Estimating population lung cancer risk from radon using a resource efficient stratified population weighted sample survey protocol - Lessons and results from Ireland

A 2018 estimate indicates that there were 226,057 radon-attributable lung cancer deaths in 66 countries that had representative radon surveys. This is a shocking figure, and as it comes from only 66 countries it underestimates the worldwide death toll. Any research that enables countries to conduct representative radon surveys and to understand better the risk to citizens from radon is surely welcome. We hope this paper provides a useful methodology for estimating population risk. The estimation of population weighted average indoor radon levels requires statistically valid sampling methodologies that use a representative sample of occupied homes throughout the country. A literature review indicates that in many population weighted surveys, the sampling methodology may not have been designed to do this. This paper describes a simple, resource efficient methodology which produces statistically valid and reliable estimates based on a small scale sample that is representative of the population distribution. The resource efficient design of this study enables it to be repeated at frequent intervals providing for a longitudinal analysis of the population risk from indoor radon. This survey was conducted in Ireland using 653 measurements and a representative sampling strategy to provide a baseline population weighted radon exposure for future comparisons. This study estimates the average population weighted indoor radon concentration in Ireland to be 97.83 Bq m^-3 (95% Confidence Interval 90.69 Bq m^-3 to 105.53 Bq m^-3), and that there are an estimated 350 lung cancer cases and 255 deaths per year due to radon exposure. The mortality rate of 5.3 per 100,000 due to indoor radon, demonstrates that radon remains one of the highest preventable causes of death in Ireland.

Treatment of non-small-cell lung cancer after progression on nivolumab or pembrolizumab

Background

Although PD-1 antibodies (PD1 Ab) are the standard of care for advanced non-small-cell lung cancer (ansclc), most patients will progress. We compared survival outcomes for patients with ansclc who received systemic therapy (st) after progression and for those who did not. Additionally, clinical characteristics that predicted receipt of st after PD1 Ab failure were evaluated.

Methods

All patients with ansclc in British Columbia initiated on nivolumab or pembrolizumab between June 2015 and November 2017, with subsequent progression, were identified. Eligibility criteria for additional st included an Eastern Cooperative Oncology Group (ecog) performance status (ps) of 3 or less and survival for more than 30 days from the last PD1 Ab treatment. Post-progression survival (pps) was assessed by landmark analysis. Baseline characteristics associated with pps were identified by multivariable analysis.

Results

Of 94 patients meeting the eligibility criteria, 33 received st after progression. In 75.6%, a PD1 Ab was received as first- or second-line treatment. The most common sts were erlotinib (36.4%) and docetaxel (27.3%). No statistically significant difference in median pps was observed between patients who did and did not receive st within 30 days of their last PD1 Ab treatment (6.9 months vs. 3.6 months, log-rank p = 0.15.) In multivariable analysis, factors associated with increased pps included an ecog ps of 0 or 1 compared with 2 or 3 [hazard ratio (hr): 0.42; 95% confidence interval (ci): 0.24 to 0.73; p = 0.002] and any response compared with no response to PD1 Ab (hr: 0.54; 95% ci: 0.33 to 0.90; p = 0.02).

Conclusions

In this cohort, only 35.1% of patients eligible for post-PD1 Ab therapy received st. Post-progression survival was not significantly affected by receipt of post-progression therapy. Prospective trials are needed to clarify the benefit of post-PD1 Ab treatments.

Update of Ireland's national average indoor radon concentration - Application of a new survey protocol

In 2002, a National Radon Survey (NRS) in Ireland established that the geographically weighted national average indoor radon concentration was 89 Bq m^-3. Since then a number of developments have taken place which are likely to have impacted on the national average radon level. Key among these was the introduction of amending Building Regulations in 1998 requiring radon preventive measures in new buildings in High Radon Areas (HRAs). In 2014, the Irish Government adopted the National Radon Control Strategy (NRCS) for Ireland. A knowledge gap identified in the NRCS was to update the national average for Ireland given the developments since 2002. The updated national average would also be used as a baseline metric to assess the effectiveness of the NRCS over time. A new national survey protocol was required that would measure radon in a sample of homes representative of radon risk and geographical location. The design of the survey protocol took into account that it is not feasible to repeat the 11,319 measurements carried out for the 2002 NRS due to time and resource constraints. However, the existence of that comprehensive survey allowed for a new protocol to be developed, involving measurements carried out in unbiased randomly selected volunteer homes. This paper sets out the development and application of that survey protocol. The results of the 2015 survey showed that the current national average indoor radon concentration for homes in Ireland is 77 Bq m^-3, a decrease from the 89 Bq m^-3 reported in the 2002 NRS. Analysis of the results by build date demonstrate that the introduction of the amending Building Regulations in 1998 have led to a reduction in the average indoor radon level in Ireland.

The rate of radon remediation in Ireland 2011-2015: Establishing a base line rate for Ireland's National Radon Control Strategy

Radon is the greatest source of radiation exposure to the public. In Ireland, it is estimated that approximately 7% of the national housing stock have radon concentrations above the Reference Level of 200 Bq m^-3. A radon test can be carried out to identify homes with radon levels above the Reference Level. However there is no health benefit associated with radon testing unless it leads to remediation. Surveys to establish the rate of remediation in Ireland, that is the proportion of householders who having found levels of radon above the Reference Level proceed to carry out remediation work have been carried out in 2011 and 2013. Reasons for not carrying out remediation work were also investigated. In 2015 the survey was repeated to establish the current rate of remediation and reasons for not remediating. This report presents the results of that survey. It also compiles the data from all three surveys to identify any trends over time. The rate of remediation is an important parameter in estimating the effectiveness of programmes aimed at reducing radon levels. Currently the rate of remediation is 22% and the main reasons householders gave for not remediating were not certain there is a serious risk and concern about the cost of the work. In Ireland, this figure of 22% will be now used as a baseline metric against which the effectiveness of its National Radon Control Strategy will be measured over time.

National radon programmes and policies: the RADPAR recommendations

Results from epidemiological studies on lung cancer and radon exposure in dwellings and mines led to a significant revision of recommendations and regulations of international organisations, such as WHO, IAEA, Nordic Countries, European Commission. Within the European project RADPAR, scientists from 18 institutions of 14 European countries worked together for 3 y (2009-12). Among other reports, a comprehensive booklet of recommendations was produced with the aim that they should be useful both for countries with a well-developed radon programme and for countries with little experience on radon issues. In this paper, the main RADPAR recommendations on radon programmes and policies are described and discussed. These recommendations should be very useful in preparing a national action plan, required by the recent Council Directive 2013/59/Euratom.

Use of health economics in the development of a national radon control strategy in Ireland

A health economics evaluation of different radon intervention strategies was undertaken including the incorporation of prevention into new buildings, the incorporation of potential remedial measures into new buildings and remediation of existing buildings. The analysis shows that (1) the incorporation of prevention into new houses at the time of construction is generally more cost effective than remediation of existing houses and (2) that the cost effectiveness of programmes aimed at encouraging householders to test and remediate their houses may be poor if they are not undertaken within the context of coherent radon reduction strategy. The results of this evaluation were used to identify the most cost-effective radon interventions in an Irish context in support of the development of a National Radon Control Strategy.

Randomised, double-blind trial of carboplatin and paclitaxel with daily oral cediranib or placebo in patients with advanced non-small cell lung cancer: NCIC Clinical Trials Group study BR29

INTRODUCTION

This randomised double-blind placebo-controlled study evaluated the addition of cediranib, an inhibitor of vascular endothelial growth factor receptors 1-3, to standard carboplatin/paclitaxel chemotherapy in advanced non-small cell lung cancer.

METHODS

Eligible patients received paclitaxel (200mg/m(2)) and carboplatin (area under the concentration time curve 6) intravenously every 3 weeks. Daily oral cediranib/placebo 20mg was commenced day 1 of cycle 1 and continued as monotherapy after completion of 4-6 cycles of chemotherapy. The primary end-point of the study was overall survival (OS). The trial would continue to full accrual if an interim analysis (IA) for progression-free survival (PFS), performed after 170 events of progression or death in the first 260 randomised patients, revealed a hazard ratio (HR) for PFS of ⩽ 0.70.

RESULTS

The trial was halted for futility at the IA (HR for PFS 0.89, 95% confidence interval [CI] 0.66-1.20, p = 0.45). A final analysis was performed on all 306 enrolled patients. The addition of cediranib increased response rate ([RR] 52% versus 34%, p = 0.001) but did not significantly improve PFS (HR 0.91, 95% CI 0.71-1.18, p = 0.49) or OS (HR 0.94, 95% CI 0.69-1.30, p=0.72). Cediranib patients had more grade 3 hypertension, diarrhoea and anorexia.

CONCLUSIONS

The addition of cediranib 20mg daily to carboplatin/paclitaxel chemotherapy increased RR and toxicity, but not survival.

The effectiveness of radon preventive and remedial measures in Irish homes

It is estimated that approximately 100 000 Irish homes have radon concentrations above the reference level of 200 Bq m(-3). To minimise the number of new homes with this problem, building regulations require that all new homes built since July 1998 in high radon areas are installed with radon barriers during construction. Measurements on local authority homes in a number of high radon areas have allowed the impact of these new regulations to be assessed. In County Cork a reduction of up to 70% in the mean radon concentration was observed in homes built since 1998 relative to those built before this date. A reduction in both the number of homes exceeding the reference level and the maximum concentration measured in homes was also measured. Homes exceeding the reference level were remediated with the use of an active sump. The results of this remedial work are also presented and show that the mean reduction in radon concentration achieved was 92%.

The relationship between cell dry weight concentration and culture turbidity for a recombinant e. Coli k12 strain producing high levels of human alpha interferon analogue

A recombinant E. Coli K12 strain carrying a runaway-type plasmid with the gene for human alpha interferon analogue and capable of producing high levels of recombinant product [1], was grown in rich medium and compared to the host strain without plasmid, and to the strain with the plasmid, but lacking the interferon gene insert. At a non-inducing temperature, gross cell morphology and the correlation between dry weight and culture turbidity was comparable for the three cultures. Following induction by temperature elevation, both plasmid-bearing strains displayed significant cell size change, but only the interferon producing strain underwent a decrease in the ratio of cell concentration measured by dry weight to culture turbidity.

Radon potential mapping of the Tralee-Castleisland and Cavan areas (Ireland) based on airborne gamma-ray spectrometry and geology

The probability of homes in Ireland having high indoor radon concentrations is estimated on the basis of known in-house radon measurements averaged over 10 km × 10 km grid squares. The scope for using airborne gamma-ray spectrometer data for the Tralee-Castleisland area of county Kerry and county Cavan to predict the radon potential (RP) in two distinct areas of Ireland is evaluated in this study. Airborne data are compared statistically with in-house radon measurements in conjunction with geological and ground permeability data to establish linear regression models and produce radon potential maps. The best agreement between the percentage of dwellings exceeding the reference level (RL) for radon concentrations in Ireland (% > RL), estimated from indoor radon data, and modelled RP in the Tralee-Castleisland area is produced using models based on airborne gamma-ray spectrometry equivalent uranium (eU) and ground permeability data. Good agreement was obtained between the % > RL from indoor radon data and RP estimated from eU data in the Cavan area using terrain specific models. In both areas, RP maps derived from eU data are spatially more detailed than the published 10 km grid map. The results show the potential for using airborne radiometric data for producing RP maps.

An overview of Ireland's National Radon Policy

In Ireland radon is a significant public health issue and is linked to 150-200 lung cancer deaths each year. Irish National Radon Policy aims to reduce individual risk by identifying and remediating buildings with high radon concentrations and also to reduce collective dose through radon prevention as required by revised building regulations. Achievements to date are significant and include the completion of the National Radon Survey, the testing of every school in Ireland, the on-going testing of social housing, collaboration between the public health and radiation protection authorities and the inclusion of radon in inspections of workplaces. However, this work now needs to be drawn together centrally to comprehensively address the radon problem. The RPII and the relevant central governing department, the Department of Environment, Heritage and Local Government are currently working to constitute a group of key experts from relevant public authorities to drive the development of a National Radon Control Strategy.

Safety of the anti-IGF-1R antibody CP-751,871 in combination with exemestane in patients with advanced breast cancer

Abstract #2136

Background: Aromatase inhibitors (AIs) are established first-line treatment for postmenopausal estrogen receptor (ER)+ metastatic breast cancer. However, not all patients benefit from AIs and those whose tumors initially respond eventually relapse. One hypothesized mechanism for tumor insensitivity to hormonal agents seems to be cross-talk between the ER pathway and other growth factor signaling pathways, in particular the insulin-like growth factor receptor type 1 (IGF-1R). In xenograft breast cancer models, CP-751,871 administration increased tumor growth inhibition induced by tamoxifen. Thus our trial addresses the effect of combining AI with an IGF-1R antagonist.
 Methods: A phase II, multicenter, randomized, two-arm, comparative, two-stage trial to determine PFS of CP-751,871, a fully human IgG2 monoclonal antibody targeting IGF-1R, in combination with exemestane versus exemestane alone as first-line treatment in patients with hormone receptor positive, advanced breast cancer. Secondary endpoints include clinical benefit (CR, PR, or SD ≥6 months), safety/tolerability and PK. Patients included in the study are post menopausal, ≥18 years with locally advanced/metastatic breast cancer (stage IIIB or IV), ECOG PS 0–2, and adequate hematological, biochemical, and cardiac functions. CP-751,871 is given by intravenous infusion at a dose of 20 mg/kg every 21 days while 25 mg exemestane was given p.o. daily.
 Results: To date 37 patients have been dosed with CP-751,871 plus exemestane. Median age is 60.5 years (range 34–84). Patients received a median of 9.5 treatment cycles (range 1–22). One GR 4 CP-751,871-related AE (hoarse voice) was reported, which resolved after 3 days without intervention. GR 3 CP-751,871-related toxicities included 8.1% hyperglycemia (n=3), 8.1% GGT elevation (n=3), 5.4% allergic reaction (n=2), 5.4% hearing loss (n=2), 5.4% weight loss (n=2), and 2.7% anorexia (n=1). GR 2 CP-751,871-related AEs >10% were headaches, muscle cramps, and nail changes. Both hyperglycemia and hypersensitivity reactions were manageable (with oral hypoglycemic drug/insulin and antihistamine), while GGT elevation seems to be reversible.
 Conclusions: CP-751,871 in combination with exemestane is well tolerated. The most frequent GR 3 side effects are either well managed with medications or appear to be reversible. Therefore, CP-751,871, due to its safety profile, is a good targeted agent to combine with standard hormonal therapy. The stage I portion of the study to determine efficacy and toxicity is ongoing.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2136.

An assessment of annual whole-body occupational radiation exposure in Ireland (1996-2005)

Whole-body occupational exposure to artificial radiation sources in Ireland for the years 1996-2005 has been reviewed. Dose data have been extracted from the database of the Radiological Protection Institute of Ireland, which contains data on >95% of monitored workers. The data have been divided into three sectors: medical, industrial and education/research. Data on exposure to radon in underground mines and show caves for the years 2001-05 are also presented. There has been a continuous increase in the number of exposed workers from 5980 in 1996 to 9892 in 2005. Over the same time period, the number of exposed workers receiving measurable doses has decreased from 676 in 1996 to 189 in 2005 and the collective dose has also decreased from 227.1 to 110.3 man millisievert (man mSv). The collective dose to workers in the medical sector has consistently declined over the 10-y period of the study while that attributable to the industrial sector has remained reasonably static. In the education/research sector, the collective dose typically represents 5% or less of the total collective dose from all practices. Over the 10 y of the study, a total of 77 914 annual dose records have been accumulated, but only 4040 (<6%) of these represent measurable radiation doses in any given year. Over the same time period, there were 283 instances in which exposed workers received individual annual doses >1 mSv and 21 of these exceeded 5 mSv. Most of the doses >1 mSv were received by individuals working in diagnostic radiology (which also includes interventional radiology) in hospitals and site industrial radiography. There has been only one instance of a dose above the annual dose limit of 20 mSv. Evaluating the data for the period 2001-05 separately, the average annual collective dose from the medical, industrial and educational/research sectors are approximately 60, 70 and 2 man mSv with the average dose per exposed worker who received a measurable dose being 0.32, 0.79 and 0.24 mSv, respectively. Diagnostic radiology and site industrial radiography each represents >60% of the collective dose in their respective sectors. Available data on radon exposure in one underground mine and in three show caves indicate an annual collective dose of 75 man mSv from these work activities. By comparison, previous estimates of exposure of Irish air crew to cosmic radiation have given rise to an estimated collective dose of 12 000 man mSv. It can be concluded therefore that the natural radioactivity sources account for well >90% of all occupational exposure in Ireland. This evaluation does not include an estimate of exposure to radon in above-ground workplaces-these data are currently being evaluated and their inclusion will increase both the total occupational collective dose as well as the percentage of that dose due to natural radiation.

Individual and collective doses from cosmic radiation in Ireland

This paper assesses the individual and collective doses in Ireland due to cosmic radiation. Information on the exposure to cosmic radiation at ground level is reviewed and published data on the frequency of routes flown by Irish residents is used to calculate the dose due to air travel. Occupational exposure of aircrew is also evaluated. Experimental data on cosmic radiation exposure at ground level is in good agreement with international estimates and the average individual dose is calculated as 300 microSv annually. Published data on international air travel by Irish residents shows a 50% increase in the number of flights taken between 2001 and 2005. This increase is primarily on short-haul flights to Europe, but there have been significant percentage increases in all long-haul flights, with the exception of flights to Africa. The additional per capita dose due to air travel is estimated to be 45 muSv, of which 51% is accumulated on European routes and 34% on routes to the United States. Exposure of aircrew to cosmic radiation is now controlled by legislation and all airlines holding an Air Operator's Certificate issued by the Irish Aviation Authority are required to report annually the doses received by their employees in the previous year. There has been a 75% increase in the number of aircrew receiving doses >1 mSv since 2002. In 2004 and 2005 the average individual doses received by Irish aircrew were 1.8 and 2.0, mSv, respectively. The corresponding per caput dose for the entire population is <3 muSv. While this is low compared with the per caput doses from other sources of cosmic radiation, aircrew exposure represents a higher collective dose than any other identified group of exposed workers in Ireland.

Radon in Irish schools: the results of a national survey

This paper presents the results of a survey of radon concentrations in Irish primary and post-primary schools. The objective of this survey was to assess the distribution of radon in Irish schools and to identify those requiring remedial work to reduce radon exposure to children and staff. All primary and post-primary schools were invited to participate in the survey. Indoor radon concentrations were measured during the academic year using integrating passive alpha track-etch detectors with a measurement period from three to nine months. The survey was carried out on a phased basis from 1998 to 2004 and is one of the most comprehensive of its kind undertaken in Europe. Measurements were completed in 38 531 ground floor classrooms and offices in 3826 schools, representing over 95% of the approximate 4000 primary and post-primary schools in Ireland. Of these, 984 schools had radon concentrations greater than 200 Bq m(-3) in 3028 rooms and 329 schools had radon concentrations in excess of 400 Bq m(-3) in 800 rooms. The average radon concentration in schools was 93 Bq m(-3). This results in an annual average effective dose to an Irish child from exposure to radon of 0.3 mSv per year, assuming that the long-term radon concentration is equal to the radon concentration present during the working hours and that the annual average occupancy is 1000 h per year. A programme of remediation of schools with radon concentrations above 200 Bq m(-3) has been put in place.

A chromosome bin map of 2148 expressed sequence tag loci of wheat homoeologous group 7

The objectives of this study were to develop a high-density chromosome bin map of homoeologous group 7 in hexaploid wheat (Triticum aestivum L.), to identify gene distribution in these chromosomes, and to perform comparative studies of wheat with rice and barley. We mapped 2148 loci from 919 EST clones onto group 7 chromosomes of wheat. In the majority of cases the numbers of loci were significantly lower in the centromeric regions and tended to increase in the distal regions. The level of duplicated loci in this group was 24% with most of these loci being localized toward the distal regions. One hundred nineteen EST probes that hybridized to three fragments and mapped to the three group 7 chromosomes were designated landmark probes and were used to construct a consensus homoeologous group 7 map. An additional 49 probes that mapped to 7AS, 7DS, and the ancestral translocated segment involving 7BS also were designated landmarks. Landmark probe orders and comparative maps of wheat, rice, and barley were produced on the basis of corresponding rice BAC/PAC and genetic markers that mapped on chromosomes 6 and 8 of rice. Identification of landmark ESTs and development of consensus maps may provide a framework of conserved coding regions predating the evolution of wheat genomes.

Current status of programmes to measure and reduce radon exposure in Irish workplaces

National legislation, which implements European Council Directive 96/29/EURATOM in Ireland, sets a reference level of 400 Bq m(-3) averaged over any 3 month period for radon exposure in the workplace and also empowers the Radiological Protection Institute of Ireland to direct employers to have radon measurements carried out. This legislation came into effect in May 2000. Radon measurements have already been completed in show caves and other underground workplaces. Between 1998 and 2001, over 33 800 individual radon measurements were carried out in all ground floor offices and classrooms in 3444 schools nationwide as part of a programme undertaken jointly with the Department of Education and Science. Where the average indoor radon concentration in one or more rooms exceeded 200 Bq m(-3), remedial measures were implemented. For concentrations up to 400 Bq m(-3) this involved increased ventilation while for higher concentrations an active sump was normally installed. The results of the survey, as well as the effectiveness of the different remedial strategies, are discussed. In the case of other above ground workplaces, different approaches have been adopted. As a first step, workplaces in two known high radon areas were directed to have radon measurements carried out. This programme had limited success because of problems in obtaining accurate workplace databases and a general lack of awareness on the part of employers of the issues involved. From a sample of 2610 employers directed to measure radon, only 408 actually completed measurements and 37 workplaces were identified as having average 3 month average radon concentrations above 400 Bq m(-3). A total of 1356 employers ignored all correspondence, some of which was sent by registered post and signed for on receipt. Current initiatives are focused on the provision of information and include newspaper advertising as well as publications aimed specifically at both employer and employee representative groups. The ability to provide accurate information that encourages both measurement and remediation is seen as central to an effective radon workplace programme.

Distribution of contaminants in biota and sediments in the Musquash Estuary, Atlantic Canada, marine protected area site initiative and contaminant exclusion zone

The Musquash Estuary, one of the last ecologically intact estuaries in New Brunswick, has been designated an area of interest for a marine protected area (MPA) under the Oceans Act. The area has been assessed for contaminant background levels as required for establishing MPA environmental quality. American lobster (Homarus americanus), blue mussel (Mytilus edulis) and sediments were collected for assessing contaminant levels and distribution in the harbour. Levels of contaminants from the indicator species and the abiotic component have shown: (1) two extremes of high and low Cu and Ag in lobster from the area; and (2) lower metal levels in inner Musquash Harbour sediments and mussels than in those from the harbour mouth. These suggest that deposition of contaminants into the Musquash MPA site was due to transport of contaminants by coastal currents from upstream coastal industrial activities. This reverse trend with higher contaminant levels in the biotic and abiotic components in the outer harbour than in the inner harbour differs from a contaminated harbour and suggests that a contaminant exclusion zone should be considered for controlling contamination from nearby coastal and estuarine industrial sites to protect the sensitive habitats within the marine protected area.

Fatal cytophagic panniculitis and haemophagocytic syndrome

We present two fatal cases of cytophagic panniculitis (CP) and haemophagocytic syndrome (HPS). In the first of these, there was an underlying T-cell lymphoma but in the second no associated disease was found. HPS is a frequently fatal disorder of immune regulation, characterized by fever, histiocytic haemophagocytosis, hepatosplenomegaly, pancytopenia, hypertriglyceridaemia and coagulopathy; CP is a less common manifestation. A number of benign and malignant conditions may present with HPS, the clinical findings and investigations aiding in determining an underlying disorder. Therapy is both supportive and directed at any associated illness, but often very difficult as diagnosis is delayed.

Effect of retinoids on follicular cells

It has been demonstrated that topical application of all-trans retinoic acid and other retinoids can alter the hair-growth cycle in the C3H mouse model. The anagen phase is prolonged and the telogen phase is shortened. This effect is similar to the effect of minoxidil on the hair-cycle dynamics in this animal model. The levels of cellular retinoic acid binding protein measured by radioreceptor assay in whole skin of C3H mice were higher during anagen and lower during telogen. Topical application of certain retinoids caused elevated levels of cellular retinoic acid-binding protein (cRABP) in the whole skin homogenates during both phases of the cycle. Of the retinoids tested, those most effective in altering the levels of cRABP in the skin of the mice were also capable of significantly altering the hair-cycle dynamics. There appeared to be a relationship between the ability of retinoid to increase cRABP, increase 3H-thymidine incorporation, and alter the dynamics of the hair cycle. Only cRABP-II is detectable in human cultured dermal fibroblasts and dermal papilla cells. Dermal fibroblasts showed higher amounts of cRABP-II as compared to dermal papilla cells. The difference in cRABP-II expression might explain a distinct response to RA by these two cell populations. Whether the difference in expression of cRABP-II might be of physiologic importance remains to be determined. Treatment of human dermal papilla cells in culture with retinoic acid does not appear to affect proliferation, at least at the doses tested.

Cysteine to serine substitutions in basic fibroblast growth factor: effect on inclusion body formation and proteolytic susceptibility during in vitro refolding

We have investigated the effect of cysteine to serine substitutions in human basic fibroblast growth factor (bFGF) on the formation of inclusion bodies in Escherichia coli. Using a temperature-sensitive expression, system, about 30% of human bFGF, which contains four cysteines at positions 26, 70, 88, and 93, is deposited into inclusion bodies. A single mutation at position 88 and a double mutation at positions 70 and 88 do not greatly alter the partition of bFGF into soluble and insoluble cell fractions. However, a single substitution of cysteine 70 by serine decreases the fraction of soluble bFGF significantly. When cysteines 26 and 93 (conserved among related growth factors) are replaced by serines, no soluble bFGF is formed in E. coli. Cysteine to serine substitutions also affect proteolytic susceptibility of bFGF during in vitro refolding from crude inclusion bodies. About 60% of human bFGF is lost to proteolytic degradation during in vitro refolding. Replacement of cysteines by serines increases the total recovery of bFGF, although more aggregates are formed during refolding. Ser-88-bFGF was expressed at the highest level, gave the highest soluble fraction in vivo, and exhibited the greatest fractional recovery and was recovered with the largest insoluble fraction after in vitro refolding. Thermal stability experiments at 42 degrees C and 70 degrees C revealed that cysteine to serine substitutions did not cause aggregation of the folded protein in vitro.

A large outbreak of Salmonella enteritidis phage type 4 associated with eggs from overseas

In February 1989 the largest reported outbreak to date in the United Kingdom of Salmonella enteritidis phage type 4 (PT4) infection occurred following a wedding reception at a hotel. One hundred and seventy-three people met the case definition of illness of whom 118 had the organism isolated from their stools. A further 17 were found to be S. enteritidis PT4 positive, but were asymptomatic. Lightly-cooked, egg-based sauces were the epidemiologically proven vehicles of infection. Investigations showed this outbreak to be the first to implicate imported European eggs as the source of infection. An unusual feature of this outbreak was a reported incubation period of less than 3 h for some of the confirmed cases of salmonellosis.

Mutilating cryoglobulinaemia rapidly improved by plasmapheresis: diagnostic features on blood film

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Application of recombinant DNA technologies to studies on chicken growth hormone

Messenger RNA isolated from chicken pituitaries was used to construct a chicken pituitary cDNA library. A chicken growth hormone cDNA clone was isolated using 32P-labeled mammalian growth hormone cDNA probes. The amino acid sequence (derived from the DNA sequence) of the mature form of chicken growth hormone shows 77% homology with that of bovine growth hormone. The chicken growth hormone cDNA clone was used to generate a vector capable of producing chicken growth hormone in Escherichia coli. The recombinant E. coli-derived chicken growth hormone was similar to pituitary chicken growth hormone in several biochemical and immunological properties. The recombinant-derived hormone has been used to establish a sensitive radioimmunoassay for growth hormone determinations made from chicken sera. The chicken growth hormone gene has also been introduced into a retroviral vector capable of establishing productive infections of chicken cells both in in vitro and in vivo. The resulting infections are accompanied by the production of radioimmunoassay-detectable growth hormone. The concentrations of growth hormone in sera of Leghorn chickens infected with the recombinant retrovirus are three- to tenfold higher than in control animals.