Biotin receptor-mediated intracellular delivery of synthetic polypeptide-protein complexes

Pulmonary delivery offers a non-invasive route for the administration of biotherapeutics. In this context, understanding and control of a transport into, and across cellular barriers is central to the design of delivery systems. Here, we report our study on receptor mediated delivery of protein cargo by a formulation comprising sub-300 nm sized non-covalent protein complexes with biotin-conjugated PEG-poly(glutamic acid) (biotin-PEG_2k-b-GA₁₀) and PEG_2k-b-GA₃₀ copolymers blend as targeting and complexing functionalities. Designed complexes achieve intracellular delivery of the cargo in lung derived A549 epithelial cells in vitro via sodium-dependent multivitamin transporter (biotin receptor). We further show that biotin receptor driven endocytosis preferentially involves dynamin- and caveolae-dependent vesicular internalization, switching the transport pathway away from predominantly clathrin-dependent entry of free protein. Significantly for a protective intracellular delivery of biotherapeutics based on non-covalent complexation with polymeric excipients, the study provides evidence of intracellular presence of the complexing copolymer; demonstrated exploiting biotin in biotin-PEG_2k-b-GA₁₀ copolymer as a tag for binding with fluorescently labelled avidin. Moreover, analysis of intracellular localization of constitutive species shortly following cellular internalization suggests a co-localization of biotin-PEG_2k-b-GA₁₀ copolymer and protein constitutive species. The study demonstrates intracellular delivery of biotin targeted non-covalent complexes with a protein cargo, the result with important implications in a design of enabling technology platforms for protective, receptor mediated intracellular delivery of biotherapeutics.

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Background

Erythropoiesis-stimulating agents (ESAs) revolutionized the management of anaemia in chronic kidney disease (CKD) when introduced in the late 1980s. A range of ESA types, preparations and administration modalities now exist, with newer agents requiring less frequent administration. Although systematic reviews and meta-analyses have been published in adults, no systematic review has been conducted investigating ESAs in children.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for the conduct of systematic reviews was used. All available literature on outcomes relating to ESAs in children with CKD was sought. A search of the MEDLINE, CINAHL and Embase databases was conducted by two independent reviewers. Inclusion criteria were published trials in English, children with chronic and end-stage kidney disease and use of any ESA studied against any outcome measure. An assessment of risk of bias was carried out in all included randomized trials using the criteria from the Cochrane Handbook for Systematic Reviews of Interventions. Two tables were used for data extraction for randomized and observational studies. Study type, participants, inclusion criteria, case characteristics, follow-up duration, ESA type and dosage, interventions and outcomes were extracted by one author.

Results

Of 965 identified articles, 58 were included covering 54 cohorts. Six were randomized trials and 48 were observational studies. A total of 38 studies assessed the efficacy of recombinant human erythropoietin (rHuEPO), 11 of darbepoetin alpha (DA) and 3 of continuous erythropoietin receptor activator (CERA), with 6 studies appraising secondary outcome measures exclusively. Recruitment to studies was a consistent challenge. The most common adverse effect was hypertension, although confounding effects often limited direct correlation. Two large cohort studies demonstrated a greater hazard of death independently associated with high ESA dose. Secondary outcome measures included quality of life measures, growth and nutrition, exercise capacity, injection site pain, cardiovascular function, intelligent quotient, evoked potentials and platelet function.

Conclusions

All ESA preparations and modes of administration were efficacious, with evidence of harm at higher doses. Evidence supports individualizing treatments, with strong consideration given to alternate treatments in patients who appear resistant to ESA therapy. Further research should focus on randomized trials comparing the efficacy of different preparations, treatment options in apparently ESA-resistant cohorts and clarification of meaningful secondary outcomes to consolidate patient-relevant indices.

Genetically-programmed, mesenchymal stromal cell-laden & mechanically strong 3D bioprinted scaffolds for bone repair

Additive manufacturing processes used to create regenerative bone tissue engineered implants are not biocompatible, thereby restricting direct use with stem cells and usually require cell seeding post-fabrication. Combined delivery of stem cells with the controlled release of osteogenic factors, within a mechanically-strong biomaterial combined during manufacturing would replace injectable defect fillers (cements) and allow personalized implants to be rapidly prototyped by 3D bioprinting. Through the use of direct genetic programming via the sustained release of an exogenously delivered transcription factor RUNX2 (delivered as recombinant GET-RUNX2 protein) encapsulated in PLGA microparticles (MPs), we demonstrate that human mesenchymal stromal (stem) cells (hMSCs) can be directly fabricated into a thermo-sintered 3D bioprintable material and achieve effective osteogenic differentiation. Importantly we observed osteogenic programming of gene expression by released GET-RUNX2 (8.2-, 3.3- and 3.9-fold increases in OSX, RUNX2 and OPN expression, respectively) and calcification (von Kossa staining) in our scaffolds. The developed biodegradable PLGA/PEG paste formulation augments high-density bone development in a defect model (~2.4-fold increase in high density bone volume) and can be used to rapidly prototype clinically-sized hMSC-laden implants within minutes using mild, cytocompatible extrusion bioprinting. The ability to create mechanically strong 'cancellous bone-like' printable implants for tissue repair that contain stem cells and controlled-release of programming factors is innovative, and will facilitate the development of novel localized delivery approaches to direct cellular behaviour for many regenerative medicine applications including those for personalized bone repair.

Bilateral primary renal diffuse large B-cell lymphoma: a rare presentation of paediatric renal disease mimicking juvenile nephronophthisis

A 12-year-old boy presented with a prolonged history of headache, fatigue and hypertension. Initial investigations were consistent with presumed non-oliguric end-stage renal disease, leading to a provisional diagnosis of juvenile nephronophthisis. Subsequent imaging demonstrated bilaterally enlarged kidneys without cystic change. Mutation analysis was negative for nephronophthisis, causing diagnostic uncertainty which prompted renal biopsy. Histology revealed a primary renal diffuse large B-cell lymphoma which was highly responsive to chemotherapy, including the anti-CD20 monoclonal agent, rituximab. Renal function improved during lymphoma treatment, with residual chronic kidney disease stage 3a once chemotherapy was completed. Atypical diagnostic features should always prompt re-evaluation of a patient. In this case, the delayed malignancy diagnosis did not have an adverse effect on patient survival or morbidity. The outcome for primary renal lymphoma (PRL) has improved markedly following the introduction of rituximab.

Singlet oxygen generation from porphyrin-functionalized hexahedral polysilicon microparticles

The generation of singlet oxygen (SO), primarily by using a combination of light and photosensitizers in the presence of a dissolved gas, finds applications in both chemistry and medicine. The efficiency of its formation can be enhanced by immobilization of the photosensitizers. In this work, we have explored the covalent functionalization in suspension of hexahedral slab-like polysilicon microparticles ( [Formula: see text]P, with a largest dimension of three microns) with a model photosensitizer, 5-(4-isothiocyanatophenyl)-10,15,20-(triphenyl)porphyrin (ITC-P), and evaluated the singlet oxygen generation of this photosensitizer in solution and after immobilization (ITC-P-[Formula: see text]P) in suspension. The SO-detection experiment on the functionalized microparticles was performed using a hydrogel as the matrix supporting the microparticles (to avoid their settling), and revealed that ITC-P-[Formula: see text]Pin suspension is capable of generating SO more efficiently than free ITC-P in solution.

Photosensitiser-gold nanoparticle conjugates for photodynamic therapy of cancer

Gold nanoparticles (AuNPs) have been extensively studied within biomedicine due to their biocompatibility and low toxicity. In particular, AuNPs have been widely used to deliver photosensitiser agents for photodynamic therapy (PDT) of cancer. Here we review the state-of-the-art for the functionalisation of the gold nanoparticle surface with both photosensitisers and targeting ligands for the active targeting of cancer cell surface receptors. From the initial use of the AuNPs as a simple carrier of the photosensitiser for PDT, the field has significantly advanced to include: the use of PEGylated modification to provide aqueous compatibility and stealth properties for in vivo use; gold metal-surface enhanced singlet oxygen generation; functionalisation of the AuNP surface with biological ligands to specifically target over-expressed receptors on the surface of cancer cells and; the creation of nanorods and nanostars to enable combined PDT and photothermal therapies. These versatile AuNPs have significantly enhanced the efficacy of traditional photosensitisers for both in vitro and in vivo cancer therapy. From this review it is apparent that AuNPs have an important future in the treatment of cancer.

Quantification of urinary sodium concentrations in term infants

BACKGROUND

Infants with gastrointestinal conditions and poor weight gain are administered sodium supplementation based on urinary sodium concentrations. However, the reference range of urinary electrolytes is unknown. The aim of this study was to ascertain the normal values of urinary electrolytes in healthy, term infants. Secondary aims were to establish the relationship between urinary electrolytes with weight velocity and feeding practices.

METHODS

Healthy, term (≥37 weeks' gestation) infants were recruited. Parental questionnaires were completed before discharge and at six weeks. Electrolytes were quantified from a urine sample at six weeks. t-Tests and Mann-Whitney U tests were conducted for parametric and non-parametric electrolytes, respectively.

RESULTS

A total of 200 infants were recruited before discharge. Twenty-nine follow-up questionnaires and urine samples were returned (nine female; mean gestational age 39 + 6 weeks [SD 9.9 days]; mean birthweight 3350 g [SD 483 g]; 17 breastfed, nine formula and three mixed; mean change in Z score for weight -0.914 [SD 0.814]). Majority (25/29) of infants had urinary sodium <20 mmo/L. Change in Z score for weight was similar between infants with sodium <20 mmol/L and >20 mmol/L ( P = 0.78). All exclusively breastfed infants had sodium <20 mmol/L, however, not statistically dissimilar to formula-fed infants ( P = 0.27).

CONCLUSION

Most term infants in this study had urinary sodium values <20 mmol/L with no identified relationship to weight velocity. Lower concentrations of sodium could be not quantified reliably because of the limitations of the analytical method that were used. More evidence is required to identify candidates for sodium supplementation.

Consensus statement on the anticipation and prevention of acute postoperative pain: multidisciplinary RADAR approach

BACKGROUND

There has been considerable investment in efforts to improve postoperative pain management, including the introduction of acute pain teams. There have also been a number of guidelines published on postoperative pain management and there is widespread agreement on how pain should be practically managed. Despite these advances, there is no apparent improvement in the number of patients experiencing moderately severe or extreme pain after surgery. This highlights significant scope for improvement in acute postoperative pain management.

SCOPE

In January 2009, a multidisciplinary UK expert panel met to define and agree a practical framework to encourage implementation of the numerous guidelines and fundamentals of pain management at a local level. The panel recognised that to do this, there was a need to organise the information and guidelines into a simplified, accessible and easy-to-implement system based on their practical clinical experience. Given the volume of literature in this area, the Chair recommended that key international guidelines from professional bodies should be distributed and then reviewed during the meeting to form the basis of the framework. Consensus was reached by unanimous agreement of all ten participants.

FINDINGS

This report provides a framework for the key themes, including consensus recommendations based upon practical experience agreed during the meeting, with the aim of consolidating the key guidelines to provide a fundamental framework which is simple to teach and implement in all areas. Key priorities that emerged were: Responsibility, Anticipation, Discussion, Assessment and Response. This formed the basis of RADAR, a novel framework to help pain specialists educate the wider care team on understanding and prioritising the management of acute pain.

CONCLUSION

Acute postoperative pain can be more effectively managed if it is prioritised and anticipated by a well-informed care team who are educated with regard to appropriate analgesic options and understand what the long-term benefits of pain relief are. The principles of RADAR provide structure to help with training and implementation of good practice, to achieve effective postoperative pain management.

Selectivity of 7-alkoxycoumarins as probe substrates for rat hepatic cytochrome P450 forms is influenced by the substitution pattern on the coumarin nucleus

1. The O-dealkylation of 7-alkoxycoumarins is widely used as an assay to characterize cytochrome P450 (CYP) activity. These substrates can also undergo oxidative attack at additional sites on the coumarin nucleus, which may influence their apparent selectivity for particular CYP forms. 2. Accordingly, the effect of blockade of these additional sites was investigated on the selectivity towards rat hepatic CYP forms, with emphasis on the CYP1A and 2B forms. 3. Blockade of the 3-/4- and 6-positions resulted in substrates for which the CYP1A1/2 selectivity of the unsubstituted 7-alkoxycoumarins was altered to a CYP2B selectivity; this was achieved with little overall change in the molecular dimensions of the substrate. Limited analysis of other inducible CYP forms indicated at most only small effects of structure modification on activity. 4. The findings suggest that the sensitivity of probe substrates for CYP forms may be limited by the occurrence of competing side reactions of the substrate, and that better probes may be derived by blocking the sites of these side reactions.

Clinical dentin hypersensitivity: understanding the causes and prescribing a treatment

Dentin hypersensitivity is a common condition of transient tooth pain associated with a variety of exogenous stimuli. There is substantial variation in the response to such stimuli from one person to another. Except for sensitivity associated with tooth bleaching or other tooth pathology, the clinical cause of dentin hypersensitivity is exposed dentinal tubules as a result of gingival recession and subsequent loss of cementum on root surfaces. The most widely accepted theory of how the pain occurs is Brännström's hydrodynamic theory of dentin hypersensitivity. Dentinal hypersensitivity must be differentiated from other conditions that may cause sensitive teeth prior to treatment. Three principal treatment strategies are used. Dentinal tubules can be covered by gingival grafts or dental restorations. The tubules can be plugged using compounds that can precipitate together into a large enough mass to occlude the tubules. The third strategy is to desensitize the nerve tissue within the tubules using potassium nitrate. Several over-the-counter products are available to patients to treat this condition.

Intergeneric communication in dental plaque biofilms

Dental plaque is a complex biofilm that accretes in a series of discrete steps proceeding from a gram-positive streptococcus-rich biofilm to a structure rich in gram-negative anaerobes. This study investigated information flow between two unrelated plaque bacteria, Streptococcus cristatus and Porphyromonas gingivalis. A surface protein of S. cristatus caused repression of the P. gingivalis fimbrial gene (fimA), as determined by a chromosomal fimA promoter-lacZ reporter construct and by reverse transcription-PCR. Signaling activity was associated with a 59-kDa surface protein of S. cristatus and showed specificity for the fimA gene. Furthermore, P. gingivalis was unable to form biofilm microcolonies with S. cristatus. Thus, S. cristatus is capable of modulating virulence gene expression in P. gingivalis, consequently influencing the development of pathogenic plaque.

Amitriptyline accumulation and elimination in Calliphora vicina larvae

Calliphora vicina larvae reared on artificial foodstuffs spiked with human equivalent therapeutic (100 ng/g), toxic (300 ng/g), lethal (500 ng/g), and 10 x lethal (5,000 ng/g) concentrations of amitriptyline and nortriptyline, alone and in various combinations, were harvested at various stages of development and analysed for drug content by high-pressure liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS). Mean (range) larval amitriptyline concentrations (ng/g) in larvae reared on foodstuffs containing 100 ng/g, 500 ng/g, and 5,000 ng/g amitriptyline were 3.21 (<1-5.72), 21.3 (14.2-27.4), and 50.1 (38.8-64.3), respectively, on day 5; 6.62 (5.98-7.72), 22.5 (16.4-32.4), and 38 (22.8-50.9) on day 8; and 4.45 (3.45-5.93), 25.2 (18.6-38.4), and 26.2 (22.7-29.7) on day 11. Nortriptyline concentrations (ng/g) in larvae reared on foodstuffs containing 100 ng/g, 500 ng/g, and 5,000 ng/g nortriptyline were 6.86 (4.48-8.96), 14.1 (11.9-17.8), and 18.5 (16.7-20.6), respectively, on day 5; 8.32 (4.9-11.7), 12.9 (11.5-14.2), and 18.8 (11.5-23) on day 8; and 5.06 (3.27-7.25), 19.4 (17.8-22.4), and 26.6 (11.7-44.7) on day 11. Among 45 separate larval rearings fed on the same foodstuff, mean larval weight ranged from 24-96 mg and larval amitriptyline concentration from <1-148 ng/g. Biological variability in larval drug concentrations were greatest in larvae reared on high drug concentrations. Such variability makes quantitative extrapolation back to the drug concentration in foodstuff unreliable. Larval drug accumulation became unpredictable when larvae encounter more than one drug or different concentrations of a single drug. Drug concentrations measured were partly due to surface contamination with drug-rich putrefactive residue and they also depend partly on the analytical method used. Fly larvae are unreliable samples for quantitative toxicological analysis.

Enhancement of thymic recovery after cyclosporine by recombinant human growth hormone and insulin-like growth factor I

Correlation of thymic changes with the development of CsA-associated syngeneic graft-versus-host disease (sGVHD) suggested that the development of tolerance depends on the prompt regeneration of the thymus after stopping CsA. Accordingly, we have tested recombinant human growth hormone (rhGH) and recombinant human insulin-like growth factor I (rhIGF-1) to determine if they accelerate reconstitution of the rat thymus after CsA-induced involution. After 14 days of CsA, the thymus has marked medullary involution but normally recovers fully in 6 weeks. In this study, LEW rats were injected with vehicle, rhGH, or rhIGF-1 for 21 days after stopping CsA and were examined. The vehicle-treated rats showed partial recovery with respect to Hassall's corpuscles, class II antigen expression, medullary size, medullary dendritic cells (DC), and T cell maturation. The mature thymocytes were predominantly CD8+ T cells. Both rhGH and rhIGF-1 induced significant thymic enlargement compared with the vehicle-treated rats. They also both significantly enhanced regeneration with respect to Hassall's corpuscles. The mature thymocyte population had significantly greater CD4+ cells. In addition, rhIGF-1 induced a significant improvement in the medullary size and medullary DC. While the medullae of a normal thymus are in intimate contact with cortical class II antigen, after CsA the cortex adjacent to the medulla is primarily class II antigen negative. RhGH significantly increased the class II antigen in the deep cortex while rhIGF-1 demonstrated a trend toward greater expression in this region (P = 0.06). We conclude that rhGH and rhIGF-1 accelerate thymic regeneration post-CsA. Further studies are now indicated to establish the potential for these factors to enhance the development of antigen-specific tolerance.

Toe-nail avulsion

This trial compares the efficiency of Comfeel Ulcer Dressing (Coloplast Ltd), a hydrocolloid dressing, with a chlorhexidine acetate impregnated dressing on iatrogenic wounds produced by toe-nail avulsion followed by treatment with phenolisation of the germinal matrix and nail bed.

The phosphorylation of choline acetyltransferase

Human placental Choline Acetyltransferase (ChAT) has been shown to be phosphorylated in vitro by kinases present in rat brain. Phosphorylation occurs at a single site with the exclusive phosphoamino acid being serine. ChAT phosphorylation was shown to be calcium, and not cyclic nucleotide, dependent and was inhibited by inhibitors of calcium/calmodulin protein kinases including anti-calmodulin anti-sera. ChAT phosphorylation was stimulated by calmodulin (9 fold) and, to a lesser extent, by phosphatidylserine (4 fold). These results indicate the involvement of a calcium/calmodulin and possibly also a calcium/phospholipid kinase. This finding was confirmed by demonstrating ChAT phosphorylation using both purified multifunctional calcium/calmodulin protein kinase (CaMK) and calcium/phospholipid protein kinase C (PKC) from rat brain. A stoichiometric incorporation of 0.9 mol phosphate/mol ChAT was achieved by CaMK. Phosphorylated ChAT could be isolated from freshly prepared rat brain synaptosomes. The results obtained with this model system support the hypothesis that in vivo a fraction of ChAT exists phosphorylated.

Production and characterization of biologically active recombinant human nerve growth factor

Nerve growth factor (NGF) is required for the differentiation and maintenance of sympathetic and sensory neurons. In animal models, NGF prevents the death of septal and basal forebrain cholinergic neurons deprived of endogenous NGF, suggesting that NGF may be of benefit in neurodegenerative diseases of humans. However, little is known about NGF in human brain, partly because a sensitive assay for hNGF has been lacking. As a first step toward developing the tools for the study of NGF in humans, recombinant human NGF (rhNGF) was produced by expressing exon 4 of the human NGF gene in COS cells. The expression vector is driven by the adenovirus major late promoter and contains an SV40 origin of replication. NGF was secreted by transiently transfected cells. Conditioned medium was assayed with an enzyme immunoassay (EIA) that utilizes a monoclonal antibody (clone 27/21) against mouse beta-NGF, and contained 15 ng/ml of rhNGF. The rhNGF migrated as a dimer of 26-29 Kd on a gel permeation chromatography column, and stimulated neurite outgrowth and neuropeptide Y mRNA levels in PC12 cells. With optimization, the described expression system is capable of providing sufficient hNGF for research and therapeutic purposes.

An atlas of the regional and laminar distribution of choline acetyltransferase immunoreactivity in rat cerebral cortex

The distribution of cholinergic fibers in rat cortex was investigated using choline acetyl-transferase immunohistochemistry. Previous studies have either shown differences in distribution, but have been limited to selected areas, or have shown no discernable differences between different cortical areas. In our study, we examined all areas of rat cortex and found that there are striking interareal and interlaminar differences in cholinergic fiber distribution. We have found that certain functionally similar cortical areas (e.g. sensory, motor, etc.) have similar patterns of cholinergic innervation and we have designated 13 general patterns of cortical cholinergic innervation. We have also compared, on an area-by-area basis, the pattern of acetylcholinesterase reactivity to that of choline acetyltransferase immunoreactivity, since acetylcholinesterase has been used for many years as a putative cholinergic marker. We found that in most cortical areas, the distribution of acetylcholinesterase-positive fibers paralleled that of choline acetyltransferase-immunoreactive fibers; however, there were some striking differences, notably primary somatosensory (the "barrelfield"), retrosplenial and cingulate cortices. In some areas, a revised concept of rat cortical organization, using cytoarchitectonics, was required. The results of this study provide a comprehensive microscopic analysis of cholinergic fiber innervation of the rat cortex. These results are discussed in relation to previous anatomical, physiological and pharmacological studies of cortical cholinergic innervation. The possible sources of this innervation are also discussed.

Skin dose near compensating filters in radiotherapy

In radiotherapy treatments with MV beams, the use of tissue compensators affects the dose to the skin. Methods of calculating the relative skin dose (RSD) are described and a formula is derived to predict the contribution of a tissue compensator to the RSD. Measurements of RSD for various field sizes and distances from the compensator are presented.

Development of cholinergic neurons in the septal/diagonal band complex of the rat

In the present study we employed immunohistochemical techniques using a polyclonal antibody against choline acetyltransferase (ChAT) to determine the distribution and cytological features of cholinergic neurons in the developing septal/diagonal band complex of the rat. ChAT-positive perikarya were first clearly detected in this region on embryonic day 17, although the neurons were faintly labeled and lacked the cytological details found in the adult. After birth we observed a dramatic increase in the intensity of the immunolabeling which continued until postnatal day 23. Thereafter, the ChAT-positive neurons assumed their adult-like characteristics.

Studies on detergent released choline acetyltransferase from membrane fractions of rat and human brain

The relationship between soluble and membrane choline acetyltransferase (ChAT) was studied. Differential solubilization of rat and human brain yielded ChAT in the soluble and membrane fractions. The addition of 1% Triton X-100 to membrane fractions resulted in a release of ChAT. A comparable release of lactate dehydrogenase was also observed. The Triton released ChAT and soluble ChAT from rat and human brain were efficiently purified by immuno-affinity chromatography. A single molecular weight of 68,000 was observed for both forms of rat and human brain ChAT. Epitope maps produced from both forms of human brain ChAT were identical. It is concluded that Triton released ChAT is identical to soluble ChAT and simply represents occluded soluble ChAT.

Response of septal cholinergic neurons to axotomy

In the present study we employed quantitative morphometric techniques to assay the response of septal cholinergic neurons following unilateral transection of the fimbria/fornix and supracallosal stria. Analysis of 50-micron-thick tissue sections with a Quantimet 920 image analysis system demonstrated a reduction in ChAT immunoreactivity as early as 1 day following denervation. This decrease was associated with a drop in the number of labeled cells ipsilateral to the lesion and a decrease in the area of cholinergic perikarya on the lesioned and nonlesioned side of the septum. The response at 1 day, however, was transient, and at 4 days the number of labeled neurons was not significantly different from controls. By 8 days we observed a dramatic reduction in the number and size of ChAT-positive cells ipsilateral to the lesion and a reduction in the size of cholinergic perikarya on the contralateral (i.e., nonlesioned) side. These values persisted throughout the remainder of the study. To assess more completely the morphologic response of neurons to axotomy than can be determined in 50-micron-thick tissue sections, we embedded the adjacent immunolabeled tissue section in Epon and then serially sectioned it to a thickness of 0.75-1.0 micron. By using this method, we were able to measure the area, length, and width of the cell, the area of the nucleus and nucleolus, and the position of the nucleus (i.e., eccentricity). Measurements were performed on ChAT-labeled and nonlabeled cells. The results of our studies demonstrate that cholinergic and noncholinergic cells responded to axotomy in a characteristic yet different fashion from each other and that this response could be quantitatively assayed. In general, labeled and nonlabeled cells on the lesioned side of the septum shrink in response to denervation. This shrunken state was reflected in measurements of cellular area, length, width, and nuclear area. Moreover, other measurements of cellular morphology (i.e., area of the nucleolus, position of the nucleus) indicate that none of the neuronal populations examined in the present study displayed morphologic evidence of regeneration. Our results indicate a dramatic loss of cholinergic perikarya ipsilateral to the lesion. Moreover, although a few neurons do persist they do so in a shrunken state. These data provide an essential baseline for the second study in this series, which will evaluate the effect of nerve growth factor on the survival of denervated septal neurons.

Distribution of choline acetyltransferase-containing neurons of the hypothalamus

A system of small to medium size choline acetyltransferase (ChAT)-containing neurons has been identified in rat, monkey and human hypothalamus. A highly sensitive polyclonal anti-human placental ChAT rabbit serum, combined with a nickel ammonium sulfate second antibody intensification method, was used to identify these relatively weakly staining ChAT-positive neurons. The most prominent hypothalamic group consisted of small neurons in the infundibular (arcuate) nucleus. Fibers extended towards the infundibulum. Other ChAT-positive cells were not identified with specific hypothalamic nuclei but were scattered loosely in the surrounding matrix. They fell into two broad complexes: a medially distributed one close to the third ventricle and running rostrocaudal to caudoventral; and a lateral one distributed principally in the region of the medial forebrain bundle. The most laterally placed hypothalamic ChAT-positive neurons slightly overlapped with the large, intensely staining cells of the medial basal forebrain cholinergic complex. The identification of these cells helps to account for previous biochemical and pharmacological studies which have strongly indicated the presence of intrinsic cholinergic neurons in the hypothalamus.

Vestibular and cochlear efferent neurons in the monkey identified by immunocytochemical methods

Attempts were made to identify vestibular (VEN) and cochlear (CEN) efferent neurons in the squirrel monkey using retrograde transport of horseradish peroxidase (HRP) and immunocytochemical methods. HRP implants in the ampulla of the lateral semicircular duct retrogradely labeled cells of VEN bilaterally and some cells of CEN. VEN located lateral to the rostral part of the abducens nucleus formed a compact collection of cells, all of which were immunoreactive only to antisera for choline acetyltransferase (ChAT). CEN, identified by immunoreactivity to ChAT were located at the hilus of the lateral superior olive (LSO), along the lateral border of the LSO and sparsely near lateral parts of the ventral trapezoid nucleus (VTN). A small number of cells and fibers near the border of the VTN and lateral to the LSO were immunoreactive for leucine enkephalin (L-ENK). Fibers immunoreactive for L-ENK also were identified in the hilus of the LSO. No cells of the superior olivary complex were immunoreactive for antisera to ChAT, L-ENK, substance P, gamma-aminobutyric acid or glutamic acid decarboxylase. Cells of VEN and CEN can be identified by their immunoreactivity to ChAT, and some cells and fibers of CEN also contain L-ENK.

Relation of pontine choline acetyltransferase immunoreactive neurons with cells which increase discharge during REM sleep

The purpose of this study was to determine whether neurons in the medial pontine reticular formation with high discharge rates during REM sleep could be localized in regions of the brainstem having neurons displaying choline acetyltransferase immunoreactivity. Six cats were implanted with sleep recording electrodes and microwires to record extracellular potentials of neurons in the pontine reticular formation. Single-units with a S:N ratio greater than 2:1 were recorded for at least two REM sleep cycles. A total of 49 units was recorded from the pontine reticular formation at medial-lateral planes ranging from 0.8 to 3.7 mm. The greatest proportion of the units (28.6%) showed highest discharge during active waking and phasic REM sleep compared to quiet waking, non-REM sleep, transition into REM sleep or quiet REM sleep periods. A percentage (20.4%) of the cells had high discharge associated with phasic REM sleep periods while 8.2% of the cells showed a progressive increase in discharge from waking to REM sleep. Subsequent examination of the distribution of choline acetyltransferase immunoreactive cells in the PRF revealed that cells showing high discharge during REM sleep were not localized near presumed cholinergic neurons. Indeed, we did not find any ChAT immunoreactive somata in the medial PRF, an area which has traditionally been implicated in the generation of REM sleep. These results suggest that while increased discharge of PRF cells may be instrumental to REM sleep generation, these cells are not cholinergic.

Choline acetyltransferase immunoreactivity in neuritic plaques of Alzheimer brain

We have observed dystrophic choline acetyltransferase (ChAT)-positive processes surrounding the amyloid core of neuritic plaques in human neocortex, amygdala and hippocampus, using a polyclonal anti-human ChAT antiserum. These data, and those from studies of the aged monkey by other investigators, provide a morphologic counterpart for the biochemical abnormality of the cholinergic system in Alzheimer's disease and senile dementia of the Alzheimer type.

Cholinergic innervation displays strikingly different laminar preferences in several cortical areas

A new rabbit polyclonal antiserum against choline acetyltransferase (ChAT) reveals that cholinergic innervation of the cortex varies strikingly among different cytoarchitecturally defined areas in the rat neocortex. These findings suggest that cholinergic transmission may be integrated differently into the local circuitries of various regions of the cerebral cortex. In addition, the pattern of staining observed with acetylcholinesterase histochemistry, which has been used for many years to demonstrate putative cholinergic fibers, only partially matches the staining pattern obtained with the more specific cholinergic marker, ChAT.

Immunohistochemical staining of cholinergic neurons in the human brain using a polyclonal antibody to human choline acetyltransferase

Antibodies against human placental choline acetyltransferase (ChAT) were used to immunohistochemically stain cholinergic neurons in the neostriatum and nucleus basalis of Meynert in human brain. Cells in both regions were intensely stained as were nerve fibers. Comparable cells were stained in these same brain regions in the rat. This anti-human ChAT antibody will enable the further detailed characterization of cholinergic neurons in the human brain in both health and disease.

A comparative study of choline acetyltransferase from normal and Alzheimer brain

A comparative study was made of the enzyme choline acetyltransferase (ChAT) from normal and Alzheimer (senile dementia of the Alzheimer type) brain. The number of molecular weight and charge forms of the enzyme were determined in the caudate region of both brains. Efficient purification of active ChAT was achieved using immuno-affinity purification. It was shown that the purified enzyme was identical in both cases, exhibiting a single charge (apparent pI approximately 8.2) and a single molecular weight (mol. wt. = 68,000). The idea of a selective loss of one particular isoform to explain the reduced levels of ChAT observed in Alzheimer's disease can be ruled out.

Immunoaffinity purification of human choline acetyltransferase: comparison of the brain and placental enzymes

A rapid and efficient immunoaffinity purification procedure has been developed for human placental choline acetyltransferase (ChAT). Using this procedure, human placental ChAT was purified to homogeneity with high recovery of enzyme activity (50-60%). Purified ChAT was used to raise a monospecific anti-human ChAT polyclonal antibody in rabbits. A comparison of the physical properties of ChAT was made between the enzymes purified from human brain and human placenta. Only one form of the enzyme exists in either tissue, having identical molecular weights of 68,000 and a single apparent pI of 8.1. A more detailed comparison of the two enzymes using peptide mapping and epitope mapping indicates identity between the brain and placental enzymes.

Breakdown of gliadin peptides by intestinal brush borders from coeliac patients

The 'missing peptidase' hypothesis to explain the aetiology of coeliac disease has never been satisfactorily resolved and recent reports suggest that coeliac brush borders may have depressed levels of specific peptidase enzymes. It has been inferred from these studies that the subsequent brush border digestion of gliadin peptides may therefore be defective. In this present study a sensitive fluorometric assay was used to measure the hydrolysis of a peptic-tryptic digest of gliadin by both normal and coeliac brush borders. The coeliac brush borders were as efficient as the normals in hydrolysing gliadin peptides and showed no depression of any specific peptidase activity.

Textual aspects of prosody in Swedish

The present paper explores the textual function of intonation in indicating coherence and boundaries between successive utterances of speech. An informal listening test showed how such prosodic coupling can be used to mark coherence between sentences of a text unit. The coherence is expressed as a downdrift of F0 peaks and valleys characterizing the whole text unit. The boundary between two text units is signalled by terminating one and beginning another downdrift ramp. The characteristic features of the downdrift pattern seem to be (1) an adjustment of F0 values to the length of the text unit, and (2) an adaptation of the F0 of the beginning of a succeeding sentence to that of the later part of a preceding one in the same unit. Some preliminary implications of these results for speech planning are discussed.

An accurate fluorometric method to measure the breakdown of gliadin and gliadin peptides

A simple and accurate method is described to measure the breakdown of gliadin and gliadin peptides. It involves measuring the release of the predominant amino acids glutamine and glutamic acid using a fluorometric double enzyme assay and contains none of the problems normally associated with previously used techniques. The assay is highly accurate in that small concentrations of the free amino acids can be measured with no interference from the peptide bound amino acids. The assay system was used to study the breakdown of: whole gliadin, a peptic/tryptic digest of gliadin (PT gliadin), and a peptic/tryptic/chymotryptic digest of gliadin (PTC gliadin) using a rat intestinal brush border fraction. Both PT and PTC gliadin are hydrolysed at higher rates than is whole gliadin. Exhaustive hydrolysis shows that a brush border fraction can totally break down PT gliadin while an initial linear rate of breakdown is observed (up to 60 min).

Vitamin status in treated patients with cystic fibrosis

The water-soluble (B1, B2, B6, C, folic acid) and fat-soluble vitamin (A, carotene, E, and D) status of 36 patients with cystic fibrosis was assessed and compared with a control group of 21 age-matched normal children. Twenty-seven of the patients were receiving vitamin supplements (except folic acid and vitamin E) at the time of investigation. Vitamin B1, B2, and B6 status was adequate in all patients, and there was little evidence of folic acid deficiency. Vitamin C stores might not have been adequate in some of these patients, despite daily supplements with 50 mg of the vitamin. Steatorrhoea, often severe, was present in most of them. Serum carotene and vitamin E concentrations were low in over 90% of patients and were related to the severity of steatorrhoea. Vitamin A was low in over 40% of the patients despite daily vitamin supplements of 4000 IU and correlated with the serum retinol-binding protein level. Serum 25-OH cholecalciferol was low in some patients whether or not they were receiving a daily supplement of 400 IU vitamin D. In a short-term supplementation trial with water-miscible preparations of vitamin A and E in 14 patients, the serum levels of both vitamins responded well to 2 weeks of treatment with 50 mg vitamin E and 4000 IU vitamin A. Except for serum vitamin A, which was lowest in patients with the poorest clinical grading, the other vitamins were not influenced by the clinical grade of the patients.