Health inequities and marginalized groups: An overview for college student travelers and travel health professionals

One of the main goals of college- and university-sponsored travel is to broaden the global perspectives of student travelers, thereby enhancing their ability to effectively communicate and work with people from different cultural backgrounds. Pre-travel consultations are important for all students traveling internationally, and especially for those facing current or past health inequities and marginalization. To offer high quality, inclusive services, college travel health clinicians must understand both the student traveler population and cultural norms at the travel destinations, especially those related to health and safety. This article provides an overview of health equity definitions and pre-travel preparation through an equity lens. It also reviews travel health equity-related clinical implications including: helping to prepare student travelers for issues related to gender, sexuality, identity, and sexual assault; assisting travelers with preexisting health conditions and disabilities; and serving older student travelers and travelers with financial limitations.

Sodium fluoride induces changes on proteoglycans synthesized by avian osteoblasts in culture

The results reported here show that sodium fluoride (NaF) at low concentration (up to 10 microM) increased four times the proliferation rate of avian osteoblasts in culture. Also NaF increases, in a concentration dependent manner, 10 times the alkaline phosphatase activity. However, NaF decreased the incorporation of 35S-sulfate into proteoglycans (PGs) synthesized by osteoblasts (60-65%). Also, we observed that PGs synthesized in the presence of NaF (50 microM) exhibited a higher sensitivity to chondroitinase ABC than PGs synthesized by osteoblasts in the absence of NaF, suggesting an increase in the chondroitin sulfate moieties associated with the core protein of PGs. The modification of glycosaminoglycan (GAG) chains composition was evidenced also by change in the mean charge density of the PGs observed by ion exchange chromatography. Since the ratio of 35SO4/3H-glucosamine incorporated into PGs was similar in the presence and in the absence of NaF (8.2 and 7, respectively), it is not possible to explain differences in mean charge density by changes in the sulfation extent of PGs. No differences were observed in the hydrodynamic size of PG synthesized in the presence of NaF, nor in the hydrodynamic size of the GAG chains. According to these results, we speculate that the stimulatory effect of fluoride on bone mineralization may be mediated, in part, by the changes in the rate of synthesis or in the structural characteristics of bone PGs. The changes produced by fluoride in PGs suggest that these molecules play an inhibitory role in the bone mineralization process.

Effects of zinc on cell proliferation and proteoglycan characteristics of epiphyseal chondrocytes

Zinc has been postulated as an important nutritional factor involved in growth promotion; however, the cellular mechanisms involved in the effects of zinc on linear growth remain to be elucidated. This study was conducted to evaluate the effects of zinc on the proliferation rate of epiphyseal growth plate chondrocytes and on the structural characteristics of the proteoglycans synthesized by these cells. For these purposes, hypertrophic and proliferating chondrocytes were isolated from the tibiae of 1- and 5-week-old chickens, respectively. Chondrocytes were cultured under serum-free conditions and primary cultures were used. The results showed that zinc stimulated proliferation by 40-50% above the baseline in the case of proliferating chondrocytes, but it had no effect on hypertrophic chondrocytes. Zinc had neither any effects on mean charge density of proteoglycans synthesized by hypertrophic chondrocytes nor in their hydrodynamic size. In contrast, zinc induced an increase in mean charge density and a decrease of hydrodynamic size of proteoglycans synthesized by proliferating chondrocytes. In both cell types zinc had no effect on the composition and hydrodynamic size of the glycosaminoglycan chains. The increased ability of proliferating chondrocytes cultured in the presence of zinc to synthesize 3'-phosphoadenosine 5'-phosphosulfate (PAPS) could be explained by the induction of enzymes participating in the sulfation pathway of proteoglycans. Therefore, the increase in mean charge density of proteoglycans observed in this study may be explained by an increase of the degree of sulfation of proteoglycan molecules. We speculate that the effect of zinc on linear growth may be explained at a cellular level by: a) an increase in proliferation rates of proliferating chondrocytes, and b) increased synthesis of highly charged proteoglycan molecules which decreases mineralization.

Type X collagen biosynthesis and expression in avian tibial dyschondroplasia

OBJECTIVE

Tibial dyschondroplasia (TD) is an abnormality of growth plate cartilage characterized by the presence of non-vascularized, non-mineralized tissue. The objective of this study was to examine structural and functional alterations of the growth plate-specific type X collagen in TD cartilage.

DESIGN

Collagen biosynthesis was examined in organ cultures and in cultured chondrocytes from normal growth plate and TD cartilage. Thermal stability of type X collagen extracted from normal and TD cartilage organ cultures to protease digestions by trypsin plus chymotrypsin or bacterial collagenase was determined. The expression of collagen genes was examined in cultured normal and TD chondrocytes.

RESULTS

Synthesis of total collagen and of type X collagen was greater than threefold higher in organ cultures from the TD lesion compared with normal growth plate. The increase in type X collagen synthesis in the lesion was compensated by a reduction in the relative proportions of types II and XI collagens. The thermal denaturation and collagenase cleavage properties of purified types II and X collagens from TD cartilage were normal. The expression of type X collagen gene was threefold higher in cultured TD chondrocytes compared to chondrocytes from normal growth plate. Normal growth plate chondrocytes in primary cultures synthesized predominantly type X collagen (80% of total collagen). In contrast, TD chondrocytes synthesized mainly types I and II collagens and type X collagen represented only 22% of total collagen. TD cells initiated the synthesis of type I collagen within 5 days of primary culture, whereas normal chondrocytes did not synthesize this collagen during the same culture period. Although type X collagen synthesis was reduced in TD chondrocytes, the mRNA levels for type X collagen were substantially higher than in normal chondrocytes.

CONCLUSION

Accumulation of type X collagen in TD cartilage results from its increased biosynthesis which is due largely to increased expression of the gene for this collagen, although, the chondrocyte culture studies suggest the possibility of postranscriptional defect in type X collagen synthesis or processing in TD lesion. Moreover, the TD chondrocytes in contrast with normal chondrocytes display evidence of prompt loss of their specific phenotype during short-term primary cultures.

Determination of gizzerosine activity in fish meal with a homologous radioimmunoassay

A homologous RIA for the determination of toxic gizzerosine activity in commercial fish meals has been developed. Three polyclonal antibodies (GR316, GR415, and GR418) were produced in female rabbits and extensively characterized for their potential use in individual RIA. The RIA had lower detection limits of 0.048, 0.78, and 0.39 ng/mg using the three respective antibodies. Because gizzerosine is derived from lysine and histidine, crossreactivity with these amino acids, and with histamine was examined. The antibodies crossreacted with histamine from 21 to 100%. No crossreactivity with histidine or lysine was observed for any of the three antibodies. Antibody GR415 was chosen for determination of gizzerosine in extracted fish meal samples because crossreactivity of histamine using this antibody was only present at high concentrations, and the Ka value for gizzerosine was 10-fold greater than for histamine. A mild buffer extraction procedure was used, resulting in 98% gizzerosine recovery. Displacement curves from extracted and serially diluted fish meal samples were parallel with gizzerosine standard. Inter-and intra-assay coefficients of variation were 11 and 15%, respectively. We used the RIA for determination of gizzerosine activity in a pool of 23 fish meal samples of known gizzerosine scores (determined with a chick bioassay), and histamine content. The partial correlation coefficient between gizzerosine content determined by the RIA and gizzerosine scores from the bioassay was high (0.83), and significant (P < 0.01). There were also significant correlations between gizzerosine scores and histamine content of the fish meals (0.63, P < 0.01), and between histamine content and gizzerosine levels determined by the RIA (0.59, P < 0.01). The application of the homologous RIA for the determination of gizzerosine activity in commercial fish meals could be of importance for the prevention of gizzard erosions in the poultry industry, and for studying gizzerosine-induced pathology and metabolism.

Plasma clearance and tissue distribution of labelled chicken and human IGF-I and IGF-II in the chicken

The metabolic clearance of chicken IGF-I (cIGF-I), cIGF-II, human IGF-I (hIGF-I), and hIGF-II was examined in the chicken using 125I-labelled growth factors. Superose-12 chromatography of plasma collected at 7.5 min post-infusion revealed peaks of radioactivity corresponding to 150 and 43 kDa and unbound tracer. Statistical analysis of trichloroacetic acid (TCA)-precipitable radioactivity in sequential plasma samples as well as following chromatography of the same samples revealed that clearance of the radiolabelled peptides followed an apparent triphasic pattern. The close similarity of the individual chromatographically defined pools in their clearance rate compared with the three components described by TCA precipitation strongly suggested their identity. Both free 125I-labelled cIGF-II (3.11 min) and hIGF-II (3.01 min) were cleared at a greater rate than their IGF-I counterparts. Unbound hIGF-I was cleared at a greater rate than cIGF-I (4.45 vs 5.66 min respectively). A similar pattern for clearance was evident in the radio-labelled growth factors associated with the 43 kDa component, although at a longer half-life. There was no difference in the apparent clearance of the radiolabelled growth factors associated with the 150 kDa component between IGF-I or -II or between species. Analysis of the chromatographic profiles of radioactive IGF-I peptides complexed to serum proteins versus those bound to labelled IGF-II peptides revealed the presence of a large molecular mass binding protein in vivo. Ligand blotting of chicken serum determined that a binding protein with a mass of 70 kDa was detectable with 125I-IGF-II probes only, and was not present in pig serum. In addition, tissue uptake of 125I-cIGF-I and -II was evaluated. Similar patterns of tissue distribution and uptake were observed for 125I-cIGF-I and -II, except that cIGF-II uptake by the liver exceeded that of 125I-cIGF-I at 15 min post-infusion. The rank order of tissue distribution was as follows: kidney > testis > heart > liver > pancreas > small intestine > cartilage > bursa > gizzard > leg muscle > breast muscle > brain. We conclude from these studies that the clearance of IGFs from the compartments identified in blood and the potential target tissues is dependent on their interactions with IGF-binding proteins and receptors.

Effect of exogenous chicken growth hormone (cGH) administration on insulin-like growth factor-I (IGF-I) gene expression in domestic fowl

The effects of chicken growth hormone (cGH) infusion on insulin-like growth factor (IGF-I) gene expression in rapidly-growing, meat-type chickens was investigated. Chicken GH was infused either continuously or in a pulsatile fashion to 8-week-old birds during a 7-day period. Following cGH infusion, both IGF-I peptide and IGF-I mRNA content were measured in selected tissues. Steady-state IGF-I mRNA abundance was determined by a solution hybridization nuclease protection assay using total cellular RNA obtained from liver, heart, kidney, spleen, epiphyseal growth plate cartilage, gastrocnemius and pectoralis muscles. Continuous infusion of cGH elicited a two-fold increase in IGF-I peptide concentration in the kidney (P < 0.05), while all other tissues remained unchanged by cGH treatment under this infusion pattern. Pulsatile cGH infusion produced a two-fold increase in IGF-I peptide content in the liver, gastrocnemius, and pectoralis muscles (P < 0.05). In contrast with the levels of IGI-I peptide, relative steady-state IGF-I mRNA content was two-fold higher in liver and spleen of birds treated continuously with cGH, but was decreased to 35 and 55% of control birds in heart and pectoralis muscle. Pulsatile cGH infusion resulted in a 64% increase in IGF-I mRNA in the liver and remained unchanged in other tissues. Under both patterns of administration, changes in IGF-I mRNA were not reflected by changes in tissue IGF-I peptide levels. Overall correlations between tissue IGF-I mRNA and peptide levels were low and not significant in the tissues studied, except for liver under pulsatile infusion, in which IGF-I peptide levels paralleled changes in IGF-I mRNA. We conclude that, in chickens, exogenous cGH treatment stimulates hepatic IGF-I transcription and translation only when the pattern of infusion mimics the natural episodic pattern of GH secretion. The low correlation between IGF-I peptide and mRNA levels in extra-hepatic tissues may indicate differential responsiveness to GH in birds, and that in some tissues IGF-I levels are under GH-independent transcriptional controls.

Developmental changes in chicken and turkey insulin-like growth factor-I (IGF-I) studied with a homologous radioimmunoassay for chicken IGF-I

The development of a homologous radioimmunoassay (RIA) for chicken insulin-like growth factor-I (cIGF-I) and its use to investigate the developmental changes in IGF-I in the chicken and turkey is described. A double-antibody RIA has been developed using recombinantly derived cIGF-I as antigen, radiolabelled tracer and standard. The resulting immunoassay has a minimum detection limit of 0.035 ng and effective dose of 2.5 ng. Dose-response curves of chicken and turkey plasma and tissue extracts were parallel with cIGF-I standard. The antiserum is specific for IGF-I as no cross-reactivity with chicken IGF-II, insulin, glucagon, gastrin or avian pancreatic polypeptide was observed. We have also established that acid/ethanol extraction of chicken and turkey plasma reduced possible interference of IGF-binding proteins (IGFBPs) in the RIA. Comparison of IGF-I immunoactivity in unextracted and acid/ethanol-extracted samples following gel filtration under acidic and neutral conditions indicates that the cIGFBPs may be acid-labile. Analyses of samples from growing chickens and turkeys using the homologous avian reagents revealed higher IGF-I concentrations than if the IGF were quantified using heterologous mammalian-derived reagents. A similar pattern was observed when tissue extracts were assayed for IGF-I content. The application of the homologous RIA to monitor blood and tissue IGF-I levels during embryonic development and posthatch growth in avian species will provide more accurate comparisons of results from studies on the role of IGF-I in growth and metabolism of domestic birds.

Effect of growth hormone, insulin-like growth factor I, basic fibroblast growth factor, and transforming growth factor beta on cell proliferation and proteoglycan synthesis by avian postembryonic growth plate chondrocytes

We examined the in vitro effects of pituitary-derived chicken growth hormone (cGH), recombinant human insulin-like growth factor-I (rhIGF-I), recombinant human basic fibroblast growth factor (rhbFGF), and porcine transforming growth factor beta (pTGF-beta) on proliferation ([3H]thymidine uptake) and matrix proteoglycan synthesis (35SO4 incorporation) by chicken epiphyseal growth plate chondrocytes. Factorial experiments were used to study the effect of these substances in a serum-free culture system. Basic FGF had to be present in the culture medium for mitogenesis to take place. In the presence of this peptide, TGF-beta, TGF-beta + IGF-I, and newborn calf serum (NCS) stimulated mitogenesis. The mitogenic activity of NCS could be duplicated by adding platelet-derived growth factor (PDGF) to the culture medium. For matrix synthesis, IGF-I was the key factor, with the addition of TGF-beta, TGF-beta+bFGF, or serum producing further stimulation in matrix synthesis. Using this culturing system, homologous cGH did not stimulate cell proliferation or proteoglycan synthesis. The lack of stimulatory activity of cGH was consistent, regardless of the age of the birds from which the chondrocytes were isolated, the zone of the growth plate, or the level of cGH used. None of the growth factors used in this study or several other systemic hormones were found to be permissive factors for GH to be active. Either other factors must be present for a direct effect of GH on growth plate chondrocytes, or the avian species differ from their mammalian counterpart.

Effect of lesion size on the metabolic activity of tibial dyschondroplastic chondrocytes

Experiments were conducted to determine the influence of lesion size and method of producing tibial dyschondroplasia on metabolic activity of cultured chondrocytes. Genetic selection was one method used to produce a high incidence of tibial dyschondroplasia. Chondrocytes obtained from severe lesions exhibited reduced mitogenic activity (3H-thymidine incorporation) and ability to synthesize matrix proteoglycans (35SO4 incorporation) when compared with normal growth plate and smaller lesions. When a commercial broiler strain was used, all chondrocytes isolated from lesions induced by feeding thiram had reduced metabolic activity. Similar results were observed with severe lesions obtained from copper-deficient chicks. It is concluded that lesion size is an important factor in determining subsequent metabolic activity of chondrocytes isolated from tibial dyschondroplastic lesions.

Development of a serum-free system to study the effect of growth hormone and insulinlike growth factor-I on cultured postembryonic growth plate chondrocytes

We have developed a serum-free system to culture postembryonic growth plate chondrocytes while maintaining some important phenotypic characteristics of their tissue of origin. This serum-free medium was as effective as medium containing 10% newborn bovine serum (NBS) for recovering the cells from enzymatic isolation. Surface secretory activity of chondrocytes cultured in monolayer, assessed through scanning electron microscopy, was also comparable to cells grown in medium containing serum. The effects of growth hormone (GH) and insulinlike growth factor-I (IGF-I) were also studied using the serum-free medium. GH had no effect on cell density and morphology of the cells compared to the control without the hormone. In contrast, chondrocytes grown in medium containing IGF-I had a marked increase in cell density after 3 days and presented similar morphologic characteristics to cells grown in the presence of NBS. The growth factors required for proliferation of chondrocytes cultured in the serum-free medium are IGF-I and fibroblast growth factor (100 ng/ml, respectively). Addition of ascorbic acid to the serum-free medium (0 to 50 micrograms/ml) produced a dose-dependent decrease in cell proliferation. This medium should provide a useful tool for studying the effects of different growth factors/hormones in the regulation of longitudinal bone growth and their interactions.