Eating Decisions Based on Alertness Levels After a Single Night of Sleep Manipulation: A Randomized Clinical Trial

Study Objectives

To determine the relationship between an ecologically-relevant change in sleep behavior and its subsequent effects on daytime alertness and feeding behavior.

Methods

Fifty healthy, young participants (10 male, 40 female) completed two 3-hour study sessions that were at least five days apart. The first session was a baseline evaluation. On the night prior to Session 2, the amount of time in bed was manipulated to be 60%-130% of the individual's habitual sleep time. Within both sessions, subjective (Stanford Sleepiness Scale) and objective (Psychomotor Vigilance Test) alertness were measured. During the middle of each session, a 40-minute ad libitum meal opportunity allowed participants to eat from eight different food items. Food healthfulness, caloric density, distribution, and number of calories were measured and compared to alertness levels.

Results

The induced variation in time in bed resulted in induced variation in both subjective and objective (p < .05) measures of alertness. Decreased subjective alertness was associated with increased total caloric consumption (p < .05), and a greater number of calories consumed from less healthy food (p < .05), as rated by both the investigators and by the participant. Decreased objective alertness was associated with less healthy food choices (p < .05), and the consumption of more food from the calorically-dense items (p < .05).

Conclusions

Ecologically-relevant impairments in subjective and objective alertness are associated with increased caloric intake and dysfunctional eating decisions. People experiencing reduced alertness after modest sleep loss may be more willing to eat food they recognize as less healthful, and appear to prefer more calorically-dense foods.

High risk of post-infectious irritable bowel syndrome in patients with Clostridium difficile infection

BACKGROUND

Infectious enteritis is a commonly identified risk factor for irritable bowel syndrome (IBS). The incidence of Clostridium difficile infection (CDI) is on the rise. However, there is limited information on post-infectious IBS (PI-IBS) development following CDI and the host- and infection-related risk factors are not known.

AIM

To determine the incidence and risk factors for PI-IBS following CDI.

METHODS

A total of 684 cases of CDI identified from September 2012 to November 2013 were surveyed. Participants completed the Rome III IBS questionnaire and details on the CDI episode. Predictive modelling was done using logistic regression to evaluate risk factors for PI-IBS development.

RESULTS

A total of 315 CDI cases responded (46% response rate) and 205 were at-risk (no pre-CDI IBS) for PI-IBS development. A total of 52/205 (25%) met the Rome III criteria for IBS ≥6 months following CDI. IBS-mixed was most common followed by IBS-diarrhoea. In comparison to those without subsequent PI-IBS, greater percentage of PI-IBS patients had CDI symptoms >7 days, nausea, vomiting, abdominal pain during CDI, anxiety and a higher BMI. Using logistic regression, CDI symptoms >7 days [Odds ratio (OR): 2.96, P = 0.01], current anxiety (OR: 1.33, P < 0.0001) and a higher BMI (OR: 1.08, P = 0.004) were independently associated with PI-IBS development; blood in the stool during CDI was protective (OR: 0.44, P = 0.06).

CONCLUSIONS

In this cohort study, new-onset IBS is common after CDI. Longer CDI duration, current anxiety and higher BMI are associated with the diagnosis of C. difficile PI-IBS. This chronic sequela should be considered during active management and follow-up of patients with CDI.

Plasma total ghrelin and leptin levels in human narcolepsy and matched healthy controls: basal concentrations and response to sodium oxybate

STUDY OBJECTIVES

Narcolepsy is caused by a selective loss of hypocretin neurons and is associated with obesity. Ghrelin and leptin interact with hypocretin neurons to influence energy homeostasis. Here, we evaluated whether human hypocretin deficiency, or the narcolepsy therapeutic agent sodium oxybate, alter the levels of these hormones.

METHODS

Eight male, medication free, hypocretin deficient, narcolepsy with cataplexy patients, and 8 healthy controls matched for age, sex, body mass index (BMI), waisttohip ratio, and body fat percentage were assessed. Blood samples of total ghrelin and leptin were collected over 24 hours at 60 and 20-min intervals, respectively, during 2 study occasions: baseline, and during the last night of 5 consecutive nights of sodium oxybate administration (2 × 3.0 g/night).

RESULTS

At baseline, mean 24-h total ghrelin (936 ± 142 vs. 949 ± 175 pg/mL, p = 0.873) and leptin (115 ± 5.0 vs. 79.0 ± 32 mg/L, p = 0.18) levels were not different between hypocretin deficient narcolepsy patients and controls. Furthermore, sodium oxybate did not significantly affect the plasma concentration of either one of these hormones.

CONCLUSIONS

The increased BMI of narcolepsy patients is unlikely to be mediated by hypocretin deficiency-mediated alterations in total ghrelin or leptin levels. Thus, the effects of these hormones on hypocretin neurons may be mainly unidirectional. Although sodium oxybate may influence body weight, the underlying mechanism is unlikely to involve changes in total ghrelin or leptin secretion.

The nightly use of sodium oxybate is associated with a reduction in nocturnal sleep disruption: a double-blind, placebo-controlled study in patients with narcolepsy

OBJECTIVE

To further explore the effects of sodium oxybate (SXB) administration on nocturnal sleep in narcolepsy patients during a double-blind, placebo-controlled, parallel group study conducted with 228 adult patients with narcolepsy/cataplexy in the United States, Canada, and Europe.

METHOD

Patients were withdrawn from antidepressants and sedative/hypnotics, and then randomized to receive 4.5, 6, or 9 g SXB or placebo nightly for 8 weeks. Patients receiving 6 and 9 g/night doses were titrated to their final dose in weekly 1.5 g increments, while patients receiving placebo were randomized to undergo a similar mock dose titration. The use of stimulant therapy continued unchanged. Changes in sleep architecture were measured using centrally scored nocturnal polysomnograms. Daily diaries were used to record changes in narcolepsy symptoms and adverse events.

RESULTS

Following 8 weeks of SXB treatment, study patients demonstrated significant dose-related increases in the duration of stage 3 and 4 sleep, reaching a median increase of 52.5 minutes in patients receiving 9 g nightly. Compared to placebo-treated patients, delta power was significantly increased in all dose groups. Stage 1 sleep and the frequency of nocturnal awakenings were each significantly decreased at the 6 and 9 g/night doses. The changes in nocturnal sleep coincided with significant decreases in the severity and frequency of narcolepsy symptoms.

CONCLUSIONS

The nightly administration of SXB to narcolepsy patients significantly impacts measures of slow wave sleep, wake after sleep onset, awakenings, total sleep time, and stage 1 sleep in a dose-related manner. The frequency and severity of narcolepsy symptoms decreased with treatment.

Illicit gamma-hydroxybutyrate (GHB) and pharmaceutical sodium oxybate (Xyrem): differences in characteristics and misuse

There are distinct differences in the accessibility, purity, dosing, and misuse associated with illicit gamma-hydroxybutyrate (GHB) compared to pharmaceutical sodium oxybate. Gamma-hydroxybutyrate sodium and sodium oxybate are the chemical and drug names, respectively, for the pharmaceutical product Xyrem (sodium oxybate) oral solution. However, the acronym GHB is also used to refer to illicit formulations that are used for non-medical purposes. This review highlights important differences between illicit GHB and sodium oxybate with regard to their relative abuse liability, which includes the likelihood and consequences of abuse. Data are summarized from the scientific literature; from national surveillance systems in the U.S., Europe, and Australia (for illicit GHB); and from clinical trials and post-marketing surveillance with sodium oxybate (Xyrem). In the U.S., the prevalence of illicit GHB use, abuse, intoxication, and overdose has declined from 2000, the year that GHB was scheduled, to the present and is lower than that of most other licit and illicit drugs. Abuse and misuse of the pharmaceutical product, sodium oxybate, has been rare over the 5 years since its introduction to the market, which is likely due in part to the risk management program associated with this product. Differences in the accessibility, purity, dosing, and misuse of illicit GHB and sodium oxybate suggest that risks associated with illicit GHB are greater than those associated with the pharmaceutical product sodium oxybate.

Sodium oxybate for excessive daytime sleepiness in Parkinson disease: an open-label polysomnographic study

BACKGROUND

Many patients with Parkinson disease (PD) have excessive daytime sleepiness and numerous nocturnal sleep abnormalities.

OBJECTIVE

To determine the safety and efficacy of the controlled drug sodium oxybate in a multicenter, open-label, polysomnographic study in subjects with PD and sleep disorders. Design, Setting, and Patients Inclusion required an Epworth Sleepiness Scale (ESS) score greater than 10 and any subjective nocturnal sleep concern, usually insomnia. An acclimation and screening polysomnogram was performed to exclude subjects with sleep-disordered breathing. The following evening, subjects underwent another polysomnogram, followed by an evaluation with the Unified Parkinson Disease Rating Scale (UPDRS) while practically defined off ("off") PD medications, ESS (primary efficacy point), Pittsburgh Sleep Quality Inventory, and Fatigue Severity Scale. Subjects then started sodium oxybate therapy, which was titrated from 3 to 9 g per night in split doses (at bedtime and 4 hours later) across 6 weeks, and returned for subjective sleep assessments. They then returned at 12 weeks after initiating therapy for a third polysomnogram, an off-medication UPDRS evaluation, and subjective sleep assessments. Data are expressed as mean (SD).

RESULTS

We enrolled 38 subjects. At screening, 8 had sleep apnea (n = 7) or depression (n = 1). Twenty-seven of 30 subjects completed the study. Three dropped out owing to dizziness (n = 3) and concurrent depression (n = 1). The mean dose of sodium oxybate was 7.8 (1.7) g per night. The ESS score improved from 15.6 (4.2) to 9.0 (5.0) (P < .001); the Pittsburgh Sleep Quality Inventory score, from 10.9 (4.0) to 6.6 (3.9) (P < .001); and the Fatigue Severity Scale score, from 42.9 (13.2) to 36.3 (14.3) (P < .001). Mean slow-wave sleep time increased from 41.3 (33.2) to 78.0 (61.2) minutes (P = .005). Changes in off-medication UPDRS scores were not significant, from 28.4 (10.3) to 26.2 (9.6).

CONCLUSION

Nocturnally administered sodium oxybate improved excessive daytime sleepiness and fatigue in PD.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00641186.

gamma-Hydroxybutyrate/sodium oxybate: neurobiology, and impact on sleep and wakefulness

gamma-Hydroxybutyrate (GHB) is an endogenous short chain fatty acid and a, mostly oral, pharmacological compound that has been utilised in a variety of ways. Endogenously, GHB is synthesised locally within the CNS, mostly from its parent compound GABA. Sodium oxybate is the sodium salt of GHB and is used for the exogenous oral administration of GHB. It is likely that supraphysiological concentrations of GHB from exogenous administration produce qualitatively different neuronal actions than those produced by endogenous GHB concentrations. Evidence suggests a role for GHB as a neuromodulator/neurotransmitter. Under endogenous conditions and concentrations, and depending on the cell group affected, GHB may increase or decrease neuronal activity by inhibiting the release of neurotransmitters that are co-localised with GHB. After exogenous administration, most of the observed behavioural effects appear to be mediated via the activity of GHB at GABA(B) receptors, as long as the concentration is sufficient to elicit binding, which does not happen at endogenous concentrations. Endogenous and exogenous GHB is rapidly and completely converted into CO(2) and H(2)O through the tricarboxylic acid cycle (Krebs cycle). Sodium oxybate has been observed to modulate sleep in nonclinical study participants, and sleep and wakefulness in clinical populations, including groups with insomnia, fibromyalgia and narcolepsy. In narcolepsy, sodium oxybate has shown dose-related effects on various properties of sleep, including increases in slow-wave sleep duration and delta power, and a reduced number of night-time awakenings. Furthermore, multiple measures of daytime sleepiness and cataplexy demonstrated consistent short- and long-term improvement in response to night-time sodium oxybate therapy. The most common reported adverse events include dose-related headache, nausea, dizziness and somnolence.

Sodium oxybate: neurobiology and clinical efficacy

Sodium oxybate is the sodium salt of γ-hydroxybutyrate (GHB), an endogenous short-chain fatty acid that is speculated to function as a neurotransmitter in the mammalian CNS. Pharmacodynamic effects of exogenously-administered sodium oxybate may include modulating the release of neurotransmitters, including γ-aminobutyric acid, dopamine, endogenous opioids and serotonin, and stimulating release of growth hormone. It is rapidly absorbed, with approximately 25% bioavailability and a plasma half-life of 40–60 min, necessitating twice-nightly dosing. Sodium oxybate is indicated for the treatment of cataplexy and excessive daytime sleepiness in patients with narcolepsy, and has been shown to improve disrupted night-time sleep and increase Stage 3 and 4 (slow-wave restorative) sleep in this patient population. The most common adverse events reported in clinical trials in patients with narcolepsy include headache, nausea, dizziness, nasopharyngitis, somnolence, vomiting and urinary incontinence.

Expression and channel properties of alpha-bungarotoxin-sensitive acetylcholine receptors on chick ciliary and choroid neurons

Cell-specific expression of nicotinic acetylcholine receptors (AChRs) was examined using ciliary and choroid neurons isolated from chick ciliary ganglia. At embryonic days 13 and 14 (E13,14) the neurons can be distinguished by size, with ciliary neuron soma diameters exceeding those of choroid neurons by about twofold. Both neuronal populations are known to express two major AChR types: alpha3*-AChRs recognized by mAb35, that contain alpha3, alpha5, beta4, and occasionally beta2 subunits, and alpha-bungarotoxin (alphaBgt)-AChRs recognized and blocked by alphaBgt, that contain alpha7 subunits. We found that maximal whole cell current densities (I/C(m)) mediated by alphaBgt-AChRs were threefold larger for choroid compared with ciliary neurons, while alpha3*-AChR current densities were similar in the two populations. Different densities of total cell-surface alphaBgt-AChRs could not explain the distinct alphaBgt-AChR response densities associated with ciliary and choroid neurons. Ciliary ganglion neurons display abundant [(125)I]-alphaBgt binding ( approximately 10(6) sites/neuron), but digital fluorescence measurements revealed equivalent site densities on both populations. AChR channel classes having single-channel conductances of approximately 30, 40, 60, and 80 pS were present in patches excised from both ciliary and choroid neurons. Treating the neurons with alphaBgt selectively abolished the 60- and 80-pS events, identifying them as arising from alphaBgt-AChRs. Kinetic measurements revealed brief open and long closed durations for alphaBgt-AChR channel currents, predicting a very low probability of being open (p(o)) when compared with 30- or 40-pS alpha3*-AChR channels. None of the channel parameters associated with the 60- and 80-pS alphaBgt-AChRs differed detectably, however, between choroid and ciliary neurons. Instead calculations based on the combined whole cell and single-channel results indicate that choroid neurons express approximately threefold larger numbers of functional alphaBgt-AChRs (N(F)) per unit area than do ciliary neurons. Comparison with total surface [(125)I]-alphaBgt-AChR sites (N(T)), reveals that N(F)/N(T) << 1 for both neuron populations, suggesting that "silent" alphaBgt-AChRs predominate. Choroid neurons may therefore express a higher density of functional alphaBgt-AChRs by recruiting a larger fraction of receptors from the silent pool than do ciliary neurons.

Pituitary adenylate cyclase-activating polypeptide activates a phospholipase C-dependent signal pathway in chick ciliary ganglion neurons that selectively inhibits alpha7-containing nicotinic receptors

Neuropeptide receptors couple via G-proteins to two principal signaling pathways that elevate cAMP through adenylate cyclase (AC) or mobilize intracellular Ca(2+) through phospholipase C (PLC)-stimulated inositol phosphate (IP) turnover and production of inositol 1,4,5-trisphosphate (IP(3)). We showed previously that high-affinity receptors for pituitary adenylate cyclase-activating polypeptide (PACAP) are present on chick ciliary ganglion neurons and that receptor occupation increases cAMP production, resulting in enhanced acetylcholine sensitivity. After we suppressed AC activity and cAMP production with 2'-5' dideoxyadenosine, however, PACAP no longer increased acetylcholine sensitivity but instead reduced it, suggesting that an AC-independent signal pathway activated by PACAP inhibits some nicotinic acetylcholine receptors (AChRs). We now use fast-perfusion, imaging, and biochemical methods to identify the AChRs modulated by PACAP and to characterize the signal pathway responsible for their inhibition. Without previous AC block, both the rapidly desensitizing, alpha-bungarotoxin (alphaBgt)-sensitive alpha7-AChRs and the slowly desensitizing, alphaBgt-insensitive alpha3*-AChRs on the neurons were potentiated by PACAP. After AC blockade, however, PACAP inhibited alpha7-AChRs but left alpha3*-AChRs unaffected. The selective inhibition of alpha7-AChRs appeared to use a PLC signaling pathway because it was not seen after lowering PLC activity or buffering intracellular Ca(2+) and was mimicked by dialyzing neurons with an IP(3) receptor agonist. PACAP also induced IP turnover and increased [Ca(2+)](i) assessed directly with Fluo-3AM imaging. Given our previous findings that PACAP receptors couple to AC, the present results demonstrate a remarkable ability of a single neuropeptide to activate two signaling pathways and in so doing selectively regulate two classes of downstream ion channel targets.

bc1-2 expression facilitates human immunodeficiency virus type-1 mediated cytopathic effects during acute spreading infections

The cytopathic effects (CPE) resulting from the infection of CD4+ T cells by human immunodeficiency virus (HIV) have generally been characterized as single-cell killing associated with apoptosis and/or the generation of syncytia resulting from the direct cell-to-cell transmission of the virus. Little is known, however, about the cellular factors influencing host cell susceptibility to HIV-mediated CPE. Because expression of the antiapoptosis gene, bcl-2, enhances cell viability after exposure to cytotoxic agents or stimuli, the effect of bcl-2 expression on HIV infection of stably transfected T-cell clones was investigated. Unexpectedly, bcl-2 expression by these cells accelerated the kinetics of an acute spreading HIV infection, as evidenced by a rapid loss of culture viability associated with the appearance of CPE and reverse transcriptase activity in the culture supernatant. This unexpected effect of bcl-2 expression results from the arrest of syncytial apoptosis, directly facilitating the cell-to-cell transmission of HIV. In addition, bcl-2 expression is associated with enhanced HIV replication as determined by HIV type 1-specific Western blot (immunoblot) analysis. These results suggest that the inhibition of apoptosis is essential for this mode of viral transmission.

Mapping of linear epitopes of the regulatory proteins of human T cell lymphotropic virus (HTLV) type II: identification of an HTLV-IIb-restricted epitope

Epitope mapping analyses using synthetic peptides representing the RexII and TaxII proteins identified predominant seroreactivity to the carboxyl terminus of the HTLV-IIG12 TaxII protein (G12Tax 22-G12Tax24, amino acids [aa] 312-356). Moderate reactivity to only 1 RexII peptide (G12Rex9, aa 121-140) was found, while all other RexII and TaxII peptides exhibited minimal reactivity. Peptide G12Tax24 (aa 337-356) corresponded to the extended portion of the TaxII protein characteristic of HTLV-IIb viruses and appeared to represent an HTLV-IIb-restricted epitope. This study showed that this peptide can be used in immunoassays as a quick, simple serologic tool for assessing the minimal number of HTLV-IIb viruses present within specific populations, especially when genomic DNA is not available.

Pituitary adenylate cyclase-activating polypeptide type I receptors mediate cyclic AMP-dependent enhancement of neuronal acetylcholine sensitivity

Nicotinic acetylcholine (ACh) receptors (AChRs) on ciliary ganglion neurons are positively regulated by elevated cAMP levels. Vasoactive intestinal peptide (VIP) can act as a first messenger in the regulation, because application of 1 microM VIP rapidly increases both neuronal cAMP levels and ACh sensitivity. We now report that high affinity receptors for a close VIP relative, pituitary adenylate cyclase-activating polypeptide (PACAP), are present on ciliary ganglion neurons and mediate the cAMP-dependent modulation of AChRs. Consistent with the presence of PACAP type I receptors, binding studies revealed sites on the neurons having approximately 1000-fold higher affinity for the 38- and 27-amino acid forms of PACAP than for VIP, and cAMP radio-immunoassays demonstrated that PACAP38 and PACAP27 are approximately 600-fold more potent agonists for mobilizing neuronal cAMP than is VIP. In accord with their higher affinity and potency, PACAP38 and -27 (both at 10 nM) increased neuronal ACh sensitivity by approximately 50% within 10 min, whereas VIP at the same low concentration was ineffective. The increased ACh sensitivity induced by 10 nM PACAP38 or PACAP27 or 1 microM VIP depends on coincident increases in cAMP levels, because treatment of neurons with adenylate cyclase inhibitors blocked both effects. The findings demonstrate the presence of functional PACAP type I receptors on ciliary ganglion neurons that preferentially recognize PACAP38 and -27 over VIP and act via adenylate cyclase to initiate cAMP-dependent enhancement of AChR function. Finally, we detected PACAP38-like material in ciliary ganglia, suggesting a role for the peptide in modulating neuronal AChRs in vivo.

Lipid hydroperoxide-induced apoptosis: lack of inhibition by Bcl-2 over-expression

Increased membrane lipid peroxidation has recently been implicated as being associated with apoptosis. In the present study the addition of 15-hydroperoxyeicosatetraenoic acid (15-HPETE) or 13-hydroperoxydodecadienoic acid (13-HPODE) to A3.01 T cells is shown to induce marked chromatin condensation coincident with DNA fragmentation, indicative of apoptosis. 15-HPETE also evoked an immediate and sustained rise in cytoplasmic calcium which was required for the induction of apoptosis. A3.01 cells transfected with the bcl-2 proto-oncogene were 6- to 8-fold more resistant to apoptotic killing by tumor necrosis factor-alpha, but only 0.4-fold more resistant to 15-HPETE. Thus, Bcl-2 is not capable of protecting cells from undergoing apoptosis following the direct addition of lipid hydroperoxides.

Genotypic characteristics of HTLV-II isolates from Amerindian and non-Indian populations

The Amerindian human T-cell lymphotropic virus type II isolate HTLV-IIG12 has been demonstrated to be an HTLV-IIb with several unique features, including several restriction enzyme site changes, a distinctive pre-gag region, a stop codon within the pol gene, and an extended Tax protein. In this study, HTLV-II isolates from Amerindian and non-Indian populations were characterized by restriction enzyme site analysis to determine the prevalent HTLV-II subtype. In addition, DNA amplification by the polymerase chain reaction and Southern blot analyses were used to probe for the HTLV-IIG12 pre-gag region. Our results showed that of 13 Guaymi Indian isolates subtyped, all were HTLV-IIb, and that approximately one third of 17 isolates had the unique pre-gag region. While other HTLV-II-infected groups contained both HTLV-IIa and HTLV-IIb isolates, none of these isolates showed evidence of the distinctive HTLV-IIG12 pre-gag region. Lastly, DNA sequence analysis was used to determine the prevalence of the stop codon within the pol gene open reading frame. These analyses revealed that the occurrence of a stop codon within this sequence appeared to be characteristic of most HTLV-IIb subtypes. These results further our understanding of the genetic variations and evolution of the HTLV-II viruses within the endemically infected Amerindian populations, as well as U.S. intravenous drug users and other non-Indian populations.

Identification and characterization of an extended Tax protein in human T-cell lymphotropic virus type II subtype b isolates

The tax gene sequence of human T-cell lymphotropic virus type II isolate G12 (HTLV-IIG12) was found to encode an extended Tax protein when compared with that of HTLV-IIMoT. In vitro transcription-translation of the HTLV-IIG12 tax gene produced a 40-kDa Tax protein that specifically reacted with serum specimens from HTLV-II-infected individuals. Limited sequence analysis demonstrated that isolates with an extended Tax protein were all HTLV-II subtype b (HTLV-IIb). Therefore, the extended Tax protein appears to be a unique characteristic of most HTLV-IIb isolates and may be useful in designing immunoassays to distinguish between HTLV-IIa and HTLV-IIb.

Evidence for mother-to-child transmission of human T lymphotropic virus type II

Serologic analysis of the children of 2 married human T lymphotropic virus type II (HTLV-II)-infected prostitutes demonstrated antibodies to HTLV-II in an 8-year-old boy whose only recognizable risk for HTLV-II infection was breast-feeding during his first 4 years of life. Limited sequence analysis of isolates infecting the mother and child demonstrated 100% identical sequences in the long terminal repeat (LTR65-297; 236 bp), pol4762-4919 (157 bp), and env5523-6003 (480 bp) regions (both isolates were subtype a), suggesting mother-to-child transmission. In contrast, isolates obtained from 2 other prostitutes from the same geographic region had sequences different from those of the first woman and her child, and the second and third women were infected with HTLV-II subtype b. Although vertical transmission of HTLV-II in this 8-year-old child cannot be conclusively ascertained, the probability is overwhelming that infection occurred through breast-feeding for an extended period of time.

Complete nucleotide sequence of an Amerindian human T-cell lymphotropic virus type II (HTLV-II) isolate: identification of a variant HTLV-II subtype b from a Guaymi Indian

The complete nucleotide sequence of a human T-cell lymphotropic virus type II (HTLV-II) isolate from a Panamanian Guaymi Indian was determined and analyzed. When this new viral isolate (HTLV-IIG12) was compared with prototypic HTLV-IIMoT, the overall nucleotide sequence similarity was 95.4%, while the predicted amino acid sequence similarity was 97.5%. Although the overall percentage of nucleotide and amino acid identity with prototypic HTLV-IIMoT (subtype a) was high, HTLV-IIG12 displayed several distinctive features that defined it as an HTLV-II subtype b. However, there were several characteristics unique to this isolate, which included a cluster of nucleotide substitutions in the pre-gag region and changes in restriction enzyme sites within the pre-gag region and the gag, pol, env, and pX genes. In addition, two nucleotide changes in the C terminus of the Tax protein coding sequence inserted an Arg residue for a stop codon and appeared to result in a larger tax gene product in HTLV-IIG12. Although the HTLV-IIG12 isolate appears to be a variant of the prototypic HTLV-IIb, this information represents the first complete nucleotide sequence of any HTLV-II subtype b. These data will allow further studies on the evolutionary relationships between the HTLV-II subtypes and between HTLV-I and HTLV-II.

Infection with human T-lymphotropic viruses leads to constitutive expression of leukemia inhibitory factor and interleukin-6

Leukemia inhibitory factor (LIF), similar to interleukin-6 (IL-6), is a glycoprotein growth factor and differentiation regulator that has pleiotropic activity in several cellular systems. Recent reports of constitutive IL-6 production from spontaneously proliferating cells from human T-cell leukemia virus (HTLV)-infected individuals led us to examine the expression of IL-6 and LIF during HTLV infection. In vitro infection of peripheral blood lymphocytes with HTLV-I was associated with production of both soluble LIF and IL-6 in conjunction with the increasing HTLV antigen concentration. Northern blot analysis of T-cell lines generated from individuals infected with HTLV-I (MT-2, HuT-102, FS, EG, SP) and HTLV-II (Mo-T, H2A, H2E) demonstrated a marked increase in constitutive expression of LIF and IL-6 transcripts, as compared with uninfected cell lines (HuT-78, Jurkat). The constitutive expression of LIF and IL-6 was independent of presence of IL-2 in the culture medium, as both IL-2-independent (MT-2, HuT-102, SP, Mo-T) and IL-2-dependent (FS, EG, H2A, H2E) cell lines expressed LIF and IL-6 transcripts. Furthermore, LIF and IL-6 RNA expression in an HTLV-I-infected cell line (MT-2) was enhanced by phorbol ester stimulation via mechanisms that appear to be dependent on the posttranscriptional regulatory controls. These results show that both LIF and IL-6 are produced by HTLV-I- and HTLV-II-infected cells, which could potentially alter the transcriptional regulation of HTLV gene expression by inducing certain early response genes.

Selective impairment of humoral immunity in feline leukemia virus-induced immunodeficiency

We used a panel of in vitro assays to investigate the nature of immune dysfunction in cats infected with FeLV-FAIDS, a naturally occurring, molecularly cloned feline leukemia virus (FeLV) isolate which induces a fatal immunodeficiency syndrome in infected cats. During the asymptomatic period preceding immunodeficiency disease, we were unable to detect any deficits in concanavalin A-induced blastogenesis, xenogeneic mixed-lymphocyte reaction assays, stimulation of lymphocytes by soluble protein antigen, and cytotoxic T lymphocyte assays. However, during this period humoral immune responses in the FeLV-FAIDS-infected cats were dramatically impaired. As early as 9 weeks after virus inoculation, the ability to mount either an IgM or IgG response to soluble protein antigens was lost. Neither B cell function, as assessed by lipopolysaccharide-induced blastogenesis or circulating B cell numbers, as assessed by immunofluorescence, differed between infected and control cats. These results suggest that FeLV-FAIDS infection may impair a subpopulation of T helper cells, that provides help for the production of antibody. Consistent with earlier observations of cats naturally infected with FeLV, our results indicate that early impairment of humoral immunity is an important component of the immunodeficiency syndrome induced by FeLV in cats.

Bone loss during gonadotropin-releasing hormone agonist treatment in girls with true precocious puberty is not due to an impairment of calcitonin secretion

Gonadal steroids drive the significant bone mineral increase that occurs at puberty, while estrogen deprivation in postmenopausal women results in bone mass reduction. We looked for bone mineralization in girls with true precocious puberty (TPP) before and after six months of LH-RH analogs treatment. Calcitonin secretion in these girls were studied too. Bone mineral content (BMC) and BMC/BW ratio (single photon absorptiometry) were measured in seven girls (aged 4.3 to 8.7 years) with TPP before LH-RH agonist therapy (long acting D-Trp6-LH-RH 60 micrograms/kg im every 28 days) was started; the patients were reevaluated after six months of therapy. Before therapy, BMC and BMC/BW were increased for chronological age but appropriate for bone age according to our mineralization normative data. After six months of LH-RH analog administration, 17 beta-estradiol and LH levels were suppressed and BMC and BMC/BW showed a small but significant decrease (respectively -5.4%, p less than 0.02 and -6.3%, p less than 0.02). Basal and calcium stimulated calcitonin levels (total and extractable) did not significantly change during the study period. We conclude that in girls with TPP bone mineralization was increased for chronological age but normal for bone age. The estrogen withdrawal secondary to LH-RH analog therapy caused a reduction in bone mass. Such a bone loss is not due to an impairment of calcitonin secretion.

Cells of chemically induced tumors differentially express major histocompatibility complex class I antigens

Several recent studies have indicated that alterations in expression of major histocompatibility complex (MHC) antigens by tumor cells affects the ability of the host to mount an effective antitumor immune response. To investigate whether newly induced tumors frequently exhibit altered MHC antigen expression, we used methylcholanthrene to induce a series of tumors and elevated MHC antigen expression by these cells. The tumors exhibited a variety of MHC phenotypes in vitro. The nature of their phenotypes suggested that these cells were, in fact, capable of independent and abnormal regulation of MHC class 1 genes. However, when maintained in vivo, these same tumor cells expressed measurable levels of all of the appropriate MHC class I antigens. Thus, newly induced tumor cells are capable of abnormal MHC class I antigen expression. However, there was no obvious correlation between the phenotypes exhibited by these tumor cells in vitro and either their phenotype or their tumorigenic potential in vivo.

Gonadotropin pulsatile secretion in girls with premature menarche

Five prepubertal girls (2.3-8.1 years old) were studied for isolated or recurrent vaginal bleeding in the absence of other signs of precocious puberty (premature menarche). Four of these girls with recurrent vaginal bleeding were studied for pulsatile gonadotropin secretory patterns. During sleep 3 girls showed luteinizing hormone (LH) pulses with low amplitude and a pubertal pattern of frequency whereas follicle-stimulating hormone (FSH) increased without demonstrable episodic secretion. Luteinizing hormone-releasing hormone (LHRH) tests demonstrated that FSH responses are greater than the LH responses, as in prepuberty. In 3 cases estradiol levels had augmented above normal prepubertal range. The menses spontaneously stopped during the follow-up. A reevaluation of the gonadotropin pattern, having the menses stopped for 6 months, in one of the girls with pulsatile LH secretion showed an apulsatile prepubertal LH pattern. Also estradiol levels returned to prepubertal range. A follow-up of 10-66 months of these patients did not show any growth and bone acceleration or signs of precocious puberty. Our data suggest that in premature menarche a partial and transient activation of hypothalamo-pituitary axis could be present. Premature menarche seems to be a benign and self-limiting condition and one of the girls had a normal onset of puberty during follow-up.

Biochemical evidence for expression of a semi-allogeneic, H-2 antigen by a murine adenocarcinoma

LT-85 is an alveolegenic adenocarcinoma induced in mutant C3HfB/HeN (C3Hf) mice. This tumor, however, grows preferentially in allogeneic, wild-type C3H/HeN (C3H) mice. The tumor-associated transplantation antigen has been mapped to the K end of the major histocompatibility complex. H-2K antigens were isolated from detergent extracts of LT-85 cells by immunoprecipitation with monoclonal antibody. The tryptic peptides of these antigens were compared, by using high-pressure liquid chromatography, with the tryptic peptides of H-2K antigens isolated from syngeneic mutant C3Hf and ancestral wild-type C3H spleen cells. We found that the H-2K antigens of the LT-85 tumor cells were very similar to, but distinct from, those present on syngeneic C3Hf lymphoid cells. We also found, however, that the H-2K antigens of LT-85 tumor cells were clearly different from the H-2K antigens of allogeneic C3H spleen cells. The H-2K antigens of LT-85 cells are therefore foreign to syngeneic C3Hf cells, but do not represent expression by the tumor cells of the allogeneic H-2K antigens expressed by normal C3H cells. Furthermore, the nature of the differences observed between the H-2K antigens of LT-85 cells and C3Hf and C3H spleen cells strongly suggests that the structure of the H-2K molecule of LT-85 cells is identical in some regions to the H-2K molecule of C3Hf cells, and in other regions to the H-2K molecule of C3H cells.

Biochemical evidence for expression of a semi-allogeneic, H-2 antigen by a murine adenocarcinoma

LT-85 is an alveolegenic adenocarcinoma induced in mutant C3HfB/HeN (C3Hf) mice. This tumor, however, grows preferentially in allogeneic, wild-type C3H/HeN (C3H) mice. The tumor-associated transplantation antigen has been mapped to the K end of the major histocompatibility complex. H-2K antigens were isolated from detergent extracts of LT-85 cells by immunoprecipitation with monoclonal antibody. The tryptic peptides of these antigens were compared, by using high-pressure liquid chromatography, with the tryptic peptides of H-2K antigens isolated from syngeneic mutant C3Hf and ancestral wild-type C3H spleen cells. We found that the H-2K antigens of the LT-85 tumor cells were very similar to, but distinct from, those present on syngeneic C3Hf lymphoid cells. We also found, however, that the H-2K antigens of LT-85 tumor cells were clearly different from the H-2K antigens of allogeneic C3H spleen cells. The H-2K antigens of LT-85 cells are therefore foreign to syngeneic C3Hf cells, but do not represent expression by the tumor cells of the allogeneic H-2K antigens expressed by normal C3H cells. Furthermore, the nature of the differences observed between the H-2K antigens of LT-85 cells and C3Hf and C3H spleen cells strongly suggests that the structure of the H-2K molecule of LT-85 cells is identical in some regions to the H-2K molecule of C3Hf cells, and in other regions to the H-2K molecule of C3H cells.

Biochemical comparison of MHC antigens isolated from mutant C3HfB/HeN and parent C3H/HeN mice

H-2K antigen heavy chains were isolated from C3HfB/HeN and C3H/HeN spleen cells by immunoprecipitation and high pressure liquid chromatography and were compared by tryptic peptide mapping. Glycopeptides obtained from 3H-glucosamine-labeled H-2Kk (C3H) and H-2Kkv1 (C3Hf) heavy chains were found to be identical, indicating that previously observed differences between the two molecules are due to alterations in amino acid sequence. I-A subregion antigen alpha- and beta-chains were also isolated from C3H and C3Hf spleen cells by immunoprecipitation and SDS-polyacrylamide gel electrophoresis, and were compared by tryptic peptide mapping analyses. Material isolated from 3H-glucosamine-labeled cells revealed that I-A alpha- and beta-chains were glycosylated, and antigens from C3H and C3Hf mice contained identical glycopeptides. Similar analyses of I-A antigen alpha- and beta-chains isolated from C3H and C3Hf spleen cells labeled with 3H-arginine or 3H-lysine revealed no differences in the amino acid sequences of the I-A antigens of these two strains. These findings indicate that all of the unique immunologic properties of mutant C3Hf cells can be attributed to modifications of the amino acid sequence of the MHC K locus gene product.

Biochemical comparison of MHC antigens isolated from mutant C3HfB/HeN and parent C3H/HeN mice

H-2K antigen heavy chains were isolated from C3HfB/HeN and C3H/HeN spleen cells by immunoprecipitation and high pressure liquid chromatography and were compared by tryptic peptide mapping. Glycopeptides obtained from 3H-glucosamine-labeled H-2Kk (C3H) and H-2Kkv1 (C3Hf) heavy chains were found to be identical, indicating that previously observed differences between the two molecules are due to alterations in amino acid sequence. I-A subregion antigen alpha- and beta-chains were also isolated from C3H and C3Hf spleen cells by immunoprecipitation and SDS-polyacrylamide gel electrophoresis, and were compared by tryptic peptide mapping analyses. Material isolated from 3H-glucosamine-labeled cells revealed that I-A alpha- and beta-chains were glycosylated, and antigens from C3H and C3Hf mice contained identical glycopeptides. Similar analyses of I-A antigen alpha- and beta-chains isolated from C3H and C3Hf spleen cells labeled with 3H-arginine or 3H-lysine revealed no differences in the amino acid sequences of the I-A antigens of these two strains. These findings indicate that all of the unique immunologic properties of mutant C3Hf cells can be attributed to modifications of the amino acid sequence of the MHC K locus gene product.

Effects of ophiobolin B on cell enlargement and H(+)/K (+) exchange in maize coleoptile tissues

Ophiobolin B (OPH B), a sesterpene metabolite of Helminthosporium oryzae, inhibits proton extrusion from maize coleoptiles. Moreover OPH B counteracts the biological activity of fusicoccin (FC), another terpenoid toxin produced by Fusicoccum amygdali having a similar basic chemical structure: OPH B inhibits FC-promoted proton extrusion, potassium uptake and cell enlargement.The findings suggest that the effect of OPH B in stimulating electrolites, glucose and aminoacid leakage, reported in a previous paper, can be explained by the capacity of the toxin to inhibit proton extrusion.