Tropism and innate host responses of influenza A/H5N6 virus: an analysis of ex vivo and in vitro cultures of the human respiratory tract

Since their first isolation in 2013, influenza A/H5N6 viruses have spread amongst poultry across multiple provinces in China and to Laos, Vietnam and Myanmar. So far, there have been 14 human H5N6 infections with 10 fatalities.We investigated the tropism, replication competence and cytokine induction of one human and two avian H5N6 isolates in ex vivo and in vitro cultures derived from the human respiratory tract. Virus tropism and replication were studied in ex vivo cultures of human nasopharynx, bronchus and lung. Induction of cytokines and chemokines was measured in vitro in virus-infected primary human alveolar epithelial cells.Human H5N6 virus replicated more efficiently than highly pathogenic avian influenza (HPAI) H5N1 virus and as efficiently as H1N1pdm in ex vivo human bronchus and lung and was also able to replicate in ex vivo cultures of human nasopharynx. Avian H5N6 viruses replicated less efficiently than H1N1pdm in human bronchial tissues and to similar titres as HPAI H5N1 in the lung. While the human H5N6 virus had affinity for avian-like receptors, the two avian isolates had binding affinity for both avian- and human-like receptors. All three H5N6 viruses were less potent inducers of pro-inflammatory cytokines compared with H5N1 virus.Human H5N6 virus appears better adapted to infect the human airways than H5N1 virus and may pose a significant public health threat.

Bid chimeras indicate that most BH3-only proteins can directly activate Bak and Bax, and show no preference for Bak versus Bax

The mitochondrial pathway of apoptosis is initiated by Bcl-2 homology region 3 (BH3)-only members of the Bcl-2 protein family. On upregulation or activation, certain BH3-only proteins can directly bind and activate Bak and Bax to induce conformation change, oligomerization and pore formation in mitochondria. BH3-only proteins, with the exception of Bid, are intrinsically disordered and therefore, functional studies often utilize peptides based on just their BH3 domains. However, these reagents do not possess the hydrophobic membrane targeting domains found on the native BH3-only molecule. To generate each BH3-only protein as a recombinant protein that could efficiently target mitochondria, we developed recombinant Bid chimeras in which the BH3 domain was replaced with that of other BH3-only proteins (Bim, Puma, Noxa, Bad, Bmf, Bik and Hrk). The chimeras were stable following purification, and each immunoprecipitated with full-length Bcl-x_L according to the specificity reported for the related BH3 peptide. When tested for activation of Bak and Bax in mitochondrial permeabilization assays, Bid chimeras were ~1000-fold more effective than the related BH3 peptides. BH3 sequences from Bid and Bim were the strongest activators, followed by Puma, Hrk, Bmf and Bik, while Bad and Noxa were not activators. Notably, chimeras and peptides showed no apparent preference for activating Bak or Bax. In addition, within the BH3 domain, the h0 position recently found to be important for Bax activation, was important also for Bak activation. Together, our data with full-length proteins indicate that most BH3-only proteins can directly activate both Bak and Bax.

Functional genomics approaches in parasitic helminths

As research on parasitic helminths is moving into the post-genomic era, an enormous effort is directed towards deciphering gene function and to achieve gene annotation. The sequences that are available in public databases undoubtedly hold information that can be utilized for new interventions and control but the exploitation of these resources has until recently remained difficult. Only now, with the emergence of methods to genetically manipulate and transform parasitic worms will it be possible to gain a comprehensive understanding of the molecular mechanisms involved in nutrition, metabolism, developmental switches/maturation and interaction with the host immune system. This review focuses on functional genomics approaches in parasitic helminths that are currently used, to highlight potential applications of these technologies in the areas of cell biology, systems biology and immunobiology of parasitic helminths.

Direct visualization of Bcl-2 family protein interactions using live cell fluorescent protein redistribution assays

Bcl-2 family proteins have important roles in tumor initiation, progression and resistance to therapy. Pro-survival Bcl-2 proteins are regulated by their interactions with pro-death BH3-only proteins making these protein–protein interactions attractive therapeutic targets. Although these interactions have been extensively characterized biochemically, there is a paucity of tools to assess these interactions in cells. Here, we address this limitation by developing quantitative, high throughput microscopy assays to characterize Bcl-2 and BH3-only protein interactions in live cells. We use fluorescent proteins to label the interacting proteins of interest, enabling visualization and quantification of their mitochondria-localized interactions. Using tool compounds, we demonstrate the suitability of our assays to characterize the cellular activity of putative therapeutic molecules that target the interaction between pro-survival Bcl-2 and pro-death BH3-only proteins. In addition to the relevance of our assays for drug discovery, we anticipate that our work will contribute to an improved understanding of the mechanisms that regulate these important protein–protein interactions within the cell.

Prognostic factors of primary adenocarcinoma of the uterine cervix

OBJECTIVE

To determine which clinicopathological factors influence the prognosis of cervical adenocarcinoma.

METHODS

Three hundred and two cases of primary adenocarcinoma of the uterine cervix, treated between 1977 and 1994, were studied retrospectively. Clinical data and pathological findings with respect to primary therapy were reviewed and evaluated.

RESULTS

The 5-year survival rates for stages I, II, and III/IV were 75.9, 62.9, and 25.1%, respectively. International Federation of Gynecology and Obstetrics stage (P < 0. 0001), cell type (P = 0.0176), tumor grade (P = 0.023), lymph node status (P = 0.018), and bulky tumor (P = 0.007) were found to be independent factors using the stepwise Cox proportional hazards model. Old age (P = 0.0581), presence of hypertension (P = 0.46), diabetes mellitus (P = 0.18), obesity (P = 0.15), and oral contraceptive use (P = 0.42) were not found to adversely influence survival rates for cervical adenocarcinoma after adjusting for other covariates. Adenosquamous adenocarcinoma had a better prognosis than endocervical columnar cell adenocarcinoma in stages I and II (P = 0. 0235). Also, in cervical adenocarcinoma's early stages, multivariate modeling revealed that chances of survival were significantly better for patients treated by radical surgery than for patients treated by radiation therapy (P < 0.001).

CONCLUSIONS

Survival rates for cervical adenocarcinoma were significantly influenced by stage, histologic subtype, tumor grade, the presence of a positive lymph node, and tumor size. Although a randomized prospective study is needed, our data imply that radical surgery may be considered a better primary modality of treatment than radiation therapy for the early stages of cervical adenocarcinoma. Further, the presence of hypertension, diabetes mellitus, or obesity may not adversely influence survival rates.

Independent clinical factors which correlate with failures in diagnosing early cervical cancer

Our aim was to identify independent factors that correlated with colposcopically directed biopsy's reliability as a method for diagnosing early cervical cancer. One hundred ninety-one of a total of 2265 patients who had colposcopic examinations because of abnormal Papanicolaou smears were included in this study. These patients had all undergone a hysterectomy after being diagnosed as having cervical intraepithelial neoplasia grade III by colposcopically directed biopsy. By univariate analysis, old age (P = 0.0195), achievement of menopausal status (P = 0.0046), large lesion size (P = 0.0021), and unsatisfactory colposcopy (P = 0.0017) were found to be associated with the nondiagnosis of early cervical cancer. However, multivariate analysis using stepwise logistic regression revealed that large lesion size (P = 0.003) and unsatisfactory colposcopy (P = 0.0008) were the only independent factors that correlated with nondiagnosis. Our findings indicate that in order to reach a clear-cut diagnosis, cases with either unsatisfactory colposcopy or satisfactory colposcopy with large lesions (despite a lack of histologic evidence of invasions) should undergo a diagnostic conization.

Does the loop electrosurgical excision procedure adversely affect the histopathological interpretation of cervical conization specimens?

OBJECTIVE

To assess the suitability of conized specimens obtained by loop electrosurgical excision procedure for histopathological interpretation.

METHODS

We evaluated the histological pictures of 215 tissue sections obtained by loop electrosurgical excision procedure. These sections came from 32 cases of patients with various degrees of cervical intraepithelial neoplasia. All women included in our study had a satisfactory colposcopy and no cytological or colposcopic evidence of invasive cancer. We quantified the thickness of thermal damage in the tissue sections using a stage-mounted, calibrated grid microscope.

RESULTS

At its greatest extent, thermal damage occurring next to incision lines ranged from 160 to 520 mu (mean 262, SE 14 mu). Two different zones of thermal damage were produced by LEEP: the carbonization and coagulation zones. The carbonization zone was located at the outermost layer and was very thin, measuring from 10 to 30 mu in depth. The coagulation zone was adjacent to the carbonization zone, was eosinophilic, and was significantly deeper than the carbonization zone at its points of greatest thickness (150 to 500 mu; p < 0.0001, Student's t-test). The depth of the coagulation zone correlated significantly with the depth of the carbonization zone (p = 0.041, least linear correlation). Tissue distortion was present in 53% (17/32) of the cases, and appeared only in the coagulation zone.

CONCLUSION

Tissue structure from the diseased portions of the conized specimens was generally well preserved. The area of thermal damage was limited and thus did not result in diagnostic problems. We conclude that LEEP is a reliable method for obtaining tissue samples for histopathological examination.

Cryptococcal infection of the vagina

BACKGROUND

Cryptococcal infection is opportunistic and occurs most commonly in immunocompromised patients. Meningitis is the most frequent manifestation and causes marked morbidity and mortality. Other sites are less common. We report a case of vaginal cryptococcal infection.

CASE

A 72-year-old patient who had undergone resection of the colon for cancer 9 years earlier was noted to have a suspicious lesion on the right vaginal wall after an abnormal Papanicolaou test. Biopsy of the lesion showed findings compatible with cryptococcal infection. Serial examinations revealed no evidence of systemic infection or immunocompromised condition. Empirical treatment was tried with fluconazole. Follow-up colposcopy showed almost complete disappearance of the vaginal lesion, and histologic section and culture of the tissue failed to reveal cryptococcus.

CONCLUSION

Cryptococcal infection is rare, especially in a patient with no evidence of an immunocompromised condition. The preliminary result of fluconazole treatment was satisfactory. However, further follow-up and evaluation are needed to confirm the effectiveness of fluconazole in our patient.

The incidence of bladder cancer in the black foot disease endemic area in Taiwan

A high incidence of bladder cancer (23.53/100,000 population per annum from 1981-1985) was found in an endemic area of peripheral vascular disease known as black foot disease (BFD) on the southwest coast of Taiwan. The average incidence of bladder cancer in the whole of the Taiwan area was 2.29/100,000 during the same period. The incidence of female bladder cancer (21.10/100,000) in this area was also high. The ratio of male to female bladder cancer in the BFD endemic area and the neighbouring area was 1.24 and 1.09, lower than that in the whole Taiwan area (2.75) and elsewhere around the world. The high content of arsenic and the high concentration of a "fluorescent substance" in artesian well water in this area are the only 2 related factors identified so far. Determination of the actual carcinogen requires further investigation.

Absolute configurations of three ent-beyerene derivatives

(1): 11 beta,17-Bis(4-bromobenzoyloxy)-9 beta-hydroxy-ent-beyerene, C34H38Br2O5, Mr = 686.5, orthorhombic, P2(1)2(1)2(1), a = 6.1686 (12), b = 14.613 (3), c = 32.935 (7) A, V = 2969 (1) A3, Z = 4, Dx = 1.536 g cm-3, lambda(Mo K alpha) = 0.71069 A, mu = 27.43 cm-1, F(000) = 1408, T = 173 K, R = 0.0347 and wR = 0.0358 for 3064 reflections [Io greater than or equal to 3 sigma(Io)]. (2): 7 beta,17-Bis(4-bromobenzoyloxy)-9 beta-hydroxy-ent-beyerene, C34H38Br2O5, Mr = 686.5, monoclinic, P2(1), a = 12.6424 (15), b = 6.8353 (12), c = 18.496 (2) A, beta = 101.901 (9) degrees, V = 1564.0 (4) A3, Z = 2, D chi = 1.458 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 26.03 cm-1, F(000) = 704, T = 173 A, R = 0.0336 and wR = 0.0361 for 4610 reflections [Io greater than or equal to 3 sigma(Io)]. (3): 17-(4-Bromobenzoyloxy)-9 beta,11 beta-epoxy-7 beta-hydroxy-ent-beyerene, C27H33BrO4, Mr = 501.5, orthorhombic, P2(1)2(1)2(1), a = 6.1315 (7), b = 18.389 (3), c = 21.109 (3) A, V = 2380.0 (6) A3, Z = 4, D chi = 1.399 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 17.38 cm-1, F(000) = 1048, T = 198 K, R = 0.0325 and wR = 0.0344 for 2292 reflections [Io greater than or equal to 3 sigma(Io)].(ABSTRACT TRUNCATED AT 250 WORDS)

Naevus fusco-caeruleus zygomaticus

One hundred and ten cases of an unusual type of naevus, which we have called naevus fusco-caeruleus zygomaticus were studied. The naevus presents as a bilateral speckled discolouration of the skin of the face principally in the zygomatic region. The condition usually does not become apparent until the second decade of life, and is much commoner in females. No association with any other abnormalities was found. Light and electron microscopy of the speckles showed the presence of dermal melanocytes mostly in the upper dermis. A survey was also carried out to determine the prevalence of this naevus in the general population.

Cytologic investigations in Chlamydia infection

Chlamydia is an extremely common genital infection. It can cause serious disseminated disease and can infect the neonate and the sexual partner. Morphologically, Chlamydia infection was identified in routine Fast smears obtained from 160 women. Chlamydia infection manifests as intracytoplasmic coccoid and inclusion bodies in the metaplastic cells. Infected cells also reveal cytomegaly and multinucleation. Immunofluorescence studies, electron microscopy, tissue studies, histochemical techniques and tissue cultures were undertaken to establish the diagnosis of Chlamydia infection as observed in Papanicolaou-stained material. Detailed cytomorphology of Chlamydia infection is described. Clinical implications of such a diagnosis are discussed.