Unsuspected osteochondroma-like outgrowths in the cranial base of Hereditary Multiple Exostoses patients and modeling and treatment with a BMP antagonist in mice

Hereditary Multiple Exostoses (HME) is a rare pediatric disorder caused by loss-of-function mutations in the genes encoding the heparan sulfate (HS)-synthesizing enzymes EXT1 or EXT2. HME is characterized by formation of cartilaginous outgrowths-called osteochondromas- next to the growth plates of many axial and appendicular skeletal elements. Surprisingly, it is not known whether such tumors also form in endochondral elements of the craniofacial skeleton. Here, we carried out a retrospective analysis of cervical spine MRI and CT scans from 50 consecutive HME patients that included cranial skeletal images. Interestingly, nearly half of the patients displayed moderate defects or osteochondroma-like outgrowths in the cranial base and specifically in the clivus. In good correlation, osteochondromas developed in the cranial base of mutant Ext1f/f;Col2-CreER or Ext1f/f;Aggrecan-CreER mouse models of HME along the synchondrosis growth plates. Osteochondroma formation was preceded by phenotypic alteration of cells at the chondro-perichondrial boundary and was accompanied by ectopic expression of major cartilage matrix genes -collagen 2 and collagen X- within the growing ectopic masses. Because chondrogenesis requires bone morphogenetic protein (BMP) signaling, we asked whether osteochondroma formation could be blocked by a BMP signaling antagonist. Systemic administration with LDN-193189 effectively inhibited osteochondroma growth in conditional Ext1-mutant mice. In vitro studies with mouse embryo chondrogenic cells clarified the mechanisms of LDN-193189 action that turned out to include decreases in canonical BMP signaling pSMAD1/5/8 effectors but interestingly, concurrent increases in such anti-chondrogenic mechanisms as pERK1/2 and Chordin, Fgf9 and Fgf18 expression. Our study is the first to reveal that the cranial base can be affected in patients with HME and that osteochondroma formation is amenable to therapeutic drug intervention.

Three-dimensional embroidered current collectors for ultra-thick electrodes in batteries

Picture (left) and photomicrograph (right) of the embroidered LiFePO₄ cathode. The discharge reaction on the electrode surface is also illustrated.

Copper(i)oxide microparticles – synthesis and antimicrobial finishing of textiles

Copper(i)oxide microparticles were be bound to textile surfaces by means of a pigment binder system to provide antibacterial activity with good wash permanence, using rather simple processing and ordinary chemicals.

Abstract P5-07-01: BreastCancerTrials.org: Early Evaluation of a Nationwide Clinical Trial Matching Service

Background: In 1999, UCSF researchers and patient advocates began a collaboration to design BreastCancerTrials.org (BCT.org), a web-based clinical trial matching service. In May 2005, the UCSF Center of Excellence for Breast Cancer Care (COE) and NCI launched BCT.org as a 2-year pilot with the participation of 13 Bay Area research sites. The pilot showed that breast cancer patients were willing to use an online clinical trial matching service, that they were able to enter their detailed health history onto web-based forms, and that the system's underlying caMATCH technology led to valid matches. In a companion study to evaluate the accuracy of patient-entered data, UCSF researchers found a 93% match rate between the data UCSF patients entered in BCT.org and their corresponding clinic charts. As a result, the COE partnered with a non-profit corporation (Quantum Leap Healthcare Collaborative or QLHC) to launch a nationwide version of BCT.org in October 2008. Development: The COE and QLHC team upgraded BCT.org to include personalized questionnaires for different breast conditions; the ability to use BCT.org anonymously; and the development of more clearly presented trial information. To improve the quality of matching, the team developed TrialCODE, a caMATCH-compatible tool for coding and validating a wide range of eligibility criteria. In July 2009, BCT.org added a Trial Alert Service to inform users when newly listed trials match their history, and SecureCONNECT, a messaging platform that enables users to share their online health history with research sites. COE researchers defined metrics and configured Google Analytics to monitor user traffic and support quality improvement.

Results: As of June 2010, the BCT.org trial registry had 331 coded trials, including 213 for treatment, 63 for psychosocial/support, and 55 distributed among diagnosis/screening, prevention, and other categories. The treatment trials were evenly divided between early and advanced disease and included additional trials for individuals with DCIS. In the 18 months between Jan. 2009 and June 2010, BCT.org received 25,206 visits with traffic increasing by 36% in the first 6 months of 2010 compared to the same period in 2009. Since its launch in July 2009, the Trial Alert Service (TAS) enrolled over 1,400 subscribers. As a result, the number of returning users increased from 1,335 to 4,007 in the 6-month period leading up to its launch, compared to the 6-month period after launch. Fifty research sites have registered to use SecureCONNECT and, with patient consent, can securely view BCT. org patient health histories. During the 18 month evaluation period, 3,563 BCT.org users started a health history with 2,206 (62%) completing it and matching to trials; among the users who matched to trials, 920 users (42%) clicked through to view a list of participating research sites. Conclusion: Thousands of patients have adopted BCT.org and use it to monitor trial opportunities. The registry of breast cancer trials is diverse and growing. The COE and QLHC are working to increase participation in SecureCONNECT and evaluate its impact on the efficiency of trial screening and enrollment.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-07-01.

Process balance and product quality in the production of natural indigo from Polygonum tinctorium Ait. applying low-technology methods

Indigo is the most important blue component in the class of natural dyes for cellulose and protein fibres. In the moderate European climate Polygonum tinctorium Ait. could be an interesting source for natural indigo (Vat blue 1). Following a cultivation of the plant material a simple procedure for the extraction of the indigo precursor indican was investigated with regard to crop and quality of dye obtained. The dependence of the crop on the storage conditions of the harvested plant material was investigated. The results quantify the distinct sensitivity of the fresh material to the time of storage before extraction with regard to the amount of natural indigo obtained, the photometrically determined indigo content in the product and the shade and colour depth observed in standardised dyeing experiments. A basic set of data is presented, which describes the process in terms of consumption of energy, water and chemicals and organic waste released from the extraction step.

In-vitro infection of chronic lymphocytic leukemia cells by Epstein-Barr virus (EBV)

We sought to determine the potential of infecting lymphoid cells from patients with chronic leukemia (CLL) with Epstein-Barr virus (EBV) by testing for EBV receptors (EBVR) by flow cytometry, assessing for infectability of these cells by culturing with B95-8-derived virus, and staining for EB nuclear-associated antigens (EBNA) at various times post-infection. EBVR were present on 54-91% of lymphoid cells in seven cases of CLL and on 46% of prolymphocytic leukemia cells. Dynamic changes regarding EBNA positivity, morphology, and viability occurred post-infection with the virus. On day 2 only a few EBNA-positive lymphoblasts were observed. On days 11-21 positivity increased from 2 to 34% of cells. Simultaneously, the viable cell number declined to approximately 1/10th of original number. A significant proportion of the EBNA-positive cells corresponded to the original CLL cells. In 3 of 7 cases of CLL a Pan T-cell phenotype was demonstrated by Leu-1 monoclonal antibody testing. The infected cells did not react with two monoclonal antibodies, EBV-CS 1 and 4, which react with B-cell lymphoblastoid cell lines (B-LCL). Moreover, the B-LCL derived at 1-2 months post-infection of CLL cells did not express the Leu-1 antigen, but expressed EBV-CS 1 or 4 defined antigens. In the prolymphocytic leukemia, 64% of the cells showed EBNA positivity on day 7 and giant cells with huge round or multiple nuclei appeared which were EBNA-positive. CLL and prolymphocytic leukemia cells can be infected as demonstrated by EBNA-positivity. This infection does not lead to immediate transformation, but evokes lymphoblast and multinucleated giant cell production prior to the death of cells.

A method for determination of antibody-dependent cellular cytotoxicity (ADCC) of human peripheral mononuclear cells

A method is described for measuring antibody-dependent cellular cytotoxicity (ADCC) of mononuclear cells from human peripheral blood using an established murine cell line and commercially prepared antisera. The test utilizes a standard 51Cr release technique. The ADCC activity of mononuclear cells obtained from 10 healthy human volunteers was measured at 4 different effector: target cell ratios. A linear relationship between %51Cr release (ADCC) and the number of effector cells was observed.

Delayed onset of infectious mononucleosis associated with acquired agammaglobulinemia and red cell aplasia

In 1974, an 11-year-old white boy with the X-linked lymphoproliferative syndrome developed hyper-IgM after becoming infected with Epstein-Barr virus. However, he failed to develop normal immune responses against the virus. In December 1981, when red cell aplasia occurred, he was given packed erythrocytes and gammaglobulin. Nine weeks later, acute infectious mononucleosis developed. Concurrently, his T4/T8 helper/suppressor ratio decreased from 2.7 to 0.2, and IgM antibodies to Epstein-Barr virus appeared. Subsequently, circulating B cells became undetectable in his blood, and agammaglobulinemia appeared. Red cell aplasia abated transiently. This patient's course was complicated by Haemophilus influenzae and Mycobacterium tuberculosis pneumonias, and red cell aplasia and agammaglobulinemia have persisted. Epstein-Barr virus acting as a slow virus probably induced the red cell aplasia and agammaglobulinemia because of the aberrant immune responses to Epstein-Barr virus. Immunodeficient responses to Epstein-Barr virus should be sought in other patients with the diseases documented in our patient.

Epstein-Barr virus and chronic lymphadenomegaly in male homosexuals with acquired immunodeficiency syndrome (AIDS)

Male homosexuals at risk for developing AIDS frequently exhibit chronic lymphadenomegaly (LAD). They are at high risk for developing malignant B cell lymphomas. A study of Epstein-Barr virus (EBV) revealed marked abnormalities in these patients. One hundred percent of the patients were seropositive. The patients with most severe acquired immune deficiency disorders manifested a decreased number of circulating B cells with EBV receptors and decreased lymphocyte transformation. Patients often showed defective memory T cell cytotoxic responses to autologous EBV infection in vitro. Three of five lymph node specimens contain significant EBV genome copies to suggest a significant etiologic role. In addition, a Burkitt-like lymphoma carried EBV genome. Although all of the men were seropositive for EBV, reactivation patterns were not as common as anticipated. Given the presence of EBV genome in the lymph nodes of the patients who lack anti-early antigen (EA) antibodies indicative of reactivation, we suggest that reliance on serology to indicate EBV involvement is insufficient for assessing the patient. The detection of a t(8;14) transposition in the monoclonal mu kappa Burkitt-like lymphoma containing EBV genome supports the view that cytogenetic transposition is a mechanism in lymphomagenesis.

Comparison of ADCC and NK activities of peripheral blood mononuclear cells from patients at risk for acquired immune deficiency syndrome (AIDS)

Numerous cellular immune defects have been described in patients with acquired immune deficiency syndrome (AIDS). These include anergy, reduced numbers of helper T cells, and decreased effectiveness of natural killer (NK) cells. In this study, we have measured the lytic activity of antibody-dependent cellular cytotoxic (K) cells using a recently described 51Cr release assay in patients clinically displaying lymphadenopathy syndrome (LAD). We then compared ADCC activity with NK activity, T helper/T suppressor ratios and NK cell number in these same patients. Our results indicate that a reduction of ADCC activity can occur in patients with LAD. In our study, patients that showed reduced ADCC activity also showed reduced NK cell function. Other individuals in this study had reduced NK function while ADCC values remained within the normal range. The degree of reversal of the T helper/T suppressor cell ratio was not a useful indicator of cellular immune function as measured by these assays in that individuals with very low ratios often had normal cytotoxic cell function while some patients with ratios in the normal range had decreased cytotoxicity. The percentage of NK cells as determined by HNK-1 monoclonal antibody also did not prove useful in defining potential cytotoxic activities.

Lymphocyte abnormalities in preleukemia--I. Decreased NK activity, anomalous immunoregulatory cell subsets and deficient EBV receptors

The development of acute non-lymphocytic leukemia is preceded by a set of symptoms described as the preleukemia syndrome. Six patients who fulfilled the criteria for this preleukemia syndrome have been evaluated for abnormalities in the lymphocyte population. The NK cell activity was reduced, the immunoregulatory cell populations were numerically abnormal, and the B cell subpopulation was deficient in EBV receptors. Thus, in addition to the abnormalities in the myeloid populations, there are serious defects in the lymphoid systems of preleukemic patients.

Cell-mediated immunity to Epstein-Barr virus (EBV) and natural killer (NK)-cell activity in the X-linked lymphoproliferative syndrome

The activity of T-cell-mediated immunity to Epstein-Barr virus (EBV) was assessed by an assay of regression of the outgrowth of EBV-infected autologous B cells. Regression and natural killer (NK)-cell activities were compared for patients and their mothers from five families with X-linked lymphoproliferative syndrome (XLP) and three control groups. Seven of the 10 patients with XLP exhibited weak T-cell activity against autologous EBV-infected lymphoblastoid cell lines (LCL) comparable to EBV-seronegative controls. In contrast, 8 of 10 obligate carrier females of XLP had unusually strong activity, which was comparable to anti-early-antigen (EA) positive controls. The results of the regression assays correlated with their EBV serology: mothers showed high titers, and their affected sons showed low-titer EBV-specific antibody responses. Defective NK-cell activity was found only in the patients with XLP. NK and regression activities did not correlate. Our findings explain, in part, the vulnerability to EBV of males with XLP and why their mothers are protected from life-threatening phenotypes of XLP.

Immune deficiency in the X-linked lymphoproliferative syndrome. I. Epstein-Barr virus-specific defects

Eleven males with XLP were evaluated for EBV-specific antibodies during periods of 2 to 7 yr. Variable responses to EBV-specific antigens were found. All 11 patients had subnormal anti-EBNA titers, which probably reflected a T cell deficiency. The patients showed four different patterns in their anti-VCA response: 1) two boys who had experienced malignant lymphoma mounted no antibodies at all; 2) two patients showed intermittent anti-VCA titers; 3) four males had persistently elevated anti-VCA titers; and 4) three patients showed normal anti-VCA titers. ADCC against EBV-infected cells was abnormally low in six patients and was elevated in two patients given gamma-globulin. ADCC titers did not correlate with anti-VCA titers. However, most patients with XLP failed to effect regression of autologous EBV-infected lymphoblastoid cell lines, indicating a deficiency in long-lived T cell-mediated immunity to EBV.

Immune deficiency in the X-linked lymphoproliferative syndrome. I. Epstein-Barr virus-specific defects

Eleven males with XLP were evaluated for EBV-specific antibodies during periods of 2 to 7 yr. Variable responses to EBV-specific antigens were found. All 11 patients had subnormal anti-EBNA titers, which probably reflected a T cell deficiency. The patients showed four different patterns in their anti-VCA response: 1) two boys who had experienced malignant lymphoma mounted no antibodies at all; 2) two patients showed intermittent anti-VCA titers; 3) four males had persistently elevated anti-VCA titers; and 4) three patients showed normal anti-VCA titers. ADCC against EBV-infected cells was abnormally low in six patients and was elevated in two patients given gamma-globulin. ADCC titers did not correlate with anti-VCA titers. However, most patients with XLP failed to effect regression of autologous EBV-infected lymphoblastoid cell lines, indicating a deficiency in long-lived T cell-mediated immunity to EBV.

Epstein-Barr virus in normal pregnant women

Acquired immune suppression accompanying normal pregnancy may be associated with reactivation of Epstein-Barr virus (EBV). Pregnant women with reactivated EBV having anti-EA antibodies show high titers of antiviral capsid antigen (VCA) geometric mean titers (GMT) of 522 versus 170 in those lacking anti-early antigen (EA). Among twenty-seven seropositive women at parturition, 17 (63%) had generated antibody to EA, and all 27 (100%) demonstrated significant increases in antibody to VCA (p less than 0.01). In contrast, antibody titers to cytomegalovirus, herpes hominis, varicella-zoster, and rubella viruses in the pregnant women were comparable to those found in nonpregnant controls. (Am J Reprod Immunol. 1982; 2:217-221.)

Epstein-Barr virus-induced diseases in boys with the X-linked lymphoproliferative syndrome (XLP): update on studies of the registry

Analyses of 100 subjects with the X-linked lymphoproliferative syndrome (XLP) in 25 kindreds revealed four major interrelated phenotypes: infectious mononucleosis, malignant B-cell lymphoma, aplastic anemia, and hypogammaglobulinemia. Eighty-one of the patients died. Two male subjects were asymptomatic but showed immunodeficiency to Epstein-Barr virus (EBV). Seventy-five subjects had the infectious mononucleosis phenotype and concurrently, 17 subjects of this group had aplastic anemia. All subjects with aplastic anemia died within a week. Aplastic anemia did not accompany hypogammaglobulinemia or malignant lymphoma phenotypes. Hypogammaglobulinemia had been detected before infectious mononucleosis in three subjects, after infectious mononucleosis in five subjects, and was not associated with infectious mononucleosis in 11 boys with hypogammaglobulinemia. In nine subjects infectious mononucleosis appeared to have evolved into malignant lymphoma; however, the majority of patients with malignant lymphoma showed no obvious antecedent infectious mononucleosis. One subject had infectious mononucleosis following recurrent malignant lymphoma. Twenty-six of 35 lymphomas were in the terminal ileum. Results of immunologic and virologic studies of 15 survivors revealed combined variable immunodeficiency and deficient antibody responses to EBV-specific antigens. Mothers of boys with XLP exhibited abnormally elevated titers of antibodies of EBV. Subjects of both sexes with phenotypes of XLP should be investigated for immunodeficiency to EBV. Persons with inherited or acquired immunodeficiency may be vulnerable to life-threatening EBV-induced diseases.