Sex omission and male bias are still widespread in cell experiments

Integrating sex as an important biological variable is imperative to enhance the accuracy and reproducibility of cell-based studies, which provide basic information for subsequent preclinical and clinical study designs. Recently, international funding agencies and renowned journals have been attempting to integrate sex as a variable in every research step. To understand what progress has been made in reporting of cell sex in the articles published in AJP-Cell Physiology since the analysis in 2013, we examined the sex notation of the cells in relevant articles published in the same journal in 2018. Of the 107 articles reporting cell experiments, 53 reported the sex of the cells, 18 used both male and female cells, 23 used male cells only, and 12 used female cells only. Sex omission was more frequent when cell lines were used than when primary cells were used. In the articles describing experiments performed using rodent primary cells, more than half of the studies used only male cells. Our results showed an overall improvement in sex reporting for cells in AJP-Cell Physiology articles from 2013 (25%) to 2018 (50%). However, sex omission and male bias were often found still. Furthermore, the obtained results were rarely analyzed by sex even when both male and female cells were used in the experiments. To boost sex-considerate research implementation in basic biomedical studies, cooperative efforts of the research community, funders, and publishers are urged.

Cell Cycle Dysregulation Is Associated With 5-Fluorouracil Resistance in Gastric Cancer Cells

BACKGROUND/AIM

5-Fluorouracil (5-FU) is an anticancer drug commonly used to treat gastric cancer; however, continuous 5-FU chemotherapy causes drug resistance.

MATERIALS AND METHODS

We established five sublines of 5-FU-resistant AGS gastric cancer cells to investigate changes that may have occurred in the development of 5-FU resistance. Drug resistance to other chemotherapeutic reagents, proliferation, cell-cycle changes, and wound healing ability were assessed for each subline.

RESULTS

Retarded cell growth, G₀/G₁ phase arrest, up-regulation of p57, and down-regulation of cyclin D1 were commonly observed in all five sublines. Resistance to paclitaxel and cisplatin was also observed in most of the sublines.

CONCLUSION

Our data support the notion that G₀/G₁ arrest due to changes in p57 and cyclin D1 expression may confer drug resistance, while EMT seems non-essential to 5-FU resistance in AGS gastric carcinoma cells.

Epstein-Barr Virus miR-BART17-5p Promotes Migration and Anchorage-Independent Growth by Targeting Kruppel-Like Factor 2 in Gastric Cancer

Epstein-Barr virus (EBV) infects more than 90% of the global population and is associated with a variety of tumors including nasopharyngeal carcinoma, Hodgkin lymphoma, natural killer/T lymphoma, and gastric carcinoma. In EBV-associated gastric cancer (EBVaGC), highly expressed EBV BamHI A rightward transcripts (BART) miRNAs may contribute to tumorigenesis with limited viral antigens. Despite previous studies on the targets of BART miRNAs, the functions of all 44 BART miRNAs have not been fully clarified. Here, we used RNA sequencing data from the Cancer Genome Atlas to find genes with decreased expression in EBVaGC. Furthermore, we used AGS cells infected with EBV to determine whether expression was reduced by BART miRNA. We showed that the expression of Kruppel-like factor 2 (KLF2) is lower in AGS-EBV cells than in the AGS control. Using bioinformatics analysis, four BART miRNAs were selected to check whether they suppress KLF2 expression. We found that only miR-BART17-5p directly down-regulated KLF2 and promoted gastric carcinoma cell migration and anchorage-independent growth. Our data suggest that KLF2 functions as a tumor suppressor in EBVaGC and that miR-BART17-5p may be a valuable target for effective EBVaGC treatment.

Epstein-Barr virus miR-BART1-3p suppresses apoptosis and promotes migration of gastric carcinoma cells by targeting DAB2

Although Epstein-Barr virus (EBV) is known to encode over 40 different miRNAs of its own, the roles of most EBV miRNAs remain unknown. Disabled homolog 2 (DAB2) is a putative tumor suppressor, but its role in gastric carcinoma (GC), especially in EBV-associated GC, needs to be clarified. Our qRT-PCR and mRNA microarray results showed that DAB2 expression was down-regulated in EBV-positive GC cells compared to EBV-negative cells. Four BART miRNAs that might target DAB2 were predicted, and we found, using a luciferase reporter assay, that miR-BART1-3p directly targeted the 3'-UTR of DAB2. The miR-BART1-3p transfection decreased DAB2 expression at both mRNA and protein levels, while transfection of an inhibitor of miR-BART1-3p, miR-BART1-3p(i), increased DAB2 expression. In addition, miR-BART1-3p as well as siDAB2 increased migration and decreased apoptosis. Meanwhile, miR-BART1-3p(i) or pcDNA3.1-DAB2 transfection decreased migration and increased apoptosis in EBV-infected GC cells. Furthermore, decreased migration by miR-BART1-3p(i) was abrogated by co-transfected siDAB2, while decreased migration by miR-BART1-3p(i) was further suppressed by a co-transfected DAB2 over-expression vector. Our data suggest that miR-BART1-3p plays an important role in the tumorigenesis of EBV-associated GC by directly targeting DAB2.

EBV miR-BART10-3p Promotes Cell Proliferation and Migration by Targeting DKK1

In Epstein-Barr virus (EBV)-infected epithelial cancers, BamHI A rightward transcript (BART) miRNAs are highly expressed. However, only a few target genes of BART miRNAs have been investigated. Our mRNA microarray data showed that DKK1 was markedly down-regulated in EBV-associated gastric carcinoma (EBVaGC) cells. Using luciferase reporter assay we tested whether miR-BART10-3p regulates DKK1 by directly targeting the 3'-UTR of DKK1 mRNA. We observed that miR-BART10-3p transfection decreased DKK1 expression, while an LNA inhibitor of miR-BART10-3p (LNA-miR-BART10-3p(i)) increased DKK1 expression. Furthermore, miR-BART10-3p and siDKK1 promoted cell proliferation and migration. In contrast, transfecting GC cells with LNA-miR-BART10-3p(i) or DKK1 over expression vector suppressed cell proliferation and migration. Our results suggest that miR-BART10-3p may be involved in the tumor progression of EBVaGC by targeting DKK1.

Efficient and wash-free labeling of membrane proteins using engineered Npu DnaE split-inteins

An efficient and wash-free method to conjugate a fluorescent tag to a target membrane protein is developed, using engineered Npu DnaE split-inteins. This approach allowed fast labeling while avoiding the strenuous synthesis of a long polypeptide. Two different modes of labeling, namely specific binding and covalent conjugation, are observed. The covalent labeling was monitored within 5 min, without background staining.

Photo-triggered fluorescent labelling of recombinant proteins in live cells

A method to photo-chemically trigger fluorescent labelling of proteins in live cells is developed. The approach is based on photo-caged split-intein mediated conditional protein trans-splicing reaction and enabled background-free fluorescent labelling of target proteins with the necessary spatiotemporal control.

Surgery for lumbar disc herniation: Analysis of 500 consecutive patients treated in an interdisciplinary spine centre

Surgical removal of a symptomatic herniated lumbar disc is performed either with or without the support of a microscope. Up to the time of writing, the literature has reported similar clinical outcomes for the two procedures. Five hundred consecutive patients, operated upon for primary single-level lumbar disc herniation in our University Spine Center between 2003-2011, with (n=275), or without (n=225), the aid of a microscope were included. Data were retrospectively analyzed, comparing the primary endpoint of clinical outcome and the secondary endpoints of complications, surgical time and length of hospitalization. Clinical outcomes and reoperation rates were comparable in both groups. Surgical time was significantly shorter with a mean time of 47minutes without use of the microscope compared to the mean time of 87minutes (p<0.001) with the use of the microscope. Mean length of hospitalization was shorter in those operated with the microscope (5.3days) compared to those without (6.1days, p=0.004). There was no difference in rates of complications. Microdiscectomy versus open sequestrectomy and discectomy for surgical treatment of lumbar disc herniation is associated with similar clinical outcomes and reoperation rates. Open sequestrectomy is associated with shorter operation times. Microdiscectomy is associated with shorter hospitalization stays.

Higher fibrinogen concentrations for reduction of transfusion requirements during major paediatric surgery: A prospective randomised controlled trial

BACKGROUND

Hypofibrinogenaemia is one of the main reasons for development of perioperative coagulopathy during major paediatric surgery. The aim of this study was to assess whether prophylactic maintenance of higher fibrinogen concentrations through administration of fibrinogen concentrate would decrease the volume of transfused red blood cell (RBCs).

METHODS

In this prospective, randomised, clinical trial, patients aged 6 months to 17 yr undergoing craniosynostosis and scoliosis surgery received fibrinogen concentrate (30 mg kg(-1)) at two predefined intraoperative fibrinogen concentrations [ROTEM(®) FIBTEM maximum clot firmness (MCF) of <8 mm (conventional) or <13 mm (early substitution)]. Total volume of transfused RBCs was recorded over 24 h after start of surgery.

RESULTS

Thirty children who underwent craniosynostosis surgery and 19 children who underwent scoliosis surgery were treated per protocol. During craniosynostosis surgery, children in the early substitution group received significantly less RBCs (median, 28 ml kg(-1); IQR, 21 to 50 ml kg(-1)) compared with the conventional fibrinogen trigger of <8 mm (median, 56 ml kg(-1); IQR, 28 to 62 ml kg(-1)) (P=0.03). Calculated blood loss as per cent of estimated total blood volume decreased from a median of 160% (IQR, 110-190%) to a median of 90% (IQR, 78-110%) (P=0.017). No significant changes were observed in the scoliosis surgery population. No bleeding events requiring surgical intervention, postoperative transfusions of RBCs, or treatment-related adverse events were observed.

CONCLUSIONS

Intraoperative administration of fibrinogen concentrate using a FIBTEM MCF trigger level of <13 mm can be successfully used to significantly decrease bleeding, and transfusion requirements in the setting of craniosynostosis surgery, but not scoliosis.

CLINICAL TRIAL REGISTRY NUMBER

ClinicalTrials.gov NCT01487837.

Semiautomatic superimposition improves radiological assessment of curve flexibility in scoliosis

OBJECTIVE

Assessment of scoliotic curve flexibility and stiffness is essential for planning surgical treatment in adolescent idiopathic scoliosis (AIS). Measurement of curve flexibility is currently insufficiently precise. The purpose of this study was to introduce and validate a novel method of superimposing radiographs for more reliable measurement of curve flexibility.

MATERIAL AND METHODS

Two independent radiologists measured Cobb angles separately on standard anterior-posterior (AP) (n = 48) and supine bending radiographs (n = 48), in patients with AIS, who were randomly included from a surgical database. The same readers repeated the measurements after the bending radiographs were semi-automatically superimposed on the AP radiographs by fusing the caudad end vertebra. Curve flexibility was calculated. Inter-reader agreement between the two independent readers was calculated using interclass correlation coefficient (ICC).

RESULTS

A moderate inter-reader agreement was achieved in the upper curve (ICC = 0.57) and a good agreement in the lower curve (ICC = 0.72) with the standard method of assessing curve flexibility. With the use of the semiautomatic superimposition, however, almost perfect agreement was achieved for both the upper and the lower curves flexibilities (ICC = 0.93 and 0.97, respectively).

CONCLUSION

The introduced semi-automatic superimposition technique for measurement of scoliotic curve flexibility in AIS is more precise and reliable than the current standard method.

Chemical biology-based approaches on fluorescent labeling of proteins in live cells

Recently, significant advances have been made in live cell imaging owing to the rapid development of selective labeling of proteins in vivo. Green fluorescent protein (GFP) was the first example of fluorescent reporters genetically introduced to protein of interest (POI). While GFP and various types of engineered fluorescent proteins (FPs) have been actively used for live cell imaging for many years, the size and the limited windows of fluorescent spectra of GFP and its variants set limits on possible applications. In order to complement FP-based labeling methods, alternative approaches that allow incorporation of synthetic fluorescent probes to target POIs were developed. Synthetic fluorescent probes are smaller than fluorescent proteins, often have improved photochemical properties, and offer a larger variety of colors. These synthetic probes can be introduced to POIs selectively by numerous approaches that can be largely categorized into chemical recognition-based labeling, which utilizes metal-chelating peptide tags and fluorophore-carrying metal complexes, and biological recognition-based labeling, such as (1) specific non-covalent binding between an enzyme tag and its fluorophore-carrying substrate, (2) self-modification of protein tags using substrate variants conjugated to fluorophores, (3) enzymatic reaction to generate a covalent binding between a small molecule substrate and a peptide tag, and (4) split-intein-based C-terminal labeling of target proteins. The chemical recognition-based labeling reaction often suffers from compromised selectivity of metal-ligand interaction in the cytosolic environment, consequently producing high background signals. Use of protein-substrate interactions or enzyme-mediated reactions generally shows improved specificity but each method has its limitations. Some examples are the presence of large linker protein, restriction on the choice of introducible probes due to the substrate specificity of enzymes, and competitive reaction mediated by an endogenous analogue of the introduced protein tag. These limitations have been addressed, in part, by the split-intein-based labeling approach, which introduces fluorescent probes with a minimal size (~4 amino acids) peptide tag. In this review, the advantages and the limitations of each labeling method are discussed.

Abduction extension cervical nerve root stress test: anatomical basis and clinical relevance

PURPOSE

While the Lasègue straight leg raising test is an established test for lumbar nerve root compression, an established equivalent for cervical nerve root compression is missing. The aim of this bi-modal study was to find the most effective way to stretch the cervical nerve roots anatomically in cadavers and to assess its value in the clinical setting.

METHODS

Three positional maneuvers of the upper limb were tested on three cadavers to determine the displacement by stretch of the nerve roots C5, C6 and C7. The maneuver which was most efficient in nerve root displacement was applied in 24 patients with confirmed symptomatic cervical nerve root compression (cases) and 65 controls to assess the clinical value of the test.

RESULTS

The most efficient way to displace the cervical nerve roots by stretch was to apply dorsal pressure on the humeral head with the shoulder in 80° of abduction and 30° of extension, with slight elbow flexion while the head is facing the contralateral side. This maneuver produced 4-5 mm of nerve root displacement in cadavers. This test aggravated radicular symptoms in 79% of the patients with cervical nerve root compression and was negative in 98% of the controls.

CONCLUSION

The described abduction extension test with posterior push on the humeral head creates a fulcrum over which the brachial plexus can be displaced to create stress on cervical nerve roots. This simple test is easy to perform clinically and aggravates radicular symptoms in most of the patients with cervical nerve root compression while it is negative in nearly all of the controls.

Flow Visualization of the Rubber Compounding Cycle in an Internal Mixer based on Elastomer Blends

A flow visualization study of the blending of elastomers and the subsequent mixing of carbon black and oil in an internal mixer is described. The elastomers studied were natural rubber, cis-polybutadiene and a solution styrene-butadiene copolymer. Studies were made of addition to the mixer of mini bales of earch rubber pigmented with different colors and their subsequent homogenization. Subsequently we investigated the blending of bales of the different rubbers and determined the homogenication times. Similar investigations were made of the addition of carbon black and oil black homogenization times and oil absorption times were determine. These are correlated with the rheological properties of the elastomers.

Modelling Flow in Pin-Barrel Screw Extruders

The flow in a pin-barrel extruder has been analyzed based on a Newtonian fluid model. A numerical simulation based on the FAN method of Tadmor and his coworkers and an analytical model were used. The calculations show that the introduction of slices into screw flights and pins make the apparatus a much poorer screw pump. It would appear that the machine is though an effective continuous (distributive) mixing device.

Flow Visualization Parallel and Perpendicular to the Rotor Axes for Elastomers and Molten Plastics in an Internal Mixer

Basic studies of flow visualization for elastomers and plastics in an internal mixer are described. A modified laboratory mixer with transparent front and trasverse windows was used to observe parallel and perpendicular motions. Shearing, stretching and tearing motions were observed especially for elastomers. Various rotor designs were used. These indicate different flow fields along the rotor axes, and the interchange of materials between rotors. We describe the different flow fields observed for elastomers and plastics creasted by various rotor designs.

Simulation of Flow and Mixing in an Internal Mixer

A mathematical model is developed for simulation of flow in an internal mixer with two counter rotating non-intermeshing rotors is presented. The model presumes rotors with a screw flight which is separated into two sections. The mixing chamber is taken to be fully filled and rotor curvature neglected in analogy to screw extruder analyses. Lubrication theory is used and the fluid presumed Newtonian. The flow patterns within the mixing chamber are computed. The conditions under which rotor designs lead to global circulation patterns within the mixing chamber and good distributive mixing are considered. We also investigated the extent of fluid motion over rotor tips which should lead to dispersive mixing.

Flow Visualization and Performance of a Non-Intermeshing Counter-Rotating Twin Screw Extruder

A laboratory modular twin screw extruder with transverse and tangential apex windows for flow visualization is described. The machine is operated as a tengential twin screw extruder with right- and left-handed screw elements. Screw characteristic curves, Q-Δ p, were measured and compared for polyethylene in matched and staggered flight screw configurations with right-handed screw elements. Configurations with matched screw elements are better pumps. We have introduced left-handed screw elements into each screw configuration. This reduces the total pressure developed. Again matched screw element configurations are better pumps. Pressure profiles are measured along the length of the extruder. For right-handed screws, the pressure rises monotonically. Left-handed screw elements produce regions of decreasing pressure. Flow visualization investigations allow us to locate the position and follow the mechanism of the melting process. Using colored markers, we were able to see that in most (but not all cases) there was no inter-screw transfer of material.

The role of external defects in chemical sensing of graphene field-effect transistors

A fundamental understanding of chemical sensing mechanisms in graphene-based chemical field-effect transistors (chemFETs) is essential for the development of next generation chemical sensors. Here we explore the hidden sensing modalities responsible for tailoring the gas detection ability of pristine graphene sensors by exposing graphene chemFETs to electron donor and acceptor trace gas vapors. We uncover that the sensitivity (in terms of modulation in electrical conductivity) of pristine graphene chemFETs is not necessarily intrinsic to graphene, but rather it is facilitated by external defects in the insulating substrate, which can modulate the electronic properties of graphene. We disclose a mixing effect caused by partial overlap of the highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) of adsorbed gas molecules to explain graphene's ability to detect adsorbed molecules. Our results open a new design space, suggesting that control of external defects in supporting substrates can lead to tunable graphene chemical sensors, which could be developed without compromising the intrinsic electrical and structural properties of graphene.

Experiments and Analysis of Effect of Calender Gaps on Melting of PVC Powders in an Intermeshing Counter-rotating Twin-screw Extruder

Our ultrasound in-line monitoring studies revealed that dispersion or dissipation melting mechanism played a dominant role during melting of unplasticized polyvinyl chloride (uPVC) in an intermeshing counter-rotating twin-screw extruder. It is found that calendering effect between two screws contributes to the melting of PVC particles, and results in dispersion or dissipation melting. Thus, in this paper, a dispersed melting model in calender gaps is considered to predict polymer melting length in terms of numbers of calender gaps. Effects of screw geometries (channel depth, calender gap clearance) and processing conditions including screw speed and leakage flow on melting length are discussed for particle-filled fluid models. The calculated results are compared with experimental observations by both “screw pulling out” method and ultrasound in-line monitoring method. Ultrasound in-line monitoring provides a solution to overcome the time delay occurred in screw-pulling out method.

Pathological correlation with diffusion restriction on diffusion-weighted imaging in patients with pathological complete response after neoadjuvant chemoradiation therapy for locally advanced rectal cancer: preliminary results

OBJECTIVE

The objective of this study was to assess causative pathological factors associated with diffusion restriction on diffusion-weighted imaging (DWI) in patients who achieved pathological complete response (pCR) after treatment with neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer.

METHODS

In total, 43 patients with locally advanced rectal cancer (≥T3 or lymph node positive) who underwent neoadjuvant CRT, subsequent surgery and ultimately achieved pCR were enrolled. All patients underwent pre- and post-CRT 3.0 T rectal MRI with DWI. Two radiologists blinded to pathological staging reviewed pre- and post-CRT 3.0 T rectal MRI for the presence of diffusion restriction in the corresponding tumour areas on post-CRT DWI, with a third radiologist arbitrating any disagreement. The consensus of these findings was then correlated with pathological data such as intramural mucin and the degree of proctitis and mural fibrosis seen on surgical specimen. Additionally, the pre-CRT tumour volume was measured to define the effect of this variable on the degree of radiation proctitis and fibrosis, as well as the presence of intramural mucin.

RESULTS

Diffusion restriction occurred in 18 subjects (41.9%), while 25 subjects remained diffusion restriction-free (58.1%). The diffusion restriction group tended to have more severe proctitis and mural fibrosis when compared with non-diffusion restriction group (p<0.001). Intramural mucin was also more common in the diffusion restriction group (p=0.052). Higher pre-CRT tumour volumes were significantly predictive of the degree of proctitis (p=0.0247) and fibrosis (p=0.0445), but not the presence of intramural mucin (p=0.0944). Proctitis and mural fibrosis severity were also identified as independent pathological risk factors for diffusion restriction on multivariate analysis (p=0.0073 and 0.0011, respectively).

CONCLUSION

Both radiation-induced proctitis and fibrosis were significant and independent predictors of diffusion restriction in patients achieving pCR after treatment with neoadjuvant CRT for locally advanced rectal cancer, and pre-CRT tumour volume significantly affects both variables.

Size and chirality dependent elastic properties of graphene nanoribbons under uniaxial tension

We investigate the mechanical strength and properties of graphene under uniaxial tensile test as a function of size and chirality using the orthogonal tight-binding method and molecular dynamics simulations with the AIREBO potential. Our results on Young's modulus, fracture strain, and fracture strength of bulk graphene are in reasonable agreement with the recently published experimental data. Our results indicate that fracture strain and fracture strength of bulk graphene under uniaxial tension can have a significant dependence on the chirality. Mechanical properties such as Young's modulus and Poisson's ratio can depend strongly on the size and chirality of the graphene nanoribbon.

Increased expression of p63 and survivin in cholesteatomas

CONCLUSION

This study showed increased expression of p63 and survivin in cholesteatoma. Our finding indicates a putative role of p63 and survivin in the development of certain cholesteatomas.

OBJECTIVES

Keratinocytes in cholesteatoma demonstrate uncoordinated hyperproliferation, migration, and invasion properties. p63 is a p53 homologue and a marker expressed in replicating keratinocytes. Survivin is an inhibitor of apoptosis protein that is abundantly expressed in most solid and hematologic malignancies. The purpose of this study was to investigate the differential expression of p63 and survivin in human middle ear cholesteatoma epithelium.

MATERIALS AND METHODS

The expression levels of p63 and survivin protein were examined by immunohistochemical analysis of 40 cholesteatomas and 5 skin tissues obtained from patients during ear surgery.

RESULTS

Expression of p63 protein was diffusely observed in entire samples of cholesteatoma, especially in acquired cholesteatoma, compared with the control group. Congenital cholesteatoma showed variable p63 reactivity in a basal cell-like pattern. Primary and recurrent cholesteatomas showed no significant difference in p63 expression. Survivin was detected in 31 of 40 cholesteatoma samples. Acquired cholesteatomas showed especially increased survivin expression compared with congenital cases. The expression of p63 was correlated with survivin expression.

Model-based evaluation of control strategies for phosphorus removal in a full-scale advanced phase isolation ditch process

A model-based evaluation of operation conditions and control strategies was conducted for phosphorus removal in a full-scale Advanced Phase Isolation Ditch (APID) process. The APID process is an alternating type and does not have a separated anaerobic reactor. We suggested that it would be a suitable operational option for robust phosphorus removal by having a different input point for the influent and return sludge flow at specific modes. For evaluation of control strategies, three cases of influent disturbance were assumed, and five manipulated variables were selected for controlling the cases of disturbance. In the case of an increased influent flow rate, a combination of four manipulated variables is proposed through our simulation results as the best control strategy. The optimal k(L)a value was found to be 250/d when pollutants loading kept increasing without variations in the flow rate. When both the pollutants loading and the influent flow rates were increased simultaneously, the robust control strategy is to combine the return sludge inflow point, the exclusive operation modes which have a relatively long hydraulic retention time (HRT), operation period of 30 minutes, and the increase of the return sludge flow rate in proportion to the influent flow rate added to 300/d of k(L)a value.

[Comparative genetic analysis of different forms of low-renin arterial hypertension]

High level of clinical and genetic heterogeneity is a characteristic of arterial hypertension (AH) that is one of the most wide-spread cardiovascular diseases. In most cases (excluding a few monogenic forms), AH is a polygenic disease and genes of renin-angiotensin-aldosterone system play an important role in AH predisposition. 20-25% AH cases occur during low activity of renin in blood plasma (low-renin form of AH) while aldosterone production can be increased (hyperaldosteronism, HA) or normal. We examined polymorphism of genes that code the renin-angiotensin-aldosterone system components in the groups of low-renin forms of AH, namely, primary HA, idiopathic HA and AH with normal level of aldosterone. For all HA cases, the absence of chimeric CYP11B2/CYP11B1 gene that is a cause for monogenic disease--amilial HA of first type, was shown. A comparison of distributions of alleles and genotypes of polymorphous regions of genes: CYP11B2 (C-344T), REN (C-5434T, C-5312T and A BglI G), AGT (Thr174Met), ACE (I/D), CMA (G-1903A), AT2R1 (A1166C) and of their combinations is the groups described above was done. The analysis of carriership of the alleles and genotypes combinations of the polymorphous regions has shown that genes CYP11B2, REN, ACE, CMA andA T2R1 participate in development of low-renin HA. The results are evidence of similarities and some definite differences in genetic nature of the different forms of low-renin AH and, to say more widely, argue that the investigation of genetic predisposition for clinically heterogeneous forms of polygene diseases by comparison of groups of patients, separated in accordance with peculiarities of disease course, holds much promise for their hereditary background understanding.

Systematic review: the lower gastrointestinal adverse effects of non-steroidal anti-inflammatory drugs

BACKGROUND

Lower gastrointestinal effects of non-steroidal anti-inflammatory drugs (NSAIDs) are much more poorly characterized than upper gastrointestinal effects.

AIM

To determine if NSAIDs increase lower gastrointestinal adverse effects and if the risk with non-selective NSAIDs is greater than with cyclooxygenase-2-selective inhibitors (coxibs).

METHODS

Computerized databases were searched to identify studies of NSAID use reporting on lower gastrointestinal integrity (e.g. permeability), visualization (e.g. erosions, ulcers) and clinical events.

RESULTS

Designs in 47 studies were randomized (18), case-control (14), cohort (eight) and before-after (seven). Non-selective-NSAIDs had significantly more adverse effects vs. no NSAIDs in 20 of 22 lower gastrointestinal integrity studies, five of seven visualization studies, seven of 11 bleeding studies (OR: 1.9-18.4 in case-control studies), two of two perforation studies (OR: 2.5-8.1) and five of seven diverticular disease studies (OR: 1.5-11.2). Coxibs had significantly less effect vs. non-selective-NSAIDs in three of four integrity studies, one endoscopic study (RR mucosal breaks: 0.3), and two randomized studies (RR lower gastrointestinal clinical events: 0.5; haematochezia: 0.4).

CONCLUSIONS

An increase in lower gastrointestinal injury and clinical events with non-selective-NSAIDs appears relatively consistent across the heterogeneous collection of trials. Coxibs are associated with lower rates of lower gastrointestinal injury than non-selective-NSAIDs. More high-quality trials are warranted to more precisely estimate the effects of non-selective-NSAIDs and coxibs on the lower gastrointestinal tract.