Novel approaches and perspectives in allergen immunotherapy

In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were broadly discussed during the first Aarhus Immunotherapy Symposium (Aarhus, Denmark) in December 2015 by leading clinicians, scientists and industry representatives in the field. The aim of this symposium was to highlight AIT-related aspects of public health, clinical efficacy evaluation, mechanisms, development of new biomarkers and an overview of novel therapeutic approaches. Allergy is a public health issue of high socioeconomic relevance, and development of evidence-based action plans to address allergy as a public health issue ought to be on national and regional agendas. The underlying mechanisms are in the focus of current research that lays the ground for innovative therapies. Standardization and harmonization of clinical endpoints in AIT trials as well as current knowledge about potential biomarkers have substantiated proof of effectiveness of this disease-modifying therapeutic option. Novel treatments such as peptide immunotherapy, intralymphatic immunotherapy and use of recombinant allergens herald a new age in which AIT may address treatment of allergy as a public health issue by reaching a large fraction of patients.

Comparison of growth performance and immune parameters of three commercial chicken lines used in organic production

Owing to the higher demands for avoiding medication and antibiotics, health status of the production animals plays an important role in the poultry industry, especially in organic poultry systems. Immunity plays a major role in keeping the host free from disease, and it is evident that the host's genetic make-up influences immunity and disease resistance/susceptibility in chickens. Previously, breeding strategies aimed at selection for resistance against specific diseases with the risk of creating less disease resistance against other pathogens. Changing breeding strategies towards selection of chickens with a more general and broad disease resistance or robustness may therefore improve the overall health status, animal welfare, and food security in the poultry production. The aim of this study was therefore to compare the immunocompetence of the presumed "robust" Hellevad chickens with two chicken lines widely used in organic production, Bovans Brown (Bovans) and Hisex White (Hisex). The chickens were subjected to a routine vaccination program comprising one parasite and four viral vaccines. The current study indicates that considerable differences in immunocompetence may exist between commercial layer lines used in organic production. The Hellevad chickens were found to have higher body weight at the end of the experiment (17 weeks of age) than the other two lines. Furthermore, Hellevad and Hisex chickens were found to have higher levels of humoral innate immunity with regard to sample to positive ratio of natural antibodies in serum and concentration of mannose-binding lectin in serum as compared to Bovans. Moreover, indications of an inflammatory response were observed in the Bovans at week 5, corresponding to 1 week after vaccination with live infectious bursal disease virus. With regard to adaptive immune parameters such as IgY concentration in blood and infectious bursal disease virus (IBDV)-specific antibody titres, the Hellevad and Hisex chickens had lower levels than the Bovans. How the differences observed in growth and immune parameters in the three chicken lines influence the immune protection against infection needs to be studied further.

Barriers toward organ donation in a Danish University Hospital

BACKGROUND

In Denmark, organ donation-rates are below the average in the western countries. We investigated the donor potential and identified barriers toward organ donation in a Danish university hospital.

METHODS

All patients who died in Aalborg University Hospital in 2012 were retrospectively identified. Patients with a CT- or MRI-proven deadly brain-lesion were eligible for inclusion.

RESULTS

Eighty-five patients with deadly brain-lesions were included, and of these 47 patients died in the intensive care unit (ICU). Older age and diagnosis of brain-hemorrhage and infarction were associated with admission to general ward (GW). In 62.4% of the patients the potential of becoming a donor was not identified. No donations occurred from patients dying from intracerebral hemorrhage or brain-infarction although they represented 44.7% of the potential donors.

DISCUSSION

This study reveals a huge, unrecognized donation potential at our hospital. About 30% was lost because they were never admitted to the ICU. After primary admission to the ICU, 15.3% of the potential donors were lost because they were transferred to the GW. In patients who died in the ICU 17.6% of the patients were not evaluated as potential donors. The relatives refused donation in 17.6% of cases.

CONCLUSION

It would be possible to raise the donation rate considerably if patients with donation potential are intubated and admitted to the ICU. When active treatment is considered withdrawn, possibility of organ donation should be evaluated, and the next of kin be approached by experienced staff.

The Impact of Intramammary Escherichia coli Challenge on Liver and Mammary Transcriptome and Cross-Talk in Dairy Cows during Early Lactation Using RNAseq

Our objective was to identify the biological response and the cross-talk between liver and mammary tissue after intramammary infection (IMI) with Escherichia coli (E. coli) using RNAseq technology. Sixteen cows were inoculated with live E. coli into one mammary quarter at ~4–6 weeks in lactation. For all cows, biopsies were performed at -144, 12 and 24 h relative to IMI in liver and at 24 h post-IMI in infected and non-infected (control) mammary quarters. For a subset of cows (n = 6), RNA was extracted from both liver and mammary tissue and sequenced using a 100 bp paired-end approach. Ingenuity Pathway Analysis and the Dynamic Impact Approach analysis of differentially expressed genes (overall effect False Discovery Rate≤0.05) indicated that IMI induced an overall activation of inflammation at 12 h post-IMI and a strong inhibition of metabolism, especially related to lipid, glucose, and xenobiotics at 24 h post-IMI in liver. The data indicated in mammary tissue an overall induction of inflammatory response with little effect on metabolism at 24 h post-IMI. We identified a large number of up-stream regulators potentially involved in the response to IMI in both tissues but a relatively small core network of transcription factors controlling the response to IMI for liver whereas a large network in mammary tissue. Transcriptomic results in liver and mammary tissue were supported by changes in inflammatory and metabolic mediators in blood and milk. The analysis of potential cross-talk between the two tissues during IMI uncovered a large communication from the mammary tissue to the liver to coordinate the inflammatory response but a relatively small communication from the liver to the mammary tissue. Our results indicate a strong induction of the inflammatory response in mammary tissue and impairment of liver metabolism 24h post-IMI partly driven by the signaling from infected mammary tissue.

Decomposing genomic variance using information from GWA, GWE and eQTL analysis

A commonly used procedure in genome-wide association (GWA), genome-wide expression (GWE) and expression quantitative trait locus (eQTL) analyses is based on a bottom-up experimental approach that attempts to individually associate molecular variants with complex traits. Top-down modeling of the entire set of genomic data and partitioning of the overall variance into subcomponents may provide further insight into the genetic basis of complex traits. To test this approach, we performed a whole-genome variance components analysis and partitioned the genomic variance using information from GWA, GWE and eQTL analyses of growth-related traits in a mouse F2 population. We characterized the mouse trait genetic architecture by ordering single nucleotide polymorphisms (SNPs) based on their P-values and studying the areas under the curve (AUCs). The observed traits were found to have a genomic variance profile that differed significantly from that expected of a trait under an infinitesimal model. This situation was particularly true for both body weight and body fat, for which the AUCs were much higher compared with that of glucose. In addition, SNPs with a high degree of trait-specific regulatory potential (SNPs associated with subset of transcripts that significantly associated with a specific trait) explained a larger proportion of the genomic variance than did SNPs with high overall regulatory potential (SNPs associated with transcripts using traditional eQTL analysis). We introduced AUC measures of genomic variance profiles that can be used to quantify relative importance of SNPs as well as degree of deviation of a trait's inheritance from an infinitesimal model. The shape of the curve aids global understanding of traits: The steeper the left-hand side of the curve, the fewer the number of SNPs controlling most of the phenotypic variance.

Flies who cannot take the heat: genome-wide gene expression analysis of temperature-sensitive lethality in an inbred line of Drosophila melanogaster

Fitness decreases associated with inbreeding depression often become more pronounced in a stressful environment. The functional genomic causes of these inbreeding-by-environment (I × E) interactions, and of inbreeding depression in general, are poorly known. To further our understanding of I × E interactions, we performed a genome-wide gene expression study of a single inbred line that suffers from temperature-sensitive lethality. We confirmed that increased differential expression between the thermosensitive line and the control line occurs at the restrictive temperature. This demonstrates that I × E interactions in survival are reflected in similar I × E interactions at the gene expression level. To make an impression of the cellular response associated with the lethal effect, we analysed all functional annotation terms that were overrepresented among the differentially expressed genes. Some sets of differentially expressed genes function in the general stress response, and these are more likely to also be differentially expressed in other studies of inbreeding, inbreeding depression, immunity and heat stress. Other sets of differentially expressed genes are shared with studies of gene expression in inbred lines, but not studies of the response to extrinsic stress, and represent a general transcriptomic signature of inbreeding. Finally, some sets of genes have an annotation that is not reported in other studies. These we consider to be candidates for the genes harbouring the mutations responsible for the thermosensitive phenotype, as these mutations are expected to be unique to this line. These genes may also serve as candidate QTL in studies of thermal tolerance and heat resistance.

The long-term effects of a life-prolonging heat treatment on the Drosophila melanogaster transcriptome suggest that heat shock proteins extend lifespan

Heat-induced hormesis, i.e. the beneficial effect of mild heat-induced stress, increases the average lifespan of many organisms. This effect, which depends on the heat shock factor, decreases the log mortality rate weeks after the stress has ceased. To identify candidate genes that mediate this lifespan-prolonging effect late in life, we treated flies with mild heat stress (34 °C for 2 h) 3 times early in life and compared the transcriptomic response in these flies versus non-heat-treated controls 10-51 days after the last heat treatment. We found significant transcriptomic changes in the heat-treated flies. Several hsp70 probe sets were up-regulated 1.7-2-fold in the mildly stressed flies weeks after the last heat treatment (P<0.01). This result was unexpected as the major Drosophila heat shock protein, Hsp70, is reported to return to normal levels of expression shortly after heat stress. We conclude that the heat shock response, and Hsp70 in particular, may be central to the heat-induced increase in the average lifespan in flies that are exposed to mild heat stress early in life.

Effects of Bos taurus autosome 9-located quantitative trait loci haplotypes on the disease phenotypes of dairy cows with experimentally induced Escherichia coli mastitis

Several quantitative trait loci (QTL) affecting mastitis incidence and mastitis-related traits such as somatic cell score exist in dairy cows. Previously, QTL haplotypes associated with susceptibility to Escherichia coli mastitis in Nordic Holstein-Friesian (HF) cows were identified on Bos taurus autosome 9. In the present study, we induced experimental E. coli mastitis in Danish HF cows to investigate the effect of 2 E. coli mastitis-associated QTL haplotypes on the cows' disease phenotypes and recovery in early lactation. Thirty-two cows were divided in 2 groups bearing haplotypes with either low (HL) or high (HH) susceptibility to E. coli. In addition, biopsies (liver and udder) were collected from half of the cows (n=16), resulting in a 2 × 2 factorial design, with haplotype being one factor (HL vs. HH) and biopsy being the other factor (biopsies vs. no biopsies). Each cow was inoculated with a low E. coli dose (20 to 40 cfu) in one front quarter at time 0 h. Liver biopsies were collected at -144, 12, 24, and 192 h; udder biopsies were collected at 24h and 192 h post-E. coli inoculation. The clinical parameters: feed intake, milk yield, body temperature, heart rate, respiration rate, rumen motility; and the paraclinical parameters: bacterial counts, somatic cell count (SCC), and milk amyloid A levels in milk; and white blood cell count, polymorphonuclear neutrophilic leukocyte (PMNL) count, and serum amyloid A levels in blood were recorded at different time points post-E. coli inoculation. Escherichia coli inoculation changed the clinical and paraclinical parameters in all cows except one that was not infected. Clinically, the HH group tended to have higher body temperature and heart rate than the HL group did. Paraclinically, the HL group had faster PMNL recruitment and SCC recovery than the HH group did. However, we also found interactions between the effects of haplotype and biopsy for body temperature, heart rate, and PMNL. In conclusion, when challenged with E. coli mastitis, HF cows with the specific Bos taurus autosome 9-located QTL haplotypes were associated with differences in leukocyte kinetics, with low-susceptibility cows having faster blood PMNL recruitment and SCC recovery and a tendency for a milder clinical response than the high-susceptibility cows did.

The future of specific immunotherapy: strategies and challenges for the next generation of allergy vaccines

: The use of specific immunotherapy (SIT) for allergic disorders has recently been extended by introduction of a convenient, tablet-based, disease-modifying vaccine against grass pollen allergy. Allergy immunotherapy tablet (AIT) programmes targeting house dust mite and other allergies are currently in late-phase development. Next-generation allergy vaccines can have optimised potency and onset of action without compromising safety or convenience. Key to achieving these objectives is a combination of evidence-based mode-of-action studies and biomarker-centric translational research approaches. This will rely on using biobank and bioinformatics resources for multi-omic characterisations of the 'immunome' of allergic disease. Other important areas are ongoing paediatric trials and long-term studies in adults for further defining the potential role of SIT in allergic disease and primary prevention of asthma. Finally, combining cellular- and serological-based assays, and developments in targeted delivery platforms and component-resolved diagnostics will lead to increased ability to stratify patients, with more personalised diagnosis and treatment.

A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis

BACKGROUND

Hypochondriasis is common in the clinic and in the community. Cognitive behavioural therapy (CBT) has been found to be effective in previous trials. Psychodynamic psychotherapy is a treatment routinely offered to patients with hypochondriasis in many countries, including Denmark. The aim of this study was to test CBT for hypochondriasis in a centre that was not involved in its development and compare both CBT and short-term psychodynamic psychotherapy (STPP) to a waiting-list control and to each other. CBT was modified by including mindfulness and group therapy sessions, reducing the therapist time required. STPP consisted of individual sessions.

METHOD

Eighty patients randomized to CBT, STPP and the waiting list were assessed on measures of health anxiety and general psychopathology before and after a 6-month treatment period. Waiting-list patients were subsequently offered one of the two active treatments on the basis of re-randomization, and assessed on the same measures post-treatment. Patients were again assessed at 6- and 12-month follow-up points.

RESULTS

Patients who received CBT did significantly better on all measures relative to the waiting-list control group, and on a specific measure of health anxiety compared with STPP. The STPP group did not significantly differ from the waiting-list group on any outcome measures. Similar differences were observed between CBT and STPP during follow-up, although some of the significant differences between groups were lost.

CONCLUSIONS

A modified and time-saving CBT programme is effective in the treatment of hypochondriasis, although the two psychotherapeutic interventions differed in structure.

MHC haplotype and susceptibility to experimental infections (Salmonella Enteritidis, Pasteurella multocida or Ascaridia galli) in a commercial and an indigenous chicken breed

In three independent experimental infection studies, the susceptibility and course of infection of three pathogens considered of importance in most poultry production systems, Ascaridia galli, Salmonella Enteritidis and Pasteurella multocida were compared in two chicken breeds, the indigenous Vietnamese Ri and the commercial Luong Phuong. Furthermore, the association of the Major Histocompatibility Complex (MHC) with disease-related parameters was evaluated, using alleles of the LEI0258 microsatellite as markers for MHC haplotypes. The Ri chickens were found to be more resistant to A. galli and S. Enteritidis than commercial Luong Phuong chickens. In contrast, the Ri chickens were more susceptible to P. multocida, although production parameters were more affected in the Luong Phuong chickens. Furthermore, it was shown that the individual variations observed in response to the infections were influenced by the MHC. Using marker alleles of the microsatellite LEI0258, which is located within the MHC region, several MHC haplotypes were identified as being associated with infection intensity of A. galli. An association of the MHC with the specific antibody response to S. Enteritidis was also found where four MHC haplotypes were shown to be associated with high specific antibody response. Finally, one MHC haplotype was identified as being associated with pathological lesions and mortality in the P. multocida experiment. Although not statistically significant, our analysis suggested that this haplotype might be associated with resistance. These results demonstrate the presence of local genetic resources in Vietnamese chickens, which could be utilized in breeding programmes aiming at improving disease resistance.

Spinal epidural abscesses: conservative treatment for selected subgroups of patients

The aim of this study was to emphasize the importance of non-surgical treatment for subgroups of patients with spinal epidural abscesses (SEA). From 1988 to 2000, thirty cases of epidural spinal abscesses were retrospectively included in the study. The records and radiological studies were evaluated. Staphylococcus aureus was the most frequent microorganism causing SEA in 18 patients. In 20 patients SEA was secondary to interventional procedures. Predisposing factors were present in 15 cases. Fifty per cent was located in the lumbar region. A total of 22 patients received MRI, which always gave the diagnosis of SEA. Surgical treatment was performed in 20 patients. Conservative treatment with antibiotics was used in 10 patients. Eight patients did not have neurological deficits. One patient was critically ill and another patient was paralysed with an epidural lesion extending over six spinal segments. In all cases, a microorganism was known at the time of diagnosis of ESA. The eight patients without deficits recovered completely following treatment with antibiotics. C-reactive protein was the most reliable inflammatory marker to monitor the effect of the treatment. MRI enables diagnosis of ESA before deficits occur. These can safely be treated with antibiotics if the causative microorganism is known, and the neurological status and laboratory values are monitored. Decompressive surgery is restricted to cases with progressive deficits, when the deficits have lasted for less than 36 h and when the microorganism is not known.

Subanalyses of the outcome of two carboplatin-based regimens in the treatment of advanced NSCLC

e19067

Background: Recent data suggest that various chemotherapy regimen may have different efficacy in subsets of patients (pts.) with advanced NSCLC. For that reason we studied if it was also the case for two Carboplatin regimens, Carboplatin-Vinorelbine (CV) and Carboplatin-Gemcitabine (CG), which were used as standard treatments in our centre for two periods Methods: From 1998–2007, 800 consecutive pts. were treated with a 3-weekly schedule of C, AUC=5, plus either V (30 mg/m2 d.1+8), or G (1000 mg/m2 d.1+8) for 4–6 cycles. CV was used as the standard regimen 1998 - 2003, and CG, 2004 - 2007. All pts. were followed to death, and most data have been prospectively recorded, but supplemented with retrospectively collected data from pts. files. The endpoint of this study was crude survival. The data was analysed according to performance status (PS), gender, age, and histology (adenoca., squamous, other NSCLC) Results: 313 pts. were treated with CV, 487 with CG. Median, 1 yr and 2 yr survival was for CV: 8.6 m, 34% and 15%, and for CG: 8.6 m, 37% and 12%, p=0.32. Analysed by histology, adenoca.'s had better median survival, 9.7 m., than non-adenoca., 8.1 m, p= .002, females better than males 10.0 m. vs. 7.9 m., p=.008, and PS 0–1 better than PS=2, 10.0 m. vs. 4.7 m. (p=.000). Age was of no importance. Cox-analyses was performed separately in the two genders. In females, PS 0–1, adenoca. and CG regimen were statistically significant favourable prognostic factors while in males only PS 0–1 were of significance. In the 379 pts. with adenoca., PS and gender were of significance while the chemotherapy was of borderline significance (p=.06). In non- adenoca.'s, only PS was of significance Conclusions: While CV and CG were overall equal effective in the treatment of NSCLC, CG may be the superior regimen in females, and in adenoca.'s. No trends for differential efficacy was found in any other subset of patients

[Table: see text]

Influence of chicken serum mannose-binding lectin levels on the immune response towards Escherichia coli

This study aimed to investigate the effect of mannose-binding lectin (MBL) on infections with Escherichia coli in chickens. Initially, the basic levels of MBL in 4 different lines of layer chickens, namely ISA Brown, Lohmann Selected Leghorn, Lohmann Braun, and Hellevad, were investigated. This investigation revealed a 2-to 3-fold difference in the basic levels of MBL in serum between some of these commercial lines. Furthermore, the ontogeny of the basic level of MBL in serum of an experimental chicken line was investigated. The level of MBL was very stabile for long periods, with an elevation at 5 to 7 wk of age. Another elevation in MBL level started around 18 to 19 wk of age and stayed elevated at least until 38 wk of age. In this study, it was hypothesized that chickens with high levels of MBL (H-type) may be less prone to disease caused by E. coli infection than chickens with low levels of MBL (L-type) after attempts were made to immunosuppress the chickens by immunization with a live attenuated infectious bursal disease virus (IBDV) vaccine strain. The H-type and L-type chickens were divided into 4 groups receiving either no treatment (I-E-), E. coli alone (I-E+), IBDV alone (I+E-), or IBDV and E. coli (I+E+). Body weight gain was depressed by IBDV immunization as well as E. coli inoculation. The depression of BW gain was significantly larger in L-type chickens compared with H-type chickens. The antibody response to E. coli was significantly depressed by IBDV vaccination and antibody titers to E. coli were elevated by experimental E. coli inoculation, but only in the group not given IBDV (I-E- vs. I-E+). On d 28, T-cell responses in L-type chickens showed a lower percentage of proliferating CD4+ and CD8+ T cells compared with the H-type, regardless of treatment. In conclusion, immune reactions toward infections with E. coli differed between chickens having different basal serum MBL levels, and as such, MBL may be of importance for future selection of more robust chickens for outdoor or organic farming.

Bilateral Wyburn-Mason syndrome presenting as acute subarachnoid haemorrhage - a very rare congenital neurocutaneous [corrected] disorder

A 30 year old young male was admitted to our department after experiencing clinical symptoms of a subarachnoid haemorrhage. Imaging studies revealed large cerebral AVMs. Fundus examination of the left eye demonstrated a retinal racemose AVM almost completely covering the posterior pole of the eye. Wyburn-Mason syndrome is a very rare congenital neurocutaneous disorder comprising of vascular malformations of the retina, ipsilateral cerebral AVMs and occasionally lesions in the oronasopharyngeal area. Subarachnoid haemorrhage associated with Wyburn-Mason syndrome has been described in only 5 patients in the literature since 1973. The finding of retinal AVMs should warrant cerebral imaging studies including CT- or MR-angiography.

Fine-mapping QTL for mastitis resistance on BTA9 in three Nordic red cattle breeds

A QTL affecting clinical mastitis and/or somatic cell score (SCS) has been reported previously on chromosome 9 from studies in 16 families from the Swedish Red and White (SRB), Finnish Ayrshire (FA) and Danish Red (DR) breeds. In order to refine the QTL location, 67 markers were genotyped over the whole chromosome in the 16 original families and 18 additional half-sib families. This enabled linkage disequilibrium information to be used in the analysis. Data were analysed by an approach that combines information from linkage and linkage disequilibrium, which allowed the QTL affecting clinical mastitis to be mapped to a small interval (<1 cM) between the markers BM4208 and INRA084. This QTL showed a pleiotropic effect on SCS in the DR and SRB breeds. Haplotypes associated with variations in mastitis resistance were identified. The haplotypes were predictive in the general population and can be used in marker-assisted selection. Pleiotropic effects of the mastitis QTL were studied for three milk production traits and eight udder conformation traits. This QTL was also associated with yield traits in DR but not in FA or SRB. No QTL were found for udder conformation traits on chromosome 9.

Gastrointestinal helminths in indigenous and exotic chickens in Vietnam: association of the intensity of infection with the Major Histocompatibility Complex

This study compared the prevalence and intensity of infections of helminths in 2 chicken breeds in Vietnam, the indigenous Ri and the exotic Luong Phuong. Also, possible correlations with the Major Histocompatibility Complex (MHC) were tested. The most prevalent helminths were Ascaridia galli, Heterakis beramporia, Tetrameres mothedai, Capillaria obsignata, Raillietina echinobothrida and Raillietina tetragona. Differences in prevalence and intensity of infection were found between the 2 breeds. Comparing the 2 groups of adult birds, Ri chickens were observed to have higher prevalence and infection intensities of several species of helminths, as well as a higher mean number of helminth species. In contrast, A. galli and C. obsignata were shown to be more prevalent in Luong Phuong chickens. Furthermore, an age-dependent difference was indicated in the group of Ri chickens in which the prevalence and the intensity of infection was higher for the adult than the young chickens for most helminths. The most notable exception was the significantly lower prevalence and intensities of A. galli in the group of adult chickens. In contrast, the prevalence and intensity were very similar in both age groups of Luong Phuong chickens. Using a genetic marker located in the MHC, a statistically significant correlation between several MHC haplotypes and the infection intensity of different helminth species was inferred. This is the first report of an association of MHC haplotype with the intensity of parasite infections in chickens.

The influence of body weight on response to ovulation induction with gonadotrophins in 335 women with World Health Organization group II anovulatory infertility

OBJECTIVE

To assess the influence of body weight on the outcome of ovulation induction in women with World Health Organization (WHO) group II anovulatory infertility.

DESIGN

The combined results of two studies in which either a highly purified urinary follicle-stimulating hormone or highly purified urinary menotrophin were compared with recombinant follicle-stimulating hormone.

SETTING

Thirty-six fertility clinics.

POPULATION

A total of 335 women with WHO group II anovulatory infertility failing to ovulate or conceive on clomifene citrate.

METHODS

Ovarian stimulation using a low-dose step-up protocol.

MAIN OUTCOME MEASURES

The effects of body weight on ovarian response, ovulation rate and pregnancy rate after one treatment cycle.

RESULTS

With increasing body mass index (BMI), a higher threshold dose of gonadotrophins was required and there were more days of stimulation; yet, despite a greater concentration of antral follicles, there were fewer intermediate and large follicles. There was no difference in the rates of ovulation and clinical pregnancy in relation to body weight.

CONCLUSIONS

Body weight affects gonadotrophin requirements but not overall outcome of ovulation induction in women with anovulatory polycystic ovary syndrome and a BMI of less than 35 kg/m2.

Foot Pad Dermatitis and Hock Burn in Broiler Chickens and Degree of Inheritance

A total of 2,118 birds from 2 strains were allocated to 12 groups of 93 to 100 each in 2 time-separated replicates. The development of foot pad dermatitis (FPD) and hock burn (HB) were recorded weekly from d 8 to slaughter on a set sample of live animals (7 per group). In addition, feet and hocks of all birds were investigated at slaughter at either 4, 6 (fast-growing strain), 8, or 10 (slow-growing strain) wk of age. Lesions were scored for both the left and right foot and classified according to a scale from 1 (no lesion) to 9 (very severe lesions) for FPD and from 1 (no lesion) to 3 (very severe lesions) for HB. No FPD lesions and very few low-grade HB lesions were found in chickens from the slow-growing strain. In the fast-growing strain, the first signs of FPD and HB were seen in wk 2. The incidence of both types of lesions increased thereafter. Foot pad dermatitis was more frequent in females (49 vs. 36%, P < 0.05). Body weight did not affect FPD, but more HB were found at higher BW (P < 0.01). Egg weight influenced neither FPD nor HB. Variance and covariance components were analyzed using a multivariate animal model, in which scores for FPD and HB were transformed into logarithmic scale. The analyses were carried out using restricted maximum likelihood algorithm. Heritabilities were estimated to be 0.31 +/- 0.12 (SE) for FPD, 0.08 +/- 0.08 for HB, and 0.38 +/- 0.13 for BW. Genetic correlations among these traits were low and nonsignificant. Phenotypic correlation between BW and FPD was low and nonsignificant and between BW and HB was 0.17 +/- 0.05 (P < 0.01). The relative high heritability of FPD and the low genetic correlation to BW suggested that genetic selection against susceptibility to FPD should be possible without negative effects on BW gain.

Multitrait Quantitative Trait Loci Mapping for Milk Production Traits in Danish Holstein Cattle

The aims of this study were (1) to confirm previously identified quantitative trait loci (QTL) on bovine chromosomes 6, 11, 14, and 23 in the Danish Holstein cattle population, (2) to assess the pleiotropic nature of each QTL on milk production traits by building multitrait and multi-QTL models, and (3) to include pedigree information on nongenotyped individuals to improve the estimation of genetic parameters underlying the random QTL model. Nineteen grandsire families were analyzed by single-trait (ST) and multitrait (MT) QTL mapping methods. The variance component-based QTL mapping model was implemented via restricted maximum likelihood (REML) to estimate QTL position and parameters. Segregation of the previously identified QTL was confirmed on bovine chromosomes 6, 11, and 14, but not on 23. A highly significant (1% chromosome-wise level) QTL was found on chromosome 6, between 37 and 73 cM. This QTL had a strong effect on protein percentage (PP) and fat percentage (FP) according to ST analyses, and effects on PP, FP, milk yield (MY), fat yield (FY), and protein yield (PY) in MT analyses. A QTL affecting PP was detected on chromosome 11 (at 70 cM) using ST analysis. The MT analysis revealed a second QTL (at 67 cM) approaching significance with an effect on MY. The ST analysis identified a QTL for MY and FP on chromosome 14, between 10 and 24 cM. The extended pedigree (nongenotyped animals) was included to estimate genetic parameters underlying the random QTL model; that is, additive polygenic and QTL variances. In general, the estimates of the QTL variance components were smaller but more precise when the extended pedigree was considered in the analysis.

Significant variation in mortality and functional outcome after acute ischaemic stroke between Western countries: data from the tinzaparin in acute ischaemic stroke trial (TAIST)

BACKGROUND

The medical care of patients with acute stroke varies considerably between countries. This could lead to measurable differences in mortality and functional outcome.

OBJECTIVE

To compare case mix, clinical management, and functional outcome in stroke between 11 countries.

METHODS

All 1484 patients from 11 countries who were enrolled into the tinzaparin in acute ischaemic stroke trial (TAIST) were included in this substudy. Information collected prospectively on demographics, risk factors, clinical features, measures of service quality (for example, admission to a stroke unit), and outcome were assessed. Outcomes were adjusted for treatment assignment, case mix, and service relative to the British Isles.

RESULTS

Differences in case mix (mostly minor) and clinical service (many of prognostic relevance) were present between the countries. Significant differences in outcome were present between the countries. When assessed by geographical region, death or dependency were lower in North America (odds ratio (OR) adjusted for treatment group only = 0.52 (95% confidence interval, 0.39 to 0.71) and north west Europe (OR = 0.54 (0.37 to 0.78)) relative to the British Isles; similar reductions were found when adjustments were made for 11 case mix variables and five service quality measures. Similarly, case fatality rates were lower in North America (OR = 0.44 (0.30 to 0.66)) and Scandinavia (OR = 0.50 (0.33 to 0.74)) relative to the British Isles, whether crude or adjusted for case mix and service quality.

CONCLUSIONS

Both functional outcome and case fatality vary considerably between countries, even when adjusted for prognostic case mix variables and measures of good stroke care. Differing health care systems and the management of patients with acute stroke may contribute to these findings.

Divergent Selection on Feather Pecking Behavior in Laying Hens Has Caused Differences Between Lines in Egg Production, Egg Quality, and Feed Efficiency

The correlated changes in egg production, egg quality, and feed efficiency (FE) due to selection for feather pecking (FP) were investigated by analyzing the data from an experiment including 2 divergently selected lines and a control line. The experiment was conducted with hens from 42 to 46 wk (hatch 1) and 39 to 43 wk (hatch 2) of age in the fifth generation of selection. The number of FP bouts per hour in the low FP line (LFP) was lower than the high FP line (HFP; 0.38 vs. 2.01), and total plumage score in line LFP was better than in line HFP (16.9 vs. 11.6). During the 4 wk, egg number and egg mass in line LFP were higher than those in HFP (24.4 vs. 18.3 and 1,223 vs. 1,132 g, respectively). On the other hand, line HFP had greater egg weight (60.7 vs. 59.2 g), albumen height (73.0 vs. 64.9 in Haugh units), shell thickness (38.1 vs. 37.0 mm), and yolk percentage (30.6 vs. 29.5%) than the LFP line. The control line was intermediate for those traits. The residual feed consumption (RFC) was highest in line HFP, lowest in line LFP, and intermediate in line C. Partial regressions of feed consumption (FC) on BW gain and egg mass were not significantly different among the 3 lines, whereas a significant difference in regression on metabolic BW (32.6 g/d in line LFP, 38.0 g/d in control line, and 43.4 g/d in line HFP) was observed. In addition, there was a negative regression of FC per day on plumage score (-1.73 g). The adjustment for plumage score accounted for 60% of the difference between regressions on metabolic BW in lines LFP and HFP. These results indicated that selection for FP has led to a change in egg production, egg quality, and FE. The better FE in line LFP resulted from a lower requirement for maintenance energy. The later was partly accounted for by a better plumage cover.

Variance components and selection response for feather-pecking behavior in laying hens

Variance components and selection response for feather pecking behavior were studied by analyzing the data from a divergent selection experiment. An investigation indicated that a Box-Cox transformation with power lambda = -0.2 made the data approximately normally distributed and gave the best fit for the model. Variance components and selection response were estimated using Bayesian analysis with Gibbs sampling technique. The total variation was rather large for the investigated traits in both the low feather-pecking line (LP) and the high feather-pecking line (HP). Based on the mean of marginal posterior distribution, in the Box-Cox transformed scale, heritability for number of feather pecking bouts (FP bouts) was 0.174 in line LP and 0.139 in line HP. For number of feather-pecking pecks (FP pecks), heritability was 0.139 in line LP and 0.105 in line HP. No full-sib group effect and observation pen effect were found in the 2 traits. After 4 generations of selection, the total response for number of FP bouts in the transformed scale was 58 and 74% of the mean of the first generation in line LP and line HP, respectively. The total response for number of FP pecks was 47 and 46% of the mean of the first generation in line LP and line HP, respectively. The variance components and the realized selection response together suggest that genetic selection can be effective in minimizing FP behavior. This would be expected to reduce one of the major welfare problems in laying hens.

Influence of early or late start of first feeding on growth and immune phenotype of broilers

1. The changes in body weight (BW) gain, immune phenotype and viability of commercial broilers, either given feed and water immediately after hatch or food-deprived for 24 or 48 h, were analysed in order to study the effect of early or late start of first feeding. 2. Chickens fed immediately had a 6.1% higher BW at slaughter age than those food-deprived for 48 h, while those chickens food-deprived for 24 h only had a 1.4% higher weight than those deprived for 48 h. 3. Those fed immediately and those food-deprived for 24 h did not differ significantly in BW. 4. Humoral immune status was measured as specific IgG antibody production and concentration of IgM and IgG in serum. Cellular immunological variables were the proportion of circulating leukocyte subpopulations and the relative expression of leukocyte surface markers, including the relative expression of Major Histocompatibility Complex (MHC) antigens. 5. Differences were found between the three feeding treatments in the relative expression of MHC class II molecules, the relative expression of BU-1 molecules, and the ratio of CD4:CD8 single positive cells. 6. For the MHC class II molecules, a lower expression was found on the surface of mainly B-cells in chickens fed immediately compared with the two other feeding regimes. 7. These results suggest that food deprivation for 48 h may be unfavourable to the growth, viability, and the immune performance of broilers, whereas deprivation for 24 h appears to be acceptable for growth and normal immunological performance.

Comparative genetic resistance to Ascaridia galli infections of 4 different commercial layer-lines

1. The objective of the study was to compare the establishment and effect of Asaridia galli infections in 4 different layer-lines. 2. A total of 160 birds comprising 4 different commercial layer-lines, ISA Brown, New Hampshire, Skalborg and a cross of New Hampshire(NH) and Skalborg (Sk), were infected with A. galli eggs. The birds were examined for the presence of parasite eggs and parasites at weeks 3, 6 and 9 post infection (pi). 3. At week 6 pi the chickens of the NH line harboured more larvae compared with the three otherlines. The Sk line chickens excreted more A. galli eggs throughout the study compared with the other lines. Female worms in the Sk line were more fecund than the worms in the other lines. Male and female worms recovered from the Sk line at week 9 pi were longer. Male worms recovered from the NH line 6 weeks pi were shorter than male worms from the other lines. Female worms recovered from the NH line were shorter than the female worms from the ISA line and the Sk line. No differences were seen in weight gain among the 4 lines. 4. The results suggest that genetic factors are involved in the establishment and survival of A. galli in the intestine of layers. Further studies are needed to elucidate the genetic mechanisms behind the observed parasitological findings.

Search for pleiotropic QTL on chromosome BTA6 affecting yield traits of milk production

The primary aim of this study was to investigate whether previous findings of similar quantitative trait loci (QTL) positions for correlated yield traits are due to a pleiotropic QTL. We applied a multitrait variance component based QTL mapping method to a dataset involving five granddaughter families from the German Holstein dairy cattle population. The marker map contained 16 microsatellite markers, distributed across chromosome BTA6. A chromosomewise significance threshold was used, because BTA6 is known to harbor QTL for several milk traits. To evaluate the results from the multivariate, across-family analysis, we also conducted single-family analyses using the least squares method of QTL estimation. The results provided two significant QTL findings at 49 and 64 cM for milk yield in different families and putative QTL at 68 cM for fat yield and at 71 cM for protein yield in another family. The results for fat and protein yield were confirmed by a univariate, across-family variance components analysis. The multivariate analysis of three bivariate trait combinations resulted in a significant pleiotropic QTL finding at 68 cM for fat yield and protein yield, bracketed by markers TGLA37 and FBN13. The estimates of variance contribution due to this QTL were 23% and 25%, respectively.

Serum levels of mannan-binding lectin in chickens prior to and during experimental infection with avian infectious bronchitis virus

Mannan-binding lectin (MBL) is a glycoprotein and a member of the C-type lectin super family, the collectin family, and the acute phase protein family. The MBL exerts its function by directly binding to microbial surfaces through its carbohydrate recognition domains, followed by direct opsonization or complement activation via MBL-associated serine proteases (MASP)-1 and -2. Thus, MBL plays a major role in the first-line innate defense against pathogens. We investigated the MBL concentrations in serum during experimental infectious bronchitis virus (IBV) infections in chickens. The results showed that the acute phase MBL response to infection with IBV was, to a degree (P < 0.0068), dependent on whether the chickens were inoculated after 12 h of rest (dark) or after 12 h of activity (light). The acute phase response in chickens challenged after 12 h of activity peaked after 4.6 d with an increase of 24%, whereas the acute phase response in chickens challenged after 12 h of rest peaked after 3.1 d with an increase of 51%. The specific antibody titer against IBV was also tested, and a difference (P < 0.0091) between the two experimental groups was found with peak titer values of 6,816 and 4,349. However, the highest value was found in chickens inoculated after 12 h of activity. Thus, an inverse relation exists between the MBL response and the IBV specific antibody response. The ability of MBL to activate the complement cascade was tested in a heterologous system by deposition of human C4 on the chicken MBL/MASP complex. The complement activation was directly associated with the concentration of MBL in serum, indicating neutralization of the virus before the humoral antibody response took over.

Multitrait fine mapping of quantitative trait loci using combined linkage disequilibria and linkage analysis

A novel multitrait fine-mapping method is presented. The method is implemented by a model that treats QTL effects as random variables. The covariance matrix of allelic effects is proportional to the IBD matrix, where each element is the probability that a pair of alleles is identical by descent, given marker information and QTL position. These probabilities are calculated on the basis of similarities of marker haplotypes of individuals of the first generation of genotyped individuals, using "gene dropping" (linkage disequilibrium) and transmission of markers from genotyped parents to genotyped offspring (linkage). A small simulation study based on a granddaughter design was carried out to illustrate that the method provides accurate estimates of QTL position. Results from the simulation also indicate that it is possible to distinguish between a model postulating one pleiotropic QTL affecting two traits vs. one postulating two closely linked loci, each affecting one of the traits.

Polymorphism in the bovine growth hormone gene affects endocrine release in dairy calves

The objective was to test whether calves with the Leu/Leu genotype release more growth hormone (GH) than calves with Leu/Val and Val/Val genotypes. Danish Holstein (n = 286), Danish Red (n = 68), and Danish Jersey (n = 61) calves were genotyped for the Leu/Val polymorphism in the GH gene and assessed for GH release following inducement by the growth hormone releasing hormone (GHRH). Three GH traits were assessed for each calf: BASELINE, PEAK, and RATE. BASELINE and PEAK are the mean concentration of GH in blood sampled before and after GHRH inducement. RATE is the disappearance rate of GH in blood sampled after GHRH inducement. Danish Jersey calves with Leu/Leu genotype had a higher PEAK and RATE than calves with the Val/Val genotype, whereas the Leu/Val genotype had an intermediate response. The contribution of the Leu/Val polymorphism to the total genetic variation of the BASELINE, PEAK, and RATE traits was 5, 30, and 27%, respectively. By contrast, the amount of GH released by the Danish Holstein and Danish Red calves was not influenced by their GH genotype. Further studies involving calves with all three genotypes are required to further elucidate whether this polymorphism has a functional role or whether it works through a linked-gene effect specific to certain cattle breeds.

Phase II study of vinorelbine in the treatment of platinum-resistant ovarian carcinoma

OBJECTIVE

The purpose of this phase II study was to evaluate on an intent-to-treat basis the activity and toxicity of single-agent vinorelbine (VRL) as second-line chemotherapy of patients with platinum-resistant ovarian cancer. Platinum-resistant disease was defined as disease refractory to or relapsing within 12 months after finishing platinum-containing chemotherapy.

METHODS

VRL (30 mg/m(2)) was administered intravenously as a bolus injection days 1 and 8 every 21 days. Initially, four courses of VRL were given. Patients with responding or stable disease received four more courses of VRL to a maximum of eight courses.

RESULTS

Twenty-eight of 33 eligible patients were considered evaluable for response. The overall response rate was 21% (7/33) (95% CI: 7--35). Median time to progression was 3.1 months and median survival was 10.1 months. Toxicity was generally mild. Leukopenia was the dose-limiting toxicity. CALGB grade III/IV infection was observed in 15/0% of patients. The most important nonhematologic toxicities were nausea and constipation. Grade III/IV nausea was observed in 6/0% and grade III/IV constipation in 3/3% of patients. Peripheral neurotoxicity was only a minor problem with no grade III/IV toxicity. No patients stopped treatment because of toxicity and no toxic death was reported.

CONCLUSION

VRL was generally well tolerated, but the activity in platinum-resistant ovarian cancer was only modest, although fully comparable to other second-line treatments. Further studies are required to define the role of VRL in combination chemotherapy for ovarian cancer.

Acute respiratory tract infections and mannose-binding lectin insufficiency during early childhood

CONTEXT

Hospital-based studies have found that increased susceptibility to certain infections is associated with low serum levels of mannose-binding lectin (MBL) due to MBL variant alleles. However, the contribution of MBL insufficiency to incidence of common childhood infections at a population level is unknown.

OBJECTIVE

To investigate the effect of MBL insufficiency on risk for acute respiratory tract infection (ARI) in unselected children younger than 2 years.

DESIGN AND SETTING

Population-based, prospective, cohort study conducted in Sisimiut, Greenland.

PARTICIPANTS

Two hundred fifty-two children younger than 2 years who were followed up weekly between August 1996 and August 1998 for morbidity surveillance.

MAIN OUTCOME MEASURE

Risk of ARI, based on medical history and clinical examination, compared by MBL genotype, determined from blood samples based on presence of structural and promoter alleles.

RESULTS

A 2.08-fold (95% confidence interval [CI], 1.41-3.06) increased relative risk (RR) of ARI was found in MBL-insufficient children (n = 13) compared with MBL-sufficient children (n = 239; P<.001). The risk association was largely restricted to children aged 6 to 17 months (RR, 2.92; 95% CI, 1.78-4.79) while less effect (RR, 1.47; 95% CI, 0.45-4.82) and no effect (RR, 1.00; 95% CI, 0.42-2.37) was shown among children aged 0 to 5 months and 18 to 23 months, respectively.

CONCLUSION

These data suggest that genetic factors such as MBL insufficiency play an important role in host defense, particularly during the vulnerable period of childhood from age 6 through 17 months, when the adaptive immune system is immature.

Divergent selection on feather pecking behaviour in laying hens (Gallus gallus domesticus)

A selection experiment was initiated in 1996 in which selection for (HP line) and against (LP line) feather pecking was performed. The foundation stock was a White Leghorn layer strain established in 1970 and maintained since then as a random bred control line at the Institute. Six hatches were produced over three generations. At the age of 68 weeks (generation 0, 1996), 35 weeks (generation 1, 1997), 30 weeks (generation 2, 1998), and 27 weeks (generation 3, 1999) female birds were transferred to observation pens and their feather pecking behaviour was recorded. In each generation, 30 females and 8 males were selected from approximately 200 females and 60 males. The selection criterion was breeding value estimated by animal model on the trait 'number of bouts of feather pecking per bird per hour'.Feather pecking behaviour in adult hens was significantly higher in HP than in LP. In generation 2 the following was recorded: 3.10 versus 1.37 bouts per bird per hour (P<0.01), 7.04 versus 3.58 pecks per bird per hour (P<0.05) and the proportion of hens recorded feather pecking in the 180min observation period was 67 versus 56% (P<0.05). In generation 3 the following was recorded: 4.56 versus 0.63 bouts per bird per hour (P<0.001), 13.9 versus 2.51 pecks per bird per hour (P<0.001) and the proportion of hens recorded feather pecking in the 180min observation period was 75 versus 49% (P<0.001).In generation 3, plumage condition was better in LP on neck, breast, back, wings and tail, as well as overall (P<0.001). Body weight did not differ between lines in generation 2, but in generation 3, HP hens were on average heavier than LP hens at the age of 27 weeks (1435g versus 1371g, P<0.001).

Relationships in broiler chickens between lameness, liveweight, growth rate and age

Thirteen genotypes of poultry were selected to represent a wide range of growth profiles and were fed either a non-limiting or Label Rouge diet. The birds' degree of lameness and liveweight were measured after 54 and 81 days. The birds reared on the Label Rouge diets were less lame than birds of the same genotype reared on the non-limiting diet. More traditional and slower growing genotypes tended to be less lame than the modern genotypes reared on the same feeding regimen. All the birds, irrespective of their genotype or diet, were less lame after 54 days than after 81 days. However, when liveweight was included in the analysis as a covariable, many of the differences disappeared. Only age at assessment significantly affected the walking ability of the birds, with the birds being approximately 0.6 units of gait score worse at 54 days of age than at 81 days. The regression coefficient between gait score and liveweight was 1.262 at 54 days and 1.128 at 84 days. The results indicated that liveweight was an important determinant of lameness in the diverse range of genotypes examined, that growth rate was also an important determinant of lameness and that younger birds may be more sensitive to differences in liveweight than older birds.

Genetic variation in stimulated GH release and in IGF-I of young dairy cattle and their associations with the leucine/valine polymorphism in the GH gene

Genetic variations in plasma GH concentrations before and following thyrotropin-releasing hormone (TRH) stimulation and in IGF-I concentrations were studied in 11-mo-old Polish Friesian cattle (104 heifers and 110 bulls). A possible association between stimulated GH release, IGF-I, and the polymorphism in the GH gene causing substitution of leucine-Leu to valine-Val at amino acid position 127 of the protein was also investigated. The GH concentrations were determined in serial plasma samples collected every 15 min from 15 min before to 135 min after intravenous administration of 0.15 microg TRH/kg live weight. The analysis was performed on three variables: baseline (mean of samples at -15 and 0 min), peak (sample at 15 min after injection) and rate (peak minus sample at 60 min, divided by 45 min). The IGF-I concentrations were measured in plasma samples taken before the TRH stimulation. Additionally, first lactation records from the 75 cows earlier tested for GH release and IGF-I were used to study a possible association of milk production traits with GH genotypes. The data were analyzed by multivariate mixed linear models. The heritability of IGF-I reached a higher value (0.35) than variables baseline, peak, and rate (0.02, 0.14, and 0.14, respectively). The GH variables were positively genetically correlated with each other (0.22 to 0.93), whereas they had negative genetic correlations with IGF-I (-0.26). The Val/Val genotypes reached the highest peak value compared with other GH genotypes (P > 0.01), whereas the Leu/Leu genotypes had the highest IGF-I concentrations (P < or = 0.05). Moreover, the Leu/Val heterozygotes were superior to others in milk and protein yields, whereas the Leu/Leu homozygotes reached the highest fat yield (P > or = 0.01). We conclude that GH peak, GH rate, and IGF-I are heritable traits in young dairy cattle and are affected by the Leu/Val polymorphism in the GH gene.