a natural food colorant and as a traditional Chinese medicine for treatment of hepatic and inflammatory diseases. "Gardenia yellow" is a natural food colorant which is extracted by ethanol from gardenia fruit. The purpose of this study was to evaluate the genotoxicity of gardenia yellow. Genotoxicity of gardenia yellow and its components, crocetin, gentiobiose (a component of crocin), geniposide and genipin (formed by hydrolysis of geniposide), was studied by Ames test, rec-assay, and sister chromatid exchange (SCE) using V79 cells. Gardenia yellow and its components were found not to be mutagenic in the Salmonella reverse mutation assay. Gardenia yellow and genipin caused damage of DNA in rec-assay. Gardenia yellow induced a significant dose-dependent increase of SCE frequency (8.6 times at 1000 microg/ml as the value for the solvent control). Only genipin induced SCEs significantly among the components of gardenia yellow. Moreover, genipin induced a significant increase of tetraploids at all doses tested (95% at 8 microg/ml). Gardenia yellow preparation was analyzed by capillary electrophoresis (CE), and geniposide was detected. However, genipin was not observed. In conclusion, we have shown that genipin possesses genotoxicity. Furthermore, there were unidentified genotoxicants in gardenia yellow.

Exertion of the suppressive effects of IFN-gamma on experimental immune mediated blepharoconjunctivitis in Brown Norway rats during the induction phase but not the effector phase

BACKGROUND/AIMS

Interferon gamma (IFN-gamma) knockout mice exhibit severe allergic conjunctivitis (AC), indicating that IFN-gamma regulates the development of AC. The authors examined whether this inhibitory effect of IFN-gamma is exerted during the induction or effector phase of experimental AC.

METHODS

Experimental immune mediated blepharoconjunctivitis (EC) was induced in Brown Norway (BN) rats, using ovalbumin (OVA) as the antigen. To investigate the role of IFN-gamma in the induction phase, EC was induced by active immunisation and IFN-gamma (10 micro g/time, total 70 micro g), or phosphate buffered saline (PBS) as a control, was injected intraperitoneally every other day from the day of immunisation. The rats were challenged with OVA eye drops 13 days after immunisation, and 24 hours later, the eyes were harvested for histology. To examine the effects of IFN-gamma in the effector phase, OVA specific T cells were transferred into syngeneic rats and IFN-gamma (10 micro g/time, total 50 micro g) or PBS was injected each day after the transfer until induction of EC 4 days later with an OVA challenge. To investigate the role of endogenous IFN-gamma during the effector phase, an anti-IFN-gamma monoclonal antibody (3 mg/time) was injected on days 3 and 4.

RESULTS

Injection of IFN-gamma into actively immunised rats suppressed eosinophilic infiltration but not infiltration of mononuclear cells. In contrast, neither IFN-gamma nor anti-IFN-gamma affected EC in passively immunised rats.

CONCLUSION

IFN-gamma is a suppressive cytokine for the development of EC and exerts this suppressive effect during the induction phase.

Rat granulocyte colony-forming unit (CFU-G) assay for the assessment of drug-induced hematotoxicity

To assess the drug-induced hematotoxicity to granulocyte progenitors, we established a modified colony-forming assay using rat bone marrow cells (BMCs). In the presence of various colony-stimulating factors (CSFs), rat BMCs were disseminated on methylcellulose at a concentration of 1.3 x 10(4) cells/cm(2) (5 x 10(4) cells/0.5 ml/well in a 12-well plate). Mouse granulocyte-macrophage colony-stimulating factor (mGM-CSF) stimulated the formation of almost all macrophage colonies. Human granulocyte colony-stimulating factor (hG-CSF) alone or in combination with mouse interleukin-3 (mIL-3) did not significantly effect on the number of rat colony-forming units in culture (CFU-C). When BMCs were seeded at 5.2 x 10(4) cells/cm(2) (5 x 10(5) cells/1 ml/dish in a 35-mm dish), hG-CSF increased the number of the colonies in a dose-dependent manner, and resulted in about 50 colonies at 50 ng/ml. The constituent cells of the colonies were identified as neutrophils. Under these conditions, the effects of 5-fluorouracil (5-FU) on granulocyte colony-forming units (CFU-G) were examined in rats and mice. The inhibitory effect of 5-FU on rat CFU-G was similar to the effect on mouse CFU-G. These results indicate that the rat CFU-G induced by hG-CSF is capable of being used for the evaluation of drug-induced hematotoxicity.

Mechanism for maintenance of dominant T helper 1 immune responses in Lewis rats

Lewis rats are prone to T helper (Th) 1 immune responses, whereas Brown Norway (BN) rats are susceptible to Th2 immune responses. Yet, the precise mechanism of induction of the different outcome between these two strains remained elusive. We investigated the expression levels of some cytokines, their receptors and accessory molecules responsible for the polarization of antigen-specific immune response into a predominant Th1 or Th2 profile in Lewis and BN rats. Lymph node (LN) cells collected from rats immunized with short ragweed (RW) were used directly or after stimulation in vitro with RW for 3 days. Expression of cytokines, their receptors and accessory molecules in these LN cells were tested by reverse transcriptase-PCR. Culture supernatant was used for ELISA to detect IL-12 protein. We observed clear differences between these strains in the expression of IL-12p40, which was high in LN cells of Lewis rats even before stimulation in vitro. In addition, a higher amount of IL-12 was present in the culture supernatant in Lewis rats. Upregulation of the expression of IL-12 receptor beta1, beta2, IFN-gamma receptor alpha and beta genes were more prominent in Lewis rats rather than BN rats. Furthermore, attenuated expression of CD40 and CD40 ligand by stimulation in vitro was noted only in BN rats. Changes in expression of these molecules by stimulation as well as higher basal level of IL-12p40 might have led to the activation of Th1 cells in Lewis rats.

Quantitative trait loci (QTLs) associated with resistance/susceptibility to infectious pancreatic necrosis virus (IPNV) in rainbow trout (Oncorhynchus mykiss)

Infectious pancreatic necrosis (IPN) is a well-known acute viral disease of salmonid species. We have identified quantitative trait loci (QTLs) associated with resistance to this disease in rainbow trout. We searched for linkage among 51 microsatellite markers used to construct a framework linkage map in backcross families of rainbow trout (Oncorhynchus mykiss), produced by crossing IPN-resistant (YN-RT201) and -susceptible (YK-RT101) strains. Two putative QTLs affecting disease resistance were detected on chromosomes A (IPN R S-1) and C (IPN R/S-2), respectively, suggesting that this is a polygenic trait in rainbow trout. These markers have great potential for use in marker-assisted selection (MAS) for IPN resistance and provide the basis for cloning of IPN resistance genes. Clarification of the genetic bases of complex traits has broad implications for fundamental research, but will also be of practical benefit to fish breeding.

Genetic mapping of the dominant albino locus in rainbow trout (Oncorhynchus mykiss)

Albinism in animals is generally a recessive trait, but in Japan a dominant oculocutaneous albino (OCA) mutant strain has been isolated in rainbow trout (Oncorhyncus mykiss). After confirming that this trait is not due to a tyrosinase gene mutation that causes OCA1 (tyrosinase-negative OCA), we combined the amplified fragment length polymorphism (AFLP) technique with bulked segregant analysis (BSA) to map the gene involved in dominant oculocutaneous albinism. Four AFLP markers tightly linked to the dominant albino locus were identified. One of these markers was codominant and we have it converted into a GGAGT-repeat microsatellite marker, OmyD-AlbnTUF. Using this pentanucleotide-repeat DNA marker, the dominant albino locus has been mapped on linkage group G of a reference linkage map of rainbow trout. The markers identified here will facilitate cloning of the dominant albino gene in rainbow trout and contribute to a better understanding of tyrosinase-negative OCA in animals.

Large-scale production of the carbohydrate portion of the sialyl-Tn epitope, alpha-Neup5Ac-(2-->6)-D-GalpNAc, through bacterial coupling

Alpha-Neup5Ac-(2-->6)-D-GalpNAc, the carbohydrate portion of sialyl-Tn epitope of the tumor-associated carbohydrate antigen, was prepared by a whole-cell reaction through the combination of recombinant Escherichia coli strains and Corynebacterium ammoniagenes. Two recombinant E. coli strains overexpressed the CMP-Neup5Ac biosynthetic genes and the alpha-(2-->6)-sialyltransferase gene of Photobacterium damsela. C. ammoniagenes contributed to the production of UTP from orotic acid. Alpha-Neup5Ac-(2-->6)-D-GalpNAc was accumulated at 87 mM (45 g/L) after a 25-h reaction starting from orotic acid, N-acetylneuraminic acid, and 2-acetamide-2-deoxy-D-galactose.

Effects of IL-4 and IL-12 on experimental immune-mediated blepharoconjunctivitis in Brown Norway rats

IL-12 and IL-4 are critical cytokines for Th1 and Th2 differentiation, respectively. To assess the roles of these cytokines in the development of experimental immune-mediated blepharoconjunctivitis (EC) in Brown Norway (BN) rats, their effects were tested either in vitro or in vivo. Draining lymph node cells from rats immunized with ragweed pollen (RW) in Al(OH)3 were collected and cultured for 3 days with RW in the presence of IL-4, IL-12, or PBS as a control. After harvesting the culture supernatants for cytokine ELISA and the cells for cytokine reverse transcriptase-polymerase chain reaction, 10 million cells were injected intravenously into syngeneic recipient rats (n = 12 per group). The rats were challenged with RW by eye drops 4 days after transfer. Eyes were harvested for histology 24 h later. Furthermore, IL-12 (500 ng per injection) or PBS was injected intraperitoneally every other day seven times from the day of active immunization (n = 6 per group). One day after the last injection, rats were challenged and EC was evaluated as above. Transfer of cells with IL-4 in vitro augmented eosinophilic infiltration in the conjunctiva compared with the other two groups, whereas IL-12 in vitro suppressed eosinophilic infiltration and increased lymphocytic infiltration. Interferon-gamma production was augmented by IL-12. IL-4 RNA expression was augmented by IL-4. IL-12 administration in vivo augmented lymphocytic infiltration in the conjunctiva without affecting infiltration of eosinophils. In conclusion, IL-4 and IL-12 either in vitro or in vivo augmented Th2 and Th1 immunity, respectively, thus leading to distinct histological features of EC.

Granulocyte colony-stimulating factor production by adult T-cell leukaemia cells

We previously demonstrated that, in about 30% of primary adult T-cell leukaemia (ATL) cases, the leukaemic cells proliferated in response to granulocyte colony-stimulating factor (G-CSF). In the present report, we describe five patients with the acute leukaemia type of ATL who showed marked neutrophilia and elevated serum G-CSF concentrations in the absence of infection. We further examined two of these patients for detailed clinical features and cellular characteristics of the tumour cells. The white blood cell counts of both patients were 62 x 10(9)/l, consisting of approximately 90% neutrophils and 10% ATL cells. Serum concentrations of G-CSF in the two patients were 138 pg/ml and 93 pg/ml. The G-CSF concentrations in supernatants of short-term cultures of the patients' peripheral blood T-cells were 2 5 pg/ml and 13 pg/ml respectively. Immunostaining with anti-G-CSF antibody demonstrated G-CSF production by primary ATL cells in both cases. The neutrophil count fluctuated simultaneously with activity of ATL. Primary ATL cells from one patient were shown to proliferate in response to G-CSF in vitro. These results suggest autocrine growth stimulation of primary ATL cells in a subgroup of patients.

Cloning and expression of beta1,4-galactosyltransferase gene from Helicobacter pylori

Helicobacter pylori, which is a human pathogen associated with gastric and duodenal ulcer, has been shown to express human oncofetal antigens Lewis X and Lewis Y. Although the mammalian glycosyltransferases that synthesize these structures are well characterized, little is known about the corresponding bacterial enzymes. We report that a novel beta1,4-galactosyltransferase gene (HpgalT) involved in the biosynthesis of lipopolysaccharides in H. pylori has been cloned and expressed in Escherichia coli. The deduced amino acid sequence of the protein (HpGal-T) encoded by HpgalT consists of 274 residues with the calculated molecular mass of 31,731 Da, which does not show significant similarity to those of beta1,4-galactosyltransferases from mammalian sources and Neisseria It was confirmed that HpGal-T catalyzed the introduction of galactose from UDP-Gal in a beta1,4 linkage to accepting N-acetylglucosamine (GlcNAc) residues by means of high-performance anion-exchange chromatography with pulsed amperometric detection (HPAEC-PAD). When the E.coli cells which overexpressed HpgalT was coupled with the UDP-Gal production system, which consisted of recombinant E.coli cells overexpressing its UDP-Gal biosynthetic genes and Corynebacterium ammoniagenes, N-acetyllactosamine, a core structure of lipopolysaccharide of H.pylori, was efficiently produced from orotic acid, galactose, and GlcNAc.

A microsatellite linkage map of rainbow trout (Oncorhynchus mykiss) characterized by large sex-specific differences in recombination rates

We constructed a genetic linkage map for a tetraploid derivative species, the rainbow trout (Oncorhynchus mykiss), using 191 microsatellite, 3 RAPD, 7 ESMP, and 7 allozyme markers in three backcross families. The linkage map consists of 29 linkage groups with potential arm displacements in the female map due to male-specific pseudolinkage arrangements. Synteny of duplicated microsatellite markers was used to identify and confirm some previously reported pseudolinkage arrangements based upon allozyme markers. Fifteen centromeric regions (20 chromosome arms) were identified with a half-tetrad analysis using gynogenetic diploids. Female map length is approximately 10 M, but this is a large underestimate as many genotyped segments remain unassigned at a LOD threshold of 3.0. Extreme differences in female:male map distances were observed (ratio F:M, 3.25:1). Females had much lower recombination rates (0.14:1) in telomeric regions than males, while recombination rates were much higher in females within regions proximal to the centromere (F:M, 10:1). Quadrivalent formations that appear almost exclusively in males are postulated to account for the observed differences.

Experimental immune-mediated blepharoconjunctivitis in rats induced by immunization with ragweed pollen

BACKGROUND

A study was performed to compare the effects of immunization with ragweed pollen (RW) in two different adjuvants on the characteristics of a previously described model of experimental immune-mediated blepharoconjunctivitis (EC) in rats.

METHODS

Lewis or Brown Norway (BN) rats were immunized with 100 microg of RW in emulsion with aluminum hydroxide [Al(OH)3] or complete Freund's adjuvant (CFA). Three weeks later, the animals were challenged with eye drops containing RW in PBS. Twenty-four hours after topical challenge, eyes, blood, and lymph nodes were obtained for histology, measurement of antigen-specific antibodies, and proliferation or cytokine assays, respectively. In addition to active immunization, recipients of RW-primed lymph node cells were challenged and evaluated as above.

RESULTS

RW in both adjuvants induced infiltration with predominantly mononuclear cells in Lewis rats and eosinophils in BN rats. As well as active immunization, eosinophils were detected only in BN rats by adoptive transfer of cells. Lymphocyte proliferative responses to RW were high in immunized Lewis rats when CFA was used as an adjuvant. In contrast, proliferative responses in BN rats were higher when Al(OH)3 was used. RW-specific IgE was detected only in BN rats. There were no significant differences in RW-specific IgG1/IgG2a ratio among the four groups. Lewis rats had higher level of RW-specific interferon-gamma in the culture supernatant.

CONCLUSIONS

The characteristics of EC are different in Lewis and BN rats, dependent on the genetic background of the rat strains. The response to RW was similar to other previously used antigens, such as ovalbumin.

Enzymatic production of trans-4-hydroxy-L-proline by regio- and stereospecific hydroxylation of L-proline

A proline 4-hydroxylase gene, which was cloned from Dactylosporangium sp. RH1, was overexpressed in Escherichia coli W1485 on a plasmid under a tryptophan tandem promoter after the codon usage of the 5' end of the gene was optimized. The proline 4-hydroxylase activity was l600-fold higher than that in Dactylosporangium sp. RH1. trans-4-Hydroxy-L-proline(Hyp) was produced and accumulated to 41 g/L (87% yield from L-proline) in 100 h when the recombinant E. coli was cultivated in a medium containing L-proline and glucose. 2-Oxoglutarate, which is necessary for the hydroxylation of L-proline by proline 4-hydroxylase, was apparently supplied from glucose through the cellular metabolic pathway. The putA mutant of W1485, which is not able to degrade L-proline, has allowed the quantitative conversion of L-proline to Hyp. The formation of other isomers of hydroxyproline was not observed. Productivity of Hyp was almost the same in a larger-scale culture. The method of manufacturing Hyp from L-proline was established.

Large-scale production of CMP-NeuAc and sialylated oligosaccharides through bacterial coupling

A large-scale production system of cytidine 5'monophospho-N-acetylneuraminic acid (CMP-NeuAc) and sialyloligosaccharides was established by a whole-cell reaction through the combination of recombinant Escherichia coli strains and Corynebacterium ammonia-genes. For the production of CMP-NeuAc, two recombinant E. coli strains were generated that overexpressed the genes of CMP-NeuAc synthetase and CTP synthetase, respectively. C. ammoniagenes contributed to the formation of UTP from orotic acid. CMP-NeuAc was accumulated at 27 mM (17 g/l) after a 27-h reaction starting with orotic acid and N-acetylneuraminic acid. When E. coli cells that overexpressed the alpha-(2-->3)-sialyltransferase gene of Neisseria gonorrhoeae were put into the CMP-NeuAc production system, 3'-sialyllactose was accumulated at 52 mM (33 g/l) after an 11-h reaction starting with orotic acid, N-acetylneuraminic acid, and lactose. Almost no oligosaccharide byproducts other than 3'-sialyllactose were observed after the reaction. The production of 3'-sialyllactose at a 5-l jar fermenter scale was almost the same as that at a beaker scale, which indicated the high potential of the 3'-sialyllactose production on an industrial scale.

Role of fracture hematoma and periosteum during fracture healing in rats: interaction of fracture hematoma and the periosteum in the initial step of the healing process

To study the mechanisms of fracture healing, we investigated the interaction between fracture hematoma and periosteum during the early phase of fracture healing in rats. Experimentally induced fractures of the tibia in untreated rats were compared histologically with such fractures in rats in which either the bone marrow or the periosteum had been removed. The extent of periosteal cell proliferation and chondrogenesis in the fracture hematoma was evaluated on experimental days 3, 6, 10, and 14. On day 3, periosteal cell proliferation at the tibial fracture site was decreased in the bone marrow-removed rats compared with the proliferation in untreated rats. Little chondrogenesis in the fracture hematoma was seen through day 6 in the periosteum-removed rats. These results suggest that the periosteum is important for mediating the primary steps of chondrogenesis and enchondral ossification in the fracture hematoma and that the fracture hematoma may be essential for periosteal cell proliferation during fracture healing.

Whole microbial cell processes for manufacturing amino acids, vitamins or ribonucleotides

The development of recombinant DNA technology has greatly expanded whole microbial cell processes for manufacturing amino acids, vitamins, or ribonucleotides. A novel well-designed scheme with integrated enzymatic conversions and fermentation enables the production of even complicated compounds, such as sugar nucleotides and oligosaccharides.

A cold-adapted protease engineered by experimental evolution system

A new cold-adapted protease subtilisin BPN' mutant, termed m-51, was successfully isolated by use of an evolutionary program consisting of two-step in vitro random mutagenesis, which we developed for the screening of mutant subtilisins with increased activity at low temperature. The m-51 mutant showed 70% higher catalytic efficiency, expressed by the k(cat)/K(m) value, than the wild-type at 10 degrees C against N-succinyl-L-Ala-L-Ala-L-Pro-L-Phe-p-nitroanilide as a synthetic substrate. This cold-adaptation was achieved mainly by the increase in the k(cat) value in a temperature-dependent manner. Genetic analysis revealed that m-51 had three mutations, Ala-->Thr at position -31 (A-31T) in the prodomain, Ala-->Val at position 88 (A88V), and Ala-->Thr at position 98 (A98T). From kinetic parameters of the purified mutant enzymes, it was found that the A98T mutation led to 30% activity increase, which was enhanced up to 70% by the accompanying neutral mutation A88V. The A-31T mutation severely constrained the autoprocessing-mediated maturation of the pro-subtilisin in the Escherichia coli expression system, thus probably causing an activity-non-detectable mutation in the first step of mutagenesis. No distinct change was observed in the thermal stability of any mutant or in the substrate specificity for m-51. In the molecular models of the two single mutants (A88V and A98T), relatively large displacements of alpha carbon atoms were found around the mutation points. In the model of the double mutant (A88V/A98T), on the other hand, the structural changes around the mutation point counterbalanced each other, and thus no crucial displacements occurred. This mutual effect may be related to the enhanced activity of the double mutant.

Improvement of cisplatin-induced emesis and delayed gastric emptying by KB-R6933, a novel 5-HT3 receptor antagonist

The effects of a novel 5-hydroxytryptamine3 (5-HT3) receptor antagonist, KB-R6933, 6-amino-5-chloro-1-isopropyl-2-(4-methyl-1-piperazinyl)-benzimidazole dimaleate, on emesis and delayed gastric emptying induced by cisplatin were assessed in experimental models. Prophylactic intravenous or oral treatment with KB-R6933 prolonged the latent period until the first emetic episode and decreased the number of emetic episodes induced by cisplatin in ferrets. KB-R6933 immediately inhibited the subsequent emesis when administered to the ferrets which exhibited established vomiting after administration of cisplatin. In rats treated with cisplatin, the gastric emptying rate was significantly reduced. KB-R6933 reversed the reduction of gastric emptying induced by cisplatin. These results suggest that KB-R6933 is an antiemetic agent, and could improve the cisplatin-induced delay of gastric emptying.

Microbial proline 4-hydroxylase screening and gene cloning

Microbial proline 4-hydroxylases, which hydroxylate free L-proline to trans-4-hydroxy-L-proline, were screened in order to establish an industrial system for biotransformation of L-proline to trans-4-hydroxy-L-proline. Enzyme activities were detected in eight strains, including strains of Dactylosporangium spp. and Amycolatopsis spp. The Dactylosporangium sp. strain RH1 enzyme was partially purified 3,300-fold and was estimated to be a monomer polypeptide with an apparent molecular mass of 31 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Degenerate primers based on the N-terminal amino acid sequence of the 31-kDa polypeptide were synthesized in order to amplify the corresponding 71-bp DNA fragment. A 5.5-kbp DNA fragment was isolated by using the 71-bp fragment labeled with digoxigenin as a probe for a genomic library of Dactylosporangium sp. strain RH1 constructed in Escherichia coli. One of the open reading frames found in the cloned DNA, which encoded a 272-amino-acid polypeptide (molecular mass, 29, 715 daltons), was thought to be a proline 4-hydroxylase gene. The gene was expressed in E. coli as a fused protein with the N-terminal 34 amino acids of the beta-galactosidase alpha-fragment. The E. coli recombinant exhibited proline 4-hydroxylase activity that was 13. 6-fold higher than the activity in the original strain, Dactylosporangium sp. strain RH1. No homology was detected with other 2-oxoglutarate-dependent dioxygenases when databases were searched; however, the histidine motif conserved in 2-oxoglutarate-dependent dioxygenases was found in the gene.