Diet changes due to urbanization in South Africa are linked to microbiome and metabolome signatures of Westernization and colorectal cancer

Transition from traditional high-fiber to Western diets in urbanizing communities of Sub-Saharan Africa is associated with increased risk of non-communicable diseases (NCD), exemplified by colorectal cancer (CRC) risk. To investigate how urbanization gives rise to microbial patterns that may be amenable by dietary intervention, we analyzed diet intake, fecal 16 S bacteriome, virome, and metabolome in a cross-sectional study in healthy rural and urban Xhosa people (South Africa). Urban Xhosa individuals had higher intakes of energy (urban: 3,578 ± 455; rural: 2,185 ± 179 kcal/d), fat and animal protein. This was associated with lower fecal bacteriome diversity and a shift from genera favoring degradation of complex carbohydrates (e.g., Prevotella) to taxa previously shown to be associated with bile acid metabolism and CRC. Urban Xhosa individuals had higher fecal levels of deoxycholic acid, shown to be associated with higher CRC risk, but similar short-chain fatty acid concentrations compared with rural individuals. Fecal virome composition was associated with distinct gut bacterial communities across urbanization, characterized by different dominant host bacteria (urban: Bacteriodota; rural: unassigned taxa) and variable correlation with fecal metabolites and dietary nutrients. Food and skin microbiota samples showed compositional differences along the urbanization gradient. Rural-urban dietary transition in South Africa is linked to major changes in the gut microbiome and metabolome. Further studies are needed to prove cause and identify whether restoration of specific components of the traditional diet will arrest the accelerating rise in NCDs in Sub-Saharan Africa.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

The qualitative evaluation of the limitation of aerosol spread by a transparent intubation box

During the current coronavirus disease of 2019 (COVID-19) pandemic personal protective equipment (PPE) and the value of able and healthy healthcare workers (HCWs) has strongly come to the fore. In support of these efforts, as many others have done, the Department of Anaesthesiology at the University of the Free State has developed a prototype transparent intubation box in collaboration with Divine Studios. Canelli et al. effectively demonstrated the protection of HCWs from droplet contamination by the use of a similar intubation box. Feldman et al. also showed that despite the current PPE recommendations, HCWs are still contaminated on exposed skin and other areas, thus additional layers of protection may still be warranted.

SASS: South African Simulation Survey – a review of simulation-based education

Background: Simulation-based education (SBE) has been shown to be an effective and reproducible learning tool. SBE is used widely internationally. The current state of SBE in South Africa is unknown. To the best of our knowledge this is the first survey that describes the use and attitudes towards SBE within South Africa. Methods: An online survey tool was distributed by email to: i) the South African Society of Anaesthesiologists (SASA) members; and ii) known simulation education providers in South Africa. The respondents were grouped into anaesthesia and non-anaesthesia participants. Descriptive statistics were used to analyse the data. Ethics approval was obtained: HREC REF 157/2017. Results: The majority of the respondents provide SBE and integrate it into formal teaching programmes. There is a will amongst respondents to grow SBE in South Africa, with it being recognised as a valuable educational tool. The user groups mainly targeted by SBE, were undergraduate students, medical interns, registrars and nurses. Learning objectives targeted include practical skills, medical knowledge, critical thinking and integrated management. Amongst anaesthesia respondents: the tool most commonly used to assess the quality of learner performance during SBE, for summative assessment, was ‘expert opinion’ (33%); the most frequent methods of evaluating SBE quality were participant feedback (42%) and peer evaluation (22%); the impact of SBE was most frequently assessed by informal discussion (42%) and learner feedback (39%). In anaesthesia SBE largely takes place within dedicated simulation facilities on site (47%). Most respondents report access to a range of SBE equipment. The main reported barriers to SBE were: finance, lack of trained educators, lack of equipment and lack of protected time. A limited number of respondents report engaging in SBE research. There is a willingness in both anaesthesia and non-anaesthesia groups (96% and 89% respectively) to collaborate with other centres. Conclusion: To the best of our knowledge this publication provides us with the first cross-sectional survey of SBE in anaesthesia and a selection of non-anaesthetic respondents within South Africa. The majority of respondents indicate that SBE is a valuable education tool. A number of barriers have been identified that limit the growth of SBE within South Africa. It is hoped that with a commitment to ongoing SBE research and evaluation, SBE can be grown in South Africa.

Serum selenium levels, the selenoprotein glutathione peroxidase and vascular protection: The SABPA study

Selenium is an important co-factor for the optimal functioning of the antioxidant enzyme, glutathione peroxidase (GPx). Studies investigating the associations of selenium with blood pressure (BP) and hemodynamic measures are sparse. This study investigated whether 24h blood pressure, vascular resistance, arterial compliance and arterial stiffness relate to both serum selenium and GPx activity. In this cross-sectional study selenium levels, GPx activity, ambulatory blood pressure and arterial stiffness of 200 black and 209 white school teachers from South Africa were measured. Serum selenium levels were significantly lower in black compared to white teachers (p<0.001), independent of sex. One in 10 black men and one in five black women were selenium deficient (<8μg/100ml). Only in white men inverse independent associations of 24h systolic BP (β=-0.19; p=0.039) and 24h diastolic BP (β=-0.21; p=0.029) with selenium were found. In the same group, an inverse association between carotid-dorsalis pedis pulse wave velocity (cd-PWV) and GPx activity (β=-0.23; p=0.017) were also found. To conclude, lower serum selenium levels in black populations from the same geographical region as their white counterparts may impact on the loss of the vasculoprotective effects of selenium and selenoproteins such as GPx.

Stopped-flow kinetics of pH-responsive polyamine latexes: how fast is the latex-to-microgel transition?

Four poly(ethylene glycol)-stabilized polyamine latexes, namely, poly(2-vinylpyridine) (P2VP), poly(2-(tert-butylamino)ethyl methacrylate) (PTBAEMA), poly(2-(diethylamino)ethyl methacrylate) (PDEA), and poly(2-(diisopropylamino)ethyl methacrylate) (PDPA) were prepared via emulsion copolymerization using divinylbenzene (DVB) as a cross-linker at 0.80 mol % for all formulations. According to dynamic light scattering studies, the resulting latexes were near-monodisperse and had approximately constant hydrodynamic diameters of 205-220 nm at pH 10; a latex-to-microgel transition was observed at around the respective pKa of each polyamine on addition of acid. The kinetics of swelling of each latex was investigated by the pH-jump method using a commercial stopped-flow instrument. The most rapid swelling was observed for the P2VP latex, which exhibited a characteristic swelling time (t*) of 5 ms. The corresponding t* values for PTBAEMA and PDEA were 25 and 35 ms, respectively, whereas the PDPA particles exhibited significantly slower swelling kinetics (t* = 180 ms). These t* values could not be correlated with either the latex Tg or the polyamine pKa. However, there is a positive correlation between t* and the repeat unit mass of the amine monomer, which suggests that the cationic charge density of the protonated polymer chains may influence the kinetics of swelling. Alternatively, the observed differences in swelling kinetics may simply reflect subtle differences in the DVB cross-link density, with more uniformly cross-linked latexes being capable of responding more quickly to a pH jump. The kinetics of deswelling for the corresponding microgel-to-latex transition was also briefly investigated for the PTBAEMA and P2VP particles. In both cases, much slower rates of deswelling were observed. This suggests that a latexlike "skin" is formed on the outer surface of the microgel particles during their deprotonation, which significantly retards the excretion of both salt and water.

Novel Pickering emulsifiers based on pH-responsive poly(2-(diethylamino)ethyl methacrylate) latexes

The emulsion copolymerization of 2-(diethylamino)ethyl methacrylate (DEA) with a divinylbenzene cross-linker in the presence of monomethoxy-capped poly(ethylene glycol) methacrylate (PEGMA) at 70 °C afforded near-monodisperse, sterically stabilized PEGMA-PDEA latexes at 10% solids. Dynamic light scattering studies indicated intensity-average diameters of 190 to 240 nm for these latexes at pH 9. A latex-to-microgel transition occurred on lowering the solution pH to below the latex pKa of 6.9. When dilute HCl/KOH was used to adjust the aqueous pH, a systematic reduction in the cationic microgel hydrodynamic diameter of 80 nm was observed over ten pH cycles as a result of the gradual buildup of background salt. However, no such size reduction was observed when using CO2/N2 gases to regulate the aqueous pH because this protocol does not generate background salt. Thus, the latter approach offers better reversibility, albeit at the cost of slower response times. PEGMA-PDEA microgel does not stabilize Pickering emulsions when homogenized at pH 3 with n-dodecane, sunflower oil, isononyl isononanoate, or isopropyl myristate. In contrast, PEGMA-PDEA latex proved to be a ubiquitous Pickering emulsifier at pH 10, forming stable oil-in-water emulsions with each of these four model oils. Lowering the solution pH from 10 to 3 resulted in demulsification within seconds. This is because these pH-responsive particles undergo a latex-to-microgel transition, which leads to their interfacial desorption. Six successive demulsification/emulsification cycles were performed on these Pickering emulsions using HCl/KOH to adjust the solution pH. Demulsification could also be achieved by purging the emulsion solution with CO2 gas to lower the aqueous pH to 4.8. However, complete phase separation required CO2 purging for 4 h at 20 °C. A subsequent N2 purge raised the aqueous pH sufficiently to induce a microgel-to-latex transition, but rehomogenization did not produce a stable Pickering emulsion. Presumably, a higher pH is required, which cannot be achieved by a N2 purge alone.

Effect of cottonseed oilcake inclusion on ostrich growth performance and meat chemical composition

This study investigated the effect of replacing dietary soybean oilcake meal with increasing levels of cottonseed oilcake meal (CSOCM) on the growth performance and meat (Iliofibularis muscle) chemical composition of ostriches in order to decrease total feed costs. A total of 105 ostriches were divided into five feeding groups according to the CSOCM inclusion level in the whole diet: Control (0% CSOCM), 3%, 6%, 9% and 12% CSOCM (of the whole diet), and fed with experimental diets from 6 to 13 months of age. As a result of feeding CSOCM, the final live weight and the average daily gain significantly increased in the 12% CSOCM group. The proximate composition, cholesterol content, mineral and fatty acid profile of the meat remained unaffected. Thus CSOCM may be used as an alternative protein source to the more expensive soybean oilcake meal in ostrich nutrition.

Novel Pickering emulsifiers based on pH-responsive poly(tert-butylaminoethyl methacrylate) latexes

Emulsion copolymerization of 2-(tert-butylamino)ethyl methacrylate in the presence of divinylbenzene (DVB) cross-linker and monomethoxy-capped poly(ethylene glycol) methacrylate (PEGMA) macromonomer at 70 °C afforded sterically-stabilized latexes at approximately 10% solids at pH 9. Dynamic light scattering and scanning electron microscopy (SEM) confirmed that relatively narrow size distributions were obtained. SEM confirmed the formation of spherical particles in the absence of any DVB cross-linker using a simple batch protocol, but in the presence of DVB it was necessary to use seeded emulsion polymerization under monomer-starved conditions to prevent the formation of latexes with ill-defined non-spherical morphologies. Lightly cross-linked latexes acquired cationic microgel character upon lowering the solution pH due to protonation of the secondary amine groups. Increasing the degree of cross-linking led to a progressively lower effective pK(a) of the copolymer chains from 8.0 to 7.3, which implies a gradual reduction in their basicity. Poly(tert-butylamino)ethyl methacrylate latex proved to be an effective Pickering emulsifier at pH 10, forming stable oil-in-water emulsions when homogenized with either n-dodecane or sunflower oil at 12,000 rpm for 2 min. These Pickering emulsions exhibited pH-responsive behavior: lowering the solution pH to 3 resulted in immediate demulsification due to the spontaneous desorption of the cationic microgels from the oil/water interface. Following rehomogenization at high pH, four successive demulsification/emulsification pH cycles could be achieved without a discernible loss in performance. However, no demulsification occurred on acidification of the fifth cycle, due to the progressive build-up of background salt.

Feasibility study of three-nerve-recognizing Lichtenstein procedure for inguinal hernia

BACKGROUND

Inguinal nerve identification during open inguinal hernia repair is associated with less chronic postoperative pain. However, most Dutch surgeons do not identify all three inguinal nerves when carrying out this procedure. The aim of this study was to evaluate the feasibility of a nerve-recognizing Lichtenstein hernia repair and to measure the extra time required for surgery

METHODS

Forty patients with primary inguinal hernia were operated on following the nerve-recognizing Lichtenstein hernia repair by four experienced hernia surgeons from four different Dutch teaching hospitals. The additional time needed to identify each individual nerve was recorded, and iatrogenic nerve injuries and anatomical characteristics were registered.

RESULTS

Identification of the iliohypogastric and ilioinguinal nerves was each performed within 1 min. Identification of the genital branch of the genitofemoral nerve was notably more difficult but could usually be performed within 2 min. Identification of the cremasteric vein, running parallel to the genital branch, was less comprehensive. The incidence of major anatomical variations was low. Twenty-five per cent of ilioinguinal nerves, however, could not be identified. In five patients inguinal nerves were damaged iatrogenically during standard manoeuvres of the Lichtenstein hernia repair.

CONCLUSION

Three-nerve-recognizing Lichtenstein hernia repair is feasible and non-time consuming if the surgeon has appropriate anatomical knowledge. In view of the low incidence of major anatomical variations, knowledge of standard inguinal nervous anatomy should be adequate. This procedure could enable the surgeon to prevent or recognize iatrogenic nerve damage and offer an opportunity to perform deliberate neurectomy as an alternative to accidental nerve injury.

A novel tyrosine kinase switch is a mechanism of imatinib resistance in gastrointestinal stromal tumors

KIT or alpha-platelet-derived growth factor receptor (alpha-PDGFR) activating mutations are the pathogenic mechanisms that characterize gastrointestinal stromal tumors (GIST). Despite excellent responses to imatinib mesylate (IM), patients are relapsing. We developed an IM-resistant GIST cell line (GIST-R) from the IM-sensitive GIST882 cell line (GIST-S) by growing these cells in IM. Gene expression profiling (GEP) of GIST-S, GIST-R cells and two IM resistant GIST patients demonstrated that KIT is downregulated implying a major role in IM resistance. Instead, GIST-R cells have acquired IM resistance by overexpressing the oncogenic receptor tyrosine kinase - AXL - in a 'kinase switch'. Further, the two IM resistant GIST patients express AXL and not c-Kit, seen by immunohistochemistry (IHC). Real time reverse transcriptase-polymerase chain reaction and Western blotting of the GIST-S and GIST-R cells confirmed the switch from Kit to AXL. In GIST-R, AXL is tyrosine phosphorylated and its ligand growth-arrest-specific gene 6 is overexpressed implying autocrine activation. The kinase switch is associated with a morphological change from spindle to epithelioid. Molecular modeling of the kinase domain of mutant c-Kit (V654A) and AXL showed no binding to IM but efficient binding to MP470, a novel c-Kit/AXL kinase inhibitor. MP470 synergizes with docetaxel (taxotere) and is cytotoxic to GIST cells.

The National Food Consumption Survey (NFCS): South Africa, 1999

OBJECTIVE

The aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1-9 years old), as well as factors that influence their dietary intake.

DESIGN

This was a cross-sectional survey of a nationally representative sample of all children aged 1-9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information.

SUBJECTS

Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%.

METHODS

The sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference.

RESULTS

At the national level, stunting (height-for-age below minus two standard deviations (< -2SD) from the reference median) was by far the most common nutritional disorder, affecting nearly one in five children. The children least affected (17%) were those living in urban areas. Even with regard to the latter, however, children living in informal urban areas were more severely affected (20%) compared with those living in formal urban areas (16%). A similar pattern emerged for the prevalence of underweight (weight-for-age < -2SD), with one in 10 children being affected at the national level. Furthermore, one in 10 (13%) and one in four (26%) children aged 1-3 years had an energy intake less than half and less than two-thirds of their daily energy needs, respectively. For South African children as a whole, the intakes of energy, calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure.

CONCLUSION

The NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa.

The influence of maternal age on pregnancy outcome in patients with early onset, severe pre-eclampsia

Pregnancy outcomes of women in three age categories, < or = 19, 20-34 and > or = 35 years, who underwent expectant management of early onset, severe pre-eclampsia were evaluated. This formed part of a prospective study involving 340 selected women from April 1992 to March 1997. Frequent monitoring of maternal and fetal status in a high-care obstetric ward was performed. Main outcome measures were major maternal complications, prolongation of gestation and perinatal outcome. Pregnancy was prolonged by a comparable number (10, 9 and 12) of days in the groups. Placental abruption was the most frequent major maternal complication, occurring more often in the youngest group (P=0.04). Women in this group also had the highest perinatal mortality and more often required anti-hypertensive medication at discharge (P<0.001). Younger women (< or = 19 years) appear to be at higher risk for maternal and perinatal complications.

The effects of the Epstein-Barr virus latent membrane protein 2A on B cell function

Epstein-Barr Virus (EBV) infects B-lymphocytes circulating through the oral epithelium and establishes a lifelong latent infection in a subset of mature-memory B cells. In these latently infected B cells, EBV exhibits limited gene expression with the latent membrane protein 2A (LMP2A) being the most consistently detected transcript. This persistent expression, coupled with many studies ofthe function of LMP2A in vitro and invivo, indicates that LMP2A is functioning to control some aspect of viral latency. Establishment and maintenance of viral latency requires exquisite manipulation of normal B cell signaling and function. LMP2A is capable of blocking normal B cell signal transduction in vitro, suggesting that LMP2A may act to regulate lytic activation from latency in vivo. Furthermore, LMP2A is capable of providing B cells with survival signals in the absence of normal BCR signaling. These data show that LMP2A may help EBV-infected cells to persist in vivo. This review discusses the advances that have been made in our understanding of LMP2A and the effects it has on B cell development, activation, and viral latency.

Latent membrane protein 2A-mediated effects on the phosphatidylinositol 3-Kinase/Akt pathway

Epstein-Barr virus (EBV) latent membrane protein 2A (LMP2A) is expressed on the membranes of B lymphocytes and blocks B-cell receptor (BCR) signaling in EBV-transformed B lymphocytes in vitro. The phosphotyrosine motifs at positions 74 or 85 and 112 within the LMP2A amino-terminal domain are essential for the LMP2A-mediated block of B-cell signal transduction. In vivo studies indicate that LMP2A allows B-cell survival in the absence of normal BCR signals. A possible role for Akt in the LMP2A-mediated B-cell survival was investigated. The protein kinase Akt is a crucial regulator of cell survival and is activated within B lymphocytes upon BCR cross-linking. LMP2A expression resulted in the constitutive phosphorylation of Akt, and this LMP2A effect is dependent on phosphatidylinositol 3-kinase activity. In addition, recruitment of Syk and Lyn protein tyrosine kinases (PTKs) to tyrosines 74 or 85 and 112, respectively, are critical for LMP2A-mediated Akt phosphorylation. However, the ability of LMP2A to mediate a survival phenotype downstream of Akt could not be detected in EBV-negative Akata cells. This would indicate that LMP2A is not responsible for EBV-dependent Burkitt's lymphoma cell survival.

Capillary solid-phase extraction-tandem mass spectrometry for fast quantification of free concentrations of tolterodine and two metabolites in ultrafiltered plasma samples

A capillary solid-phase extraction (SPE) system has been coupled directly to electrospray tandem mass spectrometry for quantification of free tolterodine and metabolite concentrations in plasma. The unbound fraction of these compounds was obtained by ultrafiltration of plasma. The ultrafiltrate was directly injected onto the SPE capillary (4 mm x 200 microm, 5 microm C18). After desalting and clean-up of the sample, the analytes were eluted in backflush mode with methanol-1 mM triethylamine (70:30, v/v), providing considerable solute focusing. Elution from the SPE capillary was improved by inserting a short trapping capillary between the SPE capillary and the MS interface, by which analyte focusing was increased. The unresolved compounds eluted simultaneously with the remaining matrix compounds and were detected in a multiple-reaction monitoring (MRM) mode. No interference of the sample matrix on detection was observed, allowing aqueous standards to be used for calibration. Linear calibration curves were obtained between 0.05 and 1000 ng/ml (corresponding to 150 pM-3 microM) and the limit of detection was 50 pg/ml injecting 10 microl. Equilibration of the SPE capillary, sample loading, elution and detection took less then 6 min per sample.

Tyrosines 60, 64, and 101 of Epstein-Barr virus LMP2A are not essential for blocking B cell signal transduction

Epstein-Barr virus (EBV) latent membrane protein 2A (LMP2A) is expressed on the membrane of B-lymphocytes and blocks B cell receptor (BCR) signaling in EBV-transformed B-lymphocytes in vitro. The LMP2A amino-terminal domain, which is essential for the LMP2A-mediated block of B cell signal transduction, contains eight tyrosine residues. Three of these tyrosine residues (Y74, Y85, and Y112) have been demonstrated to be essential for the LMP2A-mediated block on protein tyrosine phosphorylation, calcium mobilization, and induction of BZLF1 expression after BCR activation. To investigate the importance of tyrosines at positions 60, 64, and 101 on B cell signaling, EBV recombinants were constructed containing a tyrosine-to-phenylalanine point mutation at amino acid 60, 64, or 101 within LMP2A. Tyrosine phosphorylation, calcium mobilization, and induction of BZLF1 expression were not affected by any of the tyrosine point mutations after BCR activation. In addition, constitutive phosphorylation of LMP2A was unaffected by any of the tyrosine point mutations. These data indicate that tyrosines 60, 64, and 101 are not essential for the LMP2A-mediated block of B cell signal transduction in transformed cell lines.

Column switching in capillary liquid chromatography-tandem mass spectrometry for the quantitation of pg/ml concentrations of the free basic drug tolterodine and its active 5-hydroxymethyl metabolite in microliter volumes of plasma

A capillary column switching system was developed for the determination of low, unbound concentrations of the basic drug tolterodine and its active 5-hydroxymethyl (5-HM) metabolite in human plasma. Free concentrations of tolterodine and 5-HM at pM and nM (pg/ml and ng/ml) levels were obtained by ultrafiltration of 40-400 microliters plasma at 37 degrees C. The free fraction (%) was independent of the plasma concentrations of the analytes. Detection of the analytes was performed by sheathless electrospray tandem mass spectrometry in the multiple-reaction monitoring mode. The selectivity of the mass spectrometric detection and the additional clean-up on the pre-column allowed direct injection of the ultrafiltrated plasma samples. Tolterodine and 5-HM were pre-concentrated on a reversed-phase capillary pre-column (1 cm x 200 microns) and subsequently backflushed onto the separation column (25 cm x 200 microns). The stability of the chromatographic system was good; a large number of ultrafiltrated plasma samples could be injected and the relative standard deviation of the retention times was typically < or = 1% (within-day). The accuracy was between 86 and 105% and the precision was between 1 and 7% without the use of an internal standard. Linear calibration curves were obtained between 100 pM and 100 nM.

Tyrosine 112 of latent membrane protein 2A is essential for protein tyrosine kinase loading and regulation of Epstein-Barr virus latency

Latent membrane protein 2A (LMP2A) of Epstein-Barr virus (EBV) is expressed on the plasma membrane of B lymphocytes latently infected with EBV and blocks B-cell receptor (BCR) signal transduction in EBV-immortalized B cells in vitro. The LMP2A amino-terminal domain that is essential for the LMP2A-mediated block on BCR signal transduction contains eight tyrosine residues. Association of Syk protein tyrosine kinase (PTK) with LMP2A occurs at the two tyrosines of the LMP2A immunoreceptor tyrosine-based activation motif, and it is hypothesized that Lyn PTK associates with the YEEA amino acid motif at LMP2A tyrosine 112 (Y112). To examine the specific association of Lyn PTK to LMP2A, a panel of LMP2A cDNA expression vectors containing LMP2A mutations were transfected into an EBV-negative B-cell line and analyzed for Lyn and LMP2A coimmunoprecipitation. Lyn associates with wild-type LMP2A and other LMP2A mutant constructs, but Lyn association is lost in the LMP2A construct containing a tyrosine (Y)-to-phenylalanine (F) mutation at LMP2A residue Y112 (LMP2AY112F). Next, the LMP2AY112F mutation was recombined into the EBV genome to generate stable lymphoblastoid cell lines (LCLs) transformed with the LMP2AY112F mutant virus. Analysis of BCR-mediated signal transduction in the LMP2AY112F LCLs revealed loss of the LMP2A-mediated block in BCR signal transduction. In addition, LMP2A was not tyrosine phosphorylated in LMP2AY112F LCLs. Together these data indicate the importance of the LMP2A Y112 residue in the ability of LMP2A to block BCR-mediated signal transduction and place the role of this residue and its interaction with Lyn PTK as essential to LMP2A phosphorylation, PTK loading, and down-modulation of PTKs involved in BCR-mediated signal transduction.

GLI activates transcription through a herpes simplex viral protein 16-like activation domain

Three proteins have been identified in mammals, GLI, GLI2, and GLI3, which share a highly conserved zinc finger domain with Drosophila Cubitus interruptus and are believed to function as transcription factors in the vertebrate Sonic hedgehog-Patched signaling pathway. To understand the role GLI plays in the Sonic hedgehog-Patched pathway and mechanisms of GLI-induced transcriptional regulation, we have characterized its transcriptional regulatory properties and contributions of specific domains to transcriptional regulation. We have demonstrated that GLI activates expression of reporter constructs in HeLa cells in a concentration-dependent manner through the GLI consensus binding motif and that a GAL4 binding domain-GLI fusion protein activates reporter expression through the GAL4 DNA binding site. GLI-induced transcriptional activation requires the carboxyl-terminal amino acids 1020-1091, which includes an 18-amino acid region highly similar to the alpha-helical herpes simplex viral protein 16 activation domain, including the consensus recognition element for the human TFIID TATA box-binding protein-associated factor TAFII31 and conservation of all three amino acid residues believed to contact directly chemically complementary residues in TAFII31. The presence of this region in the GLI activation domain provides a mechanism for GLI-induced transcriptional regulation.

A simplified approach to sperm-cervical mucus interaction testing using a hyaluronate migration test

Fifty-one comparisons were made of human sperm migration into capillary tubes containing either human cervical mucus ('Kremer test') or a synthetic mucus substitute consisting of a 5 mg/ml solution of sodium hyaluronate (average mol. wt 2 x 10(6)) in a phosphate-buffered medium. The results of these two tests were highly significantly correlated and dependent upon the same sperm characteristics reflecting sperm progressive ability (including the specific movement characteristic of lateral head displacement amplitude), morphological normality and cellular vitality as well as the concentration of these more functional cells in the semen. The result of the hyaluronate migration test, in conjunction with the mucus quality measures of Insler score and pH, allowed a 92.2% correct prediction of the Kremer test outcome (90.9% of normal tests and 93.1% of abnormal tests). In this data set, these values also corresponded to the sensitivity and specificity of the analysis, respectively. From these studies, we propose the hyaluronate migration test as a useful adjunct to routine semen analysis, sperm movement analysis and the more traditional in-vitro tests of sperm-cervical mucus interaction in the diagnostic investigation of infertile couples. It effectively assesses the mucus-penetrating potential of a semen sample without the need for relatively large quantities of midcycle cervical mucus; it will therefore augment (as an internal control), although not necessarily replace, the homologous Kremer test and reduce the quantity of both patient and donor mucus needed for comprehensive crossed-hostility format testing of sperm-mucus interaction.