Single-dose combination nanovaccine induces both rapid and durable humoral immunity and toxin neutralizing antibody responses against Bacillus anthracis

Bacillus anthracis, the causative agent of anthrax, continues to be a prominent biological warfare and bioterrorism threat. Vaccination is likely to remain the most effective and user-friendly public health measure to counter this threat in the foreseeable future. The commercially available AVA BioThrax vaccine has a number of shortcomings where improvement would lead to a more practical and effective vaccine for use in the case of an exposure event. Identification of more effective adjuvants and novel delivery platforms is necessary to improve not only the effectiveness of the anthrax vaccine, but also enhance its shelf stability and ease-of-use. Polyanhydride particles have proven to be an effective platform at adjuvanting the vaccine-associated adaptive immune response as well as enhancing stability of encapsulated antigens. Another class of adjuvants, the STING pathway-targeting cyclic dinucleotides, have proven to be uniquely effective at inducing a beneficial inflammatory response that leads to the rapid induction of high titer antibodies post-vaccination capable of providing protection against bacterial pathogens. In this work, we evaluate the individual contributions of cyclic di-GMP (CDG), polyanhydride nanoparticles, and a combination thereof towards inducing neutralizing antibody (nAb) against the secreted protective antigen (PA) from B. anthracis. Our results show that the combination nanovaccine elicited rapid, high titer, and neutralizing IgG anti-PA antibody following single dose immunization that persisted for at least 108 DPI.

Single-dose combination nanovaccine induces both rapid and long-lived protection against pneumonic plague

Yersinia pestis, the causative agent of pneumonic plague, induces a highly lethal infection if left untreated. Currently, there is no FDA-approved vaccine against this pathogen; however, USAMRIID has developed a recombinant fusion protein, F1-V, that has been shown to induce protection against pneumonic plague. Many F1-V-based vaccine formulations require prime-boost immunization to achieve protective immunity, and there are limited reports of rapid induction of protective immunity (≤ 14 days post-immunization (DPI)). The STimulator of INterferon Genes agonists cyclic dinucleotides (CDNs) have been shown to be promising vaccine adjuvants. Polyanhydride nanoparticle-based vaccines (i.e., nanovaccines) have also shown to enhance immune responses due to their dual functionality as adjuvants and delivery vehicles. In this work, a combination nanovaccine was designed that comprised F1-V-loaded nanoparticles combined with the CDN, dithio-RP,RP-cyclic di-guanosine monophosphate, to induce rapid and long-lived protective immunity against pneumonic plague. All mice immunized with a single dose combination nanovaccine were protected from Y. pestis lethal challenge within 14 DPI and demonstrated enhanced protection over F1-V adjuvanted with CDNs alone at challenge doses ≥7000 CFU Y. pestis CO92. In addition, 75% of mice receiving the single dose of the combination nanovaccine were protected from challenge at 182 DPI, while maintaining high levels of antigen-specific serum IgG. ELISPOT analysis of vaccinated animals at 218 DPI revealed F1-V-specific long-lived plasma cells in bone marrow in mice vaccinated with CDN adjuvanted F1-V or the combination nanovaccine. Microarray analysis of serum from these vaccinated mice revealed the presence of serum antibody that bound to a broad range of F1 and V linear epitopes. These results demonstrate that combining the adjuvanticity of CDNs with a nanovaccine delivery system enables induction of both rapid and long-lived protective immunity against Y. pestis. STATEMENT OF SIGNIFICANCE: • Yersinia pestis, the causative agent of pneumonic plague, induces a highly lethal infection if left untreated. Currently, there is no FDA-approved vaccine against this biodefense pathogen. • We designed a combination nanovaccine comprising of F1-V antigen-loaded polyanhydride nanoparticles and a cyclic dinucleotide adjuvant to induce both rapid and long-lived protective immunity against pneumonic plague. • Animals immunized with the combination nanovaccine maintained high levels of antigen-specific serum IgG and long-lived plasma cells in bone marrow and the serum antibody showed a high affinity for a broad range of F1 and V linear epitopes. • The combination nanovaccine is a promising next-generation vaccine platform against weaponized Y. pestis based on its ability to induce both rapid and long-lived protective immunity.

Analysis of swine antigen-specific antibody responses to Mycoplasma hyopneumoniae infection determined by protein microarray

Pigs harbor several different species of mycoplasmas, of which Mycoplasma hyopneumoniae presents the most significant economic impact on the swine industry. While ELISAs are the predominant diagnostic assay to measure antibody responses during infection with M. hyopneumoniae, the assay itself is only a rough estimate of the total antibody response. It lends little information on pathogen-wide antigen-specific responses. In addition, antibody responses to M. hyopneumoniae as measured by ELISA are slow to develop in infected swine. Our goal was to determine if a protein microarray could be more sensitive and informative of the serological responses of pigs to M. hyopneumoniae infection. The gene sequences of approximately 50 M. hyopneumoniae surface proteins or protein fragments were cloned, mutated to remove UGA codons, expressed in Escherichia coli and purified. The arrays were used to interrogate pig sera from various sources. Sera from naturally-infected swine gave some variability in antigen-specific responses, but, unexpectedly, the responses against the C-terminal portion of the major adhesin P97 was weak in all animals, including those that were experimentally infected. In two of four 118-day experimentally-infected caesarian-derived colostrum-deprived pigs, the strongest antibody responses occurred on days 30 and 54 against members of the P97/P102 paralog families. Our Day 0 results in the other two animals indicate that although thought to be mycoplasma free by all known criteria (serology and PCR), they may have harbored an inapparent Mycoplasma infection. In summary, the protein microarray has the potential to identify new targets for assay development to enhance sensitivity of antibody-based assays.

Macrophage effector responses of horses are influenced by expression of CD154

Reactive intermediates contribute to innate immunity by providing phagocytes with a mechanism of defense against bacteria, viruses and parasites. To better characterize the role of CD154 in the production of reactive intermediates, we cloned and expressed recombinant equine CD154 (reqCD154) in Chinese Hamster Ovary (CHO). In co-culture experiments, CHO cells ectopically expressing reqCD154 elicited superoxide production in monocyte-derived macrophages (MDM). Collectively, our results indicate that regulation of CD154 expression plays a role in innate host defenses.

Proteogenomic mapping of Mycoplasma hyopneumoniae virulent strain 232

Background

Mycoplasma hyopneumoniae causes respiratory disease in swine and contributes to the porcine respiratory disease complex, a major disease problem in the swine industry. The M. hyopneumoniae strain 232 genome is one of the smallest and best annotated microbial genomes, containing only 728 annotated genes and 691 known proteins. Standard protein databases for mass spectrometry only allow for the identification of known and predicted proteins, which if incorrect can limit our understanding of the biological processes at work. Proteogenomic mapping is a methodology which allows the entire 6-frame genome translation of an organism to be used as a mass spectrometry database to help identify unknown proteins as well as correct and confirm existing annotations. This methodology will be employed to perform an in-depth analysis of the M. hyopneumoniae proteome.

Results

Proteomic analysis indicates 483 of 691 (70%) known M. hyopneumoniae strain 232 proteins are expressed under the culture conditions given in this study. Furthermore, 171 of 328 (52%) hypothetical proteins have been confirmed. Proteogenomic mapping resulted in the identification of previously unannotated genes gatC and rpmF and 5-prime extensions to genes mhp063, mhp073, and mhp451, all conserved and annotated in other M. hyopneumoniae strains and Mycoplasma species. Gene prediction with Prodigal, a prokaryotic gene predicting program, completely supports the new genomic coordinates calculated using proteogenomic mapping.

Conclusions

Proteogenomic mapping showed that the protein coding genes of the M. hyopneumoniae strain 232 identified in this study are well annotated. Only 1.8% of mapped peptides did not correspond to genes defined by the current genome annotation. This study also illustrates how proteogenomic mapping can be an important tool to help confirm, correct and append known gene models when using a genome sequence as search space for peptide mass spectra. Using a gene prediction program which scans for a wide variety of promoters can help ensure genes are accurately predicted or not missed completely. Furthermore, protein extraction using differential detergent fractionation effectively increases the number of membrane and cytoplasmic proteins identifiable my mass spectrometry.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2164-15-576) contains supplementary material, which is available to authorized users.

Chorioamniontis in preterm delivery is associated with degradation of decorin and biglycan and depletion of hyaluronan in fetal membranes

OBJECTIVE

The proteoglycan decorin stabilizes collagen whereas biglycan and hyaluronan disrupt well-organized collagen. The aim was to determine the concentrations of these constituents in fetal membranes in relation to gestational age, preterm labour, PPROM and chorioamnionitis.

STUDY DESIGN

Preterm fetal membranes (24-34 weeks gestation) were obtained from elective caesarean deliveries (N = 4), from PPROM (N = 14), and from preterm labour (N = 14). Term fetal membranes from elective caesarean deliveries (N = 9) and spontaneous vaginal deliveries (N = 11) were used for comparison. Chorioamnionitis was assessed histologically. The proteoglycans were analysed using alcian blue precipitation, SDS-PAGE and immunostaining. Hyaluronan was estimated by a radioimmunoassay.

RESULTS

Preterm amniotic membranes with chorioamnionitis displayed a 8-fold decrease in hyaluronan concentration as well as a pronounced (88%) degradation of decorin and biglycan (p < 0.05). The amnion from preterm elective caesarean sections had higher decorin (3.2 vs. 1.7 μg/mg, p < 0.05) and lower biglycan (0.4 vs. 1.0 μg/mg, p < 0.05) concentrations as compared to similar term amnion (p < 0.05), whereas the hyaluronan concentrations were not associated with gestational age. Also the chorio-decidua from preterm caesarean sections had higher decorin concentrations (1.8 vs. 1.0 μg/mg, p < 0.05) whereas the biglycan concentration was unchanged. Labour (term as well as preterm) was characterized by increased hyaluronan and biglycan concentrations in the amnion (not statistically significant).

CONCLUSION

The biglycan/decorin balance increases during third trimester of pregnancy and during active labour. This relation might contribute to mechanical weakening of the membranes. Chorioamnionitis induces dramatic degradation of both proteoglycans and hyaluronan, which can explain the decreased biomechanical strength.

Gender-specific pathways to intimacy in early adolescence

As part of a larger longitudinal study of psychosocial development, 148 girls and 130 boys were administered a series of questions regarding a close friend during their eighth-grade school year. Scales corresponding to shared experience, self-disclosure, and intimacy (defined as emotional closeness) were developed from these items. Path-analytic models tested the relative strength of the self-disclosure and shared experience paths to emotional closeness for boys and girls separately. The results indicated that the self-disclosure path to emotional closeness is significant for both boys and girls. No relationship was found between shared experience and emotional closeness in girls when controlling for self-disclosure. The relationship between shared experience and feelings of closeness was, however, significant for boys even while controlling for the effects of self-disclosure. Covariance structure analysis (LISREL) indicated that the covariance matrices for the three scales were significantly different for boys and girls. The results are considered in relation to the gender socialization and friendship literature. The potential importance of defining intimacy as emotional closeness is also discussed.

Studying the emergence of depression and depressive symptoms during adolescence

The special issue on the emergence and maintenance of depression and depressive symptoms is introduced. The special issue considers two typically separate lines of research, one focusing on severe clinical depression and another on depressive symptoms. The biological, social, and cognitive factors contributing to the emergence of depression in adolescence are highlighted in this special issue.

Adolescent depression: Why more girls?

Although there has been evidence for some time of a sex difference in depression, relatively little research has examined the developmental process by which women come to be at greater risk than men for depression. In this paper, the developmental pattern of depressed affect is examined over early and middle adolescence, with a special focus on the patterns of boys as compared to girls. In addition, a developmental model for mental health in adolescence is tested for its power in explaining the emergence of gender differences in depression. Longitudinal data on 335 adolescents randomly selected from two school districts were used to test the hypotheses. Results revealed that girls are at risk for developing depressed affect by 12th grade because they experienced more challenges in early adolescence than did boys. The sex difference in depressed affect at 12th grade disappears once early adolescent challenges are considered.

Infusion with the antioxidant N-acetylcysteine attenuates early adaptive responses to exercise in human skeletal muscle

AIM

Production of reactive oxygen species (ROS) in skeletal muscle is markedly increased during exercise and may be essential for exercise adaptation. We, therefore, investigated the effects of infusion with the antioxidant N-acetylcysteine (NAC) on exercise-induced activation of signalling pathways and genes involved in exercise adaptation in human skeletal muscle.

METHODS

Subjects completed two exercise tests, 7 days apart, with saline (control, CON) or NAC infusion before and during exercise. Exercise tests comprised of cycling at 71% VO(2peak) for 45 min, and then 92% VO(2peak) to fatigue, with vastus lateralis biopsies at pre-infusion, after 45-min cycling and at fatigue.

RESULTS

Analysis was conducted on the mitogen-activated protein kinase signalling pathways, demonstrating that NAC infusion blocked the exercise-induced increase in JNK phosphorylation, but not ERK1/2, or p38 MAPK. Nuclear factor-κB p65 phosphorylation was unaffected by exercise; however, it was reduced in NAC at fatigue by 14% (P < 0.05) compared with pre-infusion. Analysis of exercise and/or ROS-sensitive genes demonstrated that exercise-induced mRNA expression is ROS dependent of MnSOD, but not PGC-1α, interleukin-6, monocyte chemotactic protein-1, or heat-shock protein 70.

CONCLUSION

These results suggest that inhibition of ROS attenuates some skeletal muscle cell signalling pathways and gene expression involved in adaptations to exercise.

Effects of endurance training status and sex differences on Na+,K+-pump mRNA expression, content and maximal activity in human skeletal muscle

AIM

This study investigated the effects of endurance training status and sex differences on skeletal muscle Na+,K+-pump mRNA expression, content and activity.

METHODS

Forty-five endurance-trained males (ETM), 11 recreationally active males (RAM), and nine recreationally active females (RAF) underwent a vastus lateralis muscle biopsy. Muscle was analysed for Na+,K+-pump alpha1, alpha2, alpha3, beta1, beta2 and beta3 isoform mRNA expression (real-time reverse transcription-polymerase chain reaction), content ([3H]-ouabain-binding site) and maximal activity (3-O-methylfluorescein phosphatase, 3-O-MFPase).

RESULTS

ETM demonstrated lower alpha1, alpha3, beta2 and beta3 mRNA expression by 74%, 62%, 70% and 82%, respectively, than RAM (P<0.04). In contrast, [3H]-ouabain binding and 3-O-MFPase activity were each higher in ETM than in RAM, by 16% (P<0.03). RAM demonstrated a 230% and 364% higher alpha3 and beta3 mRNA expression than RAF, respectively (P<0.05), but no significant sex differences were found for alpha1, alpha2, beta1 or beta2 mRNA, [3H]-ouabain binding or 3-O-MFPase activity. No significant correlation was found between years of endurance training and either [3H]-ouabain binding or 3-O-MFPase activity. Significant but weak correlations were found between the number of training hours per week and 3-O-MFPase activity (r=0.31, P<0.02) and between incremental exercise VO2(peak)) and both [3H]-ouabain binding (r=0.33, P<0.01) and 3-O-MFPase activity (r=0.28, P<0.03).

CONCLUSIONS

Isoform-specific differences in Na+,K+-pump mRNA expression were found with both training status and sex differences, but only training status influenced Na+,K+-pump content and maximal activity in human skeletal muscle.

Prolonged submaximal exercise induces isoform-specific Na+-K+-ATPase mRNA and protein responses in human skeletal muscle

This study investigated effects of prolonged submaximal exercise on Na+-K+-ATPase mRNA and protein expression, maximal activity, and content in human skeletal muscle. We also investigated the effects on mRNA expression of the transcription initiator gene, RNA polymerase II (RNAP II), and key genes involved in protein translation, eukaryotic initiation factor-4E (eIF-4E) and 4E-binding protein 1 (4E-BP1). Eleven subjects (6 men, 5 women) cycled at 75.5% (SD 4.8%) peak O2uptake and continued until fatigue. A vastus lateralis muscle biopsy was taken at rest, fatigue, and 3 and 24 h postexercise. We analyzed muscle for Na+-K+-ATPase α1, α2, α3, β1, β2, and β3, as well for RNAP II, eIF-4E, and 4E-BP1 mRNA expression by real-time RT-PCR and Na+-K+-ATPase isoform protein abundance using immunoblotting. Muscle homogenate maximal Na+-K+-ATPase activity was determined by 3 -O-methylfluorescein phosphatase activity and Na+-K+-ATPase content by [3H]ouabain binding. Cycling to fatigue [54.5 (SD 20.6) min] immediately increased α3( P = 0.044) and β2mRNA ( P = 0.042) by 2.2- and 1.9-fold, respectively, whereas α1mRNA was elevated by 2.0-fold at 24 h postexercise ( P = 0.036). A significant time main effect was found for α3protein abundance ( P = 0.046). Exercise transiently depressed maximal Na+-K+-ATPase activity ( P = 0.004), but Na+-K+-ATPase content was unaltered throughout recovery. Exercise immediately increased RNAP II mRNA by 2.6-fold ( P = 0.011) but had no effect on eIF-4E and 4E-BP1 mRNA. Thus a single bout of prolonged submaximal exercise induced isoform-specific Na+-K+-ATPase responses, increasing α1, α3, and β2mRNA but only α3protein expression. Exercise also increased mRNA expression of RNAP II, a gene initiating transcription, but not of eIF-4E and 4E-BP1, key genes initiating protein translation.

Depressed Na+-K+-ATPase activity in skeletal muscle at fatigue is correlated with increased Na+-K+-ATPase mRNA expression following intense exercise

We investigated whether depressed muscle Na+-K+-ATPase activity with exercise reflected a loss of Na+-K+-ATPase units, the time course of its recovery postexercise, and whether this depressed activity was related to increased Na+-K+-ATPase isoform gene expression. Fifteen subjects performed fatiguing, knee extensor exercise at ∼40% maximal work output per contraction. A vastus lateralis muscle biopsy was taken at rest, fatigue, 3 h, and 24 h postexercise and analyzed for maximal Na+-K+-ATPase activity via 3- O-methylfluorescein phosphatase (3- O-MFPase) activity, Na+-K+-ATPase content via [3H]ouabain binding sites, and Na+-K+-ATPase α1-, α2-, α3-, β1-, β2- and β3-isoform mRNA expression by real-time RT-PCR. Exercise [352 (SD 267) s] did not affect [3H]ouabain binding sites but decreased 3- O-MFPase activity by 10.7 (SD 8)% ( P < 0.05), which had recovered by 3 h postexercise, without further change at 24 h. Exercise elevated α1-isoform mRNA by 1.5-fold at fatigue ( P < 0.05). This increase was inversely correlated with the percent change in 3- O-MFPase activity from rest to fatigue (%Δ3- O-MFPaserest-fatigue) ( r = −0.60, P < 0.05). The average postexercise (fatigue, 3 h, 24 h) α1-isoform mRNA was increased 1.4-fold ( P < 0.05) and approached a significant inverse correlation with %Δ3- O-MFPaserest-fatigue( r = −0.56, P = 0.08). Exercise elevated α2-isoform mRNA at fatigue 2.5-fold ( P < 0.05), which was inversely correlated with %Δ3- O-MFPaserest-fatigue( r = −0.60, P = 0.05). The average postexercise α2-isoform mRNA was increased 2.2-fold ( P < 0.05) and was inversely correlated with the %Δ3- O-MFPaserest-fatigue( r = −0.68, P < 0.05). Nonsignificant correlations were found between %Δ3- O-MFPaserest-fatigueand other isoforms. Thus acute exercise transiently decreased Na+-K+-ATPase activity, which was correlated with increased Na+-K+-ATPase gene expression. This suggests a possible signal-transduction role for depressed muscle Na+-K+-ATPase activity with exercise.

A guidance for assessing and communicating uncertainties

In the daily practice of science for policy, as experienced by governmental agencies which inform the policy and the public on the state and outlook of the environment, there is a pressing need for guidance in assessing and communicating uncertainties. This need extends beyond the quantitative assessment of uncertainties in model results, and focuses on the entire process of environmental assessment, running from problem framing towards reporting the results of the study. Using the Netherlands Environmental Assessment Agency (RIVM/MNP) as a case, the development, structure and content of such a guidance system is highlighted. Conditions for a successful implementation of the guidance system are discussed, and some prospects for future work are outlined.

N-acetylcysteine enhances muscle cysteine and glutathione availability and attenuates fatigue during prolonged exercise in endurance-trained individuals

The production of reactive oxygen species in skeletal muscle is linked with muscle fatigue. This study investigated the effects of the antioxidant compound N-acetylcysteine (NAC) on muscle cysteine, cystine, and glutathione and on time to fatigue during prolonged, submaximal exercise in endurance athletes. Eight men completed a double-blind, crossover study, receiving NAC or placebo before and during cycling for 45 min at 71% peak oxygen consumption (VO2 peak) and then to fatigue at 92% VO2 peak. NAC was intravenously infused at 125 mg.kg(-1).h(-1) for 15 min and then at 25 mg.kg(-1).h(-1) for 20 min before and throughout exercise. Arterialized venous blood was analyzed for NAC, glutathione status, and cysteine concentration. A vastus lateralis biopsy was taken preinfusion, at 45 min of exercise, and at fatigue and was analyzed for NAC, total glutathione (TGSH), reduced glutathione (GSH), cysteine, and cystine. Time to fatigue at 92% VO2 peak was reproducible in preliminary trials (coefficient of variation 5.6 +/- 0.6%) and with NAC was enhanced by 26.3 +/- 9.1% (NAC 6.4 +/- 0.6 min vs. Con 5.3 +/- 0.7 min; P <0.05). NAC increased muscle total and reduced NAC at both 45 min and fatigue (P <0.005). Muscle cysteine and cystine were unchanged during Con, but were elevated above preinfusion levels with NAC (P <0.001). Muscle TGSH (P <0.05) declined and muscle GSH tended to decline (P=0.06) during exercise. Both were greater with NAC (P <0.05). Neither exercise nor NAC affected whole blood TGSH. Whereas blood GSH was decreased and calculated oxidized glutathione increased with exercise (P <0.05), both were unaffected by NAC. In conclusion, NAC improved performance in well-trained individuals, with enhanced muscle cysteine and GSH availability a likely mechanism.

Chronic intermittent hypoxia and incremental cycling exercise independently depress muscle in vitro maximal Na+-K+-ATPase activity in well-trained athletes

Athletes commonly attempt to enhance performance by training in normoxia but sleeping in hypoxia [live high and train low (LHTL)]. However, chronic hypoxia reduces muscle Na(+)-K(+)-ATPase content, whereas fatiguing contractions reduce Na(+)-K(+)-ATPase activity, which each may impair performance. We examined whether LHTL and intense exercise would decrease muscle Na(+)-K(+)-ATPase activity and whether these effects would be additive and sufficient to impair performance or plasma K(+) regulation. Thirteen subjects were randomly assigned to two fitness-matched groups, LHTL (n = 6) or control (Con, n = 7). LHTL slept at simulated moderate altitude (3,000 m, inspired O(2) fraction = 15.48%) for 23 nights and lived and trained by day under normoxic conditions in Canberra (altitude approximately 600 m). Con lived, trained, and slept in normoxia. A standardized incremental exercise test was conducted before and after LHTL. A vastus lateralis muscle biopsy was taken at rest and after exercise, before and after LHTL or Con, and analyzed for maximal Na(+)-K(+)-ATPase activity [K(+)-stimulated 3-O-methylfluorescein phosphatase (3-O-MFPase)] and Na(+)-K(+)-ATPase content ([(3)H]ouabain binding sites). 3-O-MFPase activity was decreased by -2.9 +/- 2.6% in LHTL (P < 0.05) and was depressed immediately after exercise (P < 0.05) similarly in Con and LHTL (-13.0 +/- 3.2 and -11.8 +/- 1.5%, respectively). Plasma K(+) concentration during exercise was unchanged by LHTL; [(3)H]ouabain binding was unchanged with LHTL or exercise. Peak oxygen consumption was reduced in LHTL (P < 0.05) but not in Con, whereas exercise work was unchanged in either group. Thus LHTL had a minor effect on, and incremental exercise reduced, Na(+)-K(+)-ATPase activity. However, the small LHTL-induced depression of 3-O-MFPase activity was insufficient to adversely affect either K(+) regulation or total work performed.

Intense exercise up-regulates Na+,K+-ATPase isoform mRNA, but not protein expression in human skeletal muscle

Characterization of expression of, and consequently also the acute exercise effects on, Na(+),K(+)-ATPase isoforms in human skeletal muscle remains incomplete and was therefore investigated. Fifteen healthy subjects (eight males, seven females) performed fatiguing, knee extensor exercise at approximately 40% of their maximal work output per contraction. A vastus lateralis muscle biopsy was taken at rest, fatigue and 3 and 24 h postexercise, and analysed for Na(+),K(+)-ATPase alpha(1), alpha(2), alpha(3), beta(1), beta(2) and beta(3) mRNA and crude homogenate protein expression, using Real-Time RT-PCR and immunoblotting, respectively. Each individual expressed gene transcripts and protein bands for each Na(+),K(+)-ATPase isoform. Each isoform was also expressed in a primary human skeletal muscle cell culture. Intense exercise (352 +/- 69 s; mean +/-s.e.m.) immediately increased alpha(3) and beta(2) mRNA by 2.4- and 1.7-fold, respectively (P < 0.05), whilst alpha(1) and alpha(2) mRNA were increased by 2.5- and 3.5-fold at 24 h and 3 h postexercise, respectively (P < 0.05). No significant change occurred for beta(1) and beta(3) mRNA, reflecting variable time-dependent responses. When the average postexercise value was contrasted to rest, mRNA increased for alpha(1), alpha(2), alpha(3), beta(1), beta(2) and beta(3) isoforms, by 1.4-, 2.2-, 1.4-, 1.1-, 1.0- and 1.0-fold, respectively (P < 0.05). However, exercise did not alter the protein abundance of the alpha(1)-alpha(3) and beta(1)-beta(3) isoforms. Thus, human skeletal muscle expresses each of the Na(+),K(+)-ATPase alpha(1), alpha(2), alpha(3), beta(1), beta(2) and beta(3) isoforms, evidenced at both transcription and protein levels. Whilst brief exercise increased Na(+),K(+)-ATPase isoform mRNA expression, there was no effect on isoform protein expression, suggesting that the exercise challenge was insufficient for muscle Na(+),K(+)-ATPase up-regulation.

Granulosa Cell Tumor of the Ovary: A Population-Based Study of 37 Women with Stage I Disease

OBJECTIVES

The goal of this work was to evaluate clinical and pathological findings, surgical procedures, and postoperative treatment in women with stage I granulosa cell tumor.

METHODS

Data for 49 women with granulosa cell tumor were collected retrospectively. All pathological sections and findings were reviewed from diagnosis until recently. Follow-up data were collected from the general practitioner, hospital records, or death certificate. Fisher's exact test, Student's t test, Mann-Whitney test, and Kaplan-Meier survival analysis were applied, as appropriate.

RESULTS

Thirty-seven women of median age 58 years (range, 33-82) were diagnosed in stage I. Follow-up time was 8 years (range, 8 months to 26 years). The estimated survival for stage I was 93% at 5 years, 84% at 10 years, and 62% at 20 years; the actual survival rates were 94, 82, and 62% after 5, 10, and 20 years, respectively. Primary treatment consisting of total abdominal hysterectomy and bilateral salpingo-oophorectomy was associated with improved survival (P < 0.05) and tended to be associated with longer relapse-free interval (P < 0.06). The 10-year survival rate was 40% in postmenopausal women operated conservatively and more than 90% for the extensively treated women (P < 0.05). Evidence of increased estrogen secretion was found more often in postmenopausal woman as compared with premenopausal women (P < 0.01) but did not affect survival. No pathological parameter correlated with prognosis.

CONCLUSION

Granulosa cell tumor is a tumor of unquestionable malignant potential and has a tendency for late relapses. Long-time follow-up is recommended.

Proteoglycans and hyaluronan in human fetal membranes

OBJECTIVE

The aim of this study was to describe the distributions of major extracellular matrix components, such as proteoglycans, collagen and hyaluronan, in the fetal membranes at term.

STUDY DESIGN

Fetal membranes were obtained from elective cesarean deliveries at term. Guanidinium extracts were analyzed for proteoglycans with alcian blue precipitation, sodium dodecyl sulfate- polyacrylamide gel electrophoresis, and Western blotting and for hyaluronan with a radioimmunoassay. Collagen was measured by estimating hydroxyproline content. Tissue sections were immunostained for decorin and biglycan and stained for hyaluronan with a biotin-labeled hyaluronan-binding protein.

RESULTS

The fetal membranes contained predominantly smaller proteoglycans, such as biglycan and decorin. The amnion consisted of typical fibrous connective tissue with a high concentration of collagen. The amnion was dominated by decorin located in close connection with the collagen fibrils. The chorion was composed of a fibroblastic part containing collagen and decorin and a trophoblastic part mainly containing biglycan. In addition, large amounts of hyaluronan were found, especially in the amnion and in the decidual cell layers.

CONCLUSION

The distributions of proteoglycans, collagen, and hyaluronan in human fetal membranes may explain the biomechanical properties of this tissue. We suggest that changes in the relative proportions of these extracellular molecules are crucial for the proposed maturation process in the fetal membranes during the last weeks of pregnancy.

Prevention of high-risk behaviors in adolescent women

PURPOSE

To better delineate the impact of health risk behaviors on adolescent women's current and future health and development.

METHOD

The Commonwealth Fund Survey of Adolescent Health, a national survey of adolescents in Grades 5-12 designed to better understand their health and health care needs, was used as the basis for this study. Survey data were collected in 1997 from a total of 6730 adolescents (3568 females, 3162 males). Areas examined include smoking, drinking, use of other drugs, violence, safety, reproductive risks, and the prevention of risk behaviors in adolescent women.

RESULTS

Adolescent women are almost equally likely to smoke, drink, and engage in other substance use as their male counterparts, but with increased health risks. Different motivations for engaging in risk behavior also are evident. Adolescent women are also more likely than adolescent men to experience physical abuse, and they are twice as likely to be sexually abused.

CONCLUSIONS

Effective prevention programs need to recognize that the motivations for engaging in risk behaviors may differ by gender. Developmental awareness, proper assessment, and pivotal institutions can provide and shape what is needed for healthy development.

An interlaboratory study to find an alternative to the MPN technique for enumerating Escherichia coli in shellfish

Nine laboratories in eight countries tested 16 batches of common mussels (Mytilus edulis) over a 32 week period in order to find an alternative to the Most Probable Number (MPN) technique to enumerate E. coli. The alternatives investigated included the 3M Petrifilm system, the Merck Chromocult agar method and a Malthus conductance technique. The Petrifilm was found to be unsuitable and was subsequently dropped from the trial. After 669 analyses, a correlation of 0.83 was observed for log E. coli counts between the MPN and Chromocult methods and there was no significant evidence that either method tended to give higher readings than the other. The MPN was slightly better than the Chromocult method for repeatability but the Chromocult was slightly better for reproducibility. However, the observed differences are probably too small to be of practical importance. On the basis of these data therefore, the two methods appear equally suitable for E. coli enumeration in shellfish. There were poor correlations between these methods and the Malthus technique. A small but significant number of samples tested positive on the Malthus instrument but were recorded negative on the MPN and Chromocult tests. Subsequent analysis positively identified E. coli from these Malthus assays. After statistical analysis, errors were noted in both the MPN and Chromocult methods but it was found that there would be no statistical differences if the Chromocult agar were used as an alternative to the MPN technique.

Developmental issues influencing guidelines for adolescent health research: a review

Adolescent development brings many opportunities to adolescents as research participants. They may be enthusiastic participants, especially if the focus of the research is of interest to the adolescents. Their increasing sense of self and development of autonomy may yield open, thoughtful responses less likely with older research participants. At the same time, the researcher must be aware of particular vulnerabilities of adolescents. Cognitive and reasoning capacity emerges gradually over the adolescent decade, making younger adolescents less capable than older adolescents of effective reasoning. The researcher can adjust materials to be understandable to the younger adolescent but should also recognize that inexperience could increase anxiety or emotionality about an issue not problematic to an older adolescent or adult. Making clear the right of the adolescent to refuse to discuss particular issues usually permits more honest responses, and increases the likelihood of consent to research or parts of research. Especially stressful circumstances may cause degradation of reasoning capacity suggesting that the researcher needs to assess whether the adolescent is able to make a wise decision about participation, as well as about particular responses. The researcher can usually identify ways to alleviate stress in the study situation and should take all steps necessary to obtain both informed consent and valid responses. Existing research provides clear evidence that most adolescents, at least past age 14 or 15 years, are able to function as well as adults research participants under most circumstances. With younger adolescents and under stressful situations, the researcher can find ways to minimize risk from research and increase the likelihood of valid responses.

Adolescent development and the emergence of sexuality

Adolescence is a time of significant opportunity and significant challenge. Challenges can be difficult for some adolescents, which may result in problems that are expressed as affective disturbances or by the adolescent's participation in risk-taking behaviors. This review emphasizes the changes in biopsychosocial development during adolescence. We specifically address aspects of individual change during the adolescent decade (e.g., biological, cognitive, psychosocial, and sexual development) as well as the effects of context on normal development and responses to challenges during this period. Predispositions or vulnerabilities present prior to a developmental transition may be exacerbated by the transition. Adolescents can become healthy adults with the encouragement to develop gradually by limiting the simultaneous changes they experience, where possible, and by supporting healthy development through developmentally appropriate activities and supportive relationships with adults and peers.

Social changes among youth: the United States experience

The tremendous increase in research on adolescence over the past 20 years, and especially the last decade, has produced a great deal of knowledge about adolescent development and the development of problems during adolescence. This new knowledge should lead to more effective interventions. Although more research is needed on basic developmental processes and context influences, this is especially the case in the area of effective interventions. The next decade may bring significant new knowledge that will dramatically improve the lives of young people in the United States. This is desperately needed as the current status of youth must change.

[Granulosa cell tumor. A 30-year material from a central hospital]

During a 30-years period seventeen women were correctly diagnosed as having a granulosa cell tumour. Two died of the tumour, while six women died of other causes. No pathological features correlated to prognosis. A conservative surgical approach to preserve fertility is not recommended; of the three fertile women in our group one died of the disease and another one had two relapses within three years. Eleven tumours showed evidence of increased oestradiol production, and this proved useful as a tumour marker. Follow up is rarely performed unless relapse occurs.

Coping with challenge in adolescence: a conceptual model and psycho-educational intervention

This paper presents a conceptual model for understanding the nature, timing, synchronicity and impact of developmental stressors and their implications for adolescent mental health trajectories. The model is derived, in part, from a longitudinal program of research investigating the development of adolescent mental health. Developments in the areas of life-span development, developmental psychopathology, and stress and coping also inform the model. In this model, stressors are viewed as challenges to the coping responses and resources of adolescents. Some challenges can be risks to adolescent mental health while others can be opportunities for further growth and development. Moderators of the association between challenge and mental health outcomes include internal/personal and external/interpersonal resources. This model has led to a psycho-educational program to enhance coping and reduce depression. Its design and some preliminary results from a longitudinal study of the short- and long-term effectiveness of the program in enhancing adolescent mental health are described.

Depression in adolescence

Adolescence is an important developmental period for understanding the nature, course, and treatment of depression. Recent research concerned with depressive mood, syndromes, and disorders during adolescence is reviewed, including investigations of the prevalence, course, risk factors, and prevention and treatment programs for each of these three levels of depressive phenomena in adolescence. A broad biopsychosocial perspective on adolescent depression is recommended, and possible directions for future integrative research are proposed. Based on current research and knowledge, implications for research, program, and national policy are considered.

Depression in adolescence

Adolescence is an important developmental period for understanding the nature, course, and treatment of depression. Recent research concerned with depressive mood, syndromes, and disorders during adolescence is reviewed, including investigations of the prevalence, course, risk factors, and prevention and treatment programs for each of these three levels of depressive phenomena in adolescence. A broad biopsychosocial perspective on adolescent depression is recommended, and possible directions for future integrative research are proposed. Based on current research and knowledge, implications for research, program, and national policy are considered.

Cortisol reactivity and anxiety and depression in pregnant adolescents: a longitudinal perspective

The purpose of this investigation was to examine: (1) the relations among cortisol reactivity (short term changes in cortisol concentration) and anxiety and depression symptoms in adolescents during pregnancy and early postpartum, and (2) cortisol reactivity and psychosocial variables as predictors of anxiety and depression symptoms in pregnancy and early postpartum. Cortisol reactivity, an index of hypothalamic-pituitary-adrenal activity, was hypothesized to be a vulnerability factor for poor physical and mental health outcomes in adolescents. Forty adolescents aged 14 to 19 years (M = 17.3, SD = 1.3) were enrolled in the study and were seen at < 20 weeks gestation (T1), 34-36 weeks gestation (T2), and 2-3 weeks postpartum (T3). Blood was drawn for cortisol at T1 and T3. Psychological assessments of anxiety and depression symptoms, life optimism, and self-worth were administered at T1, T2, and T3. There were significant correlations among cortisol reactivity and anxiety and depression symptoms at T1 and T3, but the correlations were the reverse of the hypothesized direction. Pregnant adolescents with increased cortisol reactivity (cortisol concentrations that increased across a 40-min period) had fewer symptoms of anxiety and depression than other adolescents. Longitudinal analyses showed that anxiety and depression symptoms at T1 were a stronger predictor of postpartum anxiety and depression than was cortisol reactivity, life optimism, self-worth, or age at pregnancy.

External skeletal fixation as treatment for total puerperal rupture of the pubic symphysis

A case of total puerperal rupture of the pubic symphysis during non-operative delivery is reported and the literature reviewed. The patient in our case was successfully treated by external skeletal fixation. In agreement with the literature the authors recommend external skeletal fixation when lesions are unstable, when inadequate reduction is achieved, or when the diastasis is more than 40 mm.

Masculinity, femininity, and sex role attitudes in early adolescence: exploring gender intensification

This longitudinal study of 200 young adolescent girls and boys (mean age 11.6 years in sixth grade) investigated the hypothesis that differences in masculinity, femininity, and sex role attitudes would intensify across the sixth, seventh, and eighth grades (between 11 and 13 years of age) and that pubertal timing (early, on time, late) would play a role in this intensification. Analyses revealed that sex differences in masculinity and sex role attitudes increased across grades, but not sex differences in femininity. Pubertal timing was not associated with this gender divergence, although the evidence is equivocal for boys. The results provide support for gender intensification, but the role of pubertal timing may not be as strong as previously supposed.

[Pyometra without accompanying malignant uterine disease]

Twenty-two cases of non-malignant pyometra which were observed during a period of 15 years are described. 22% were recurrences. All of the women were postmenopausal with discharge and haemorrhage as the commonest symptoms. Pyrexia was rare. Pyometra cannot be excluded or diagnosed by means of gynaecological examination. In cases of suspected pyometra, thorough cervical dilatation and curettage are recommended. Antibiotics should only be administered if there is evidence of invasive infection, in the form of pyrexia, generalised malaise or altered laboratory parameters. In cases such as these, preparations which are effective for aerobic and also anaerobic bacteria should be employed. Follow-up control every six months is recommended on account of the great tendency to recur.

Emergence and characterization of sex differences in spatial ability: a meta-analysis

Sex differences in spatial ability are widely acknowledged, yet considerable dispute surrounds the magnitude, nature, and age of first occurrence of these differences. This article focuses on 3 questions about sex differences in spatial ability: What is the magnitude of sex differences in spatial ability? On which aspects of spatial ability are sex differences found? and When, in the life span, are sex differences in spatial ability first detected? Implications for clarifying the linkage between sex differences in spatial ability and other differences between males and females are discussed. We use meta-analysis, a method for synthesizing empirical studies, to investigate these questions. Results of the meta-analysis suggest that sex differences arise on some types of spatial ability but not others, that large sex differences are found only on measures of mental rotation, that smaller sex differences are found on measures of spatial perception, and that, when sex differences are found, they can be detected across the life span.

Pubertal timing and grade effects on adjustment

Effects on adjustment of biological maturation and social timing were compared using data from a longitudinal sample of 335 young adolescents, who were followed from the sixth through eighth grades. Biological maturation was estimated from the relative timing of the adolescent growth spurt. Social timing was assessed by grade in school. Five adjustment constructs were examined: school achievement (course grades in five subjects), family relations (a 17-item scale), peer relations (a 10-item scale), body image (an 11-item scale), impulse control (an 8-item scale), and psychopathology (an 11-item emotional tone scale and an 11-item general psychopathology scale). All but one adjustment construct showed grade effects, but only three of the six constructs showed pubertal timing effects. There were no grade by pubertal timing effects. Although there were gender differences for some of the adjustment constructs, there were no gender by pubertal timing effects. The results are discussed in terms of the life-span developmental perspective.