OCTN2 mutation (R254X) found in Saudi Arabian kindred: recurrent mutation or ancient founder mutation?

The truncating R254X mutation in the OCTN2 gene results in defective high-affinity carnitine transport and has been previously described as a founder mutation in the Chinese population. We now report a Saudi Arabian kindred with this same mutation, suggesting that it may be a recurrent mutation or a very ancient founder mutation. Western blot analysis of skin fibroblast lysates from the proband with our specific anti-murine OCTN2 antibody revealed the absence of the OCTN2 protein.

Purification of the major allergen of red soft coral (Dendronephthya nipponica)

Red soft coral (RSC; Dendronephthya nipponica, a marine coelenterate) causes spiny lobster fishermen living along the Pacific coast of Miyazaki Prefecture in Japan to develop occupational allergies, such as conjunctivitis, rhinitis, dermatitis and bronchial asthma. The aim of this study was to purify and to characterize RSC allergen, which causes occupational asthma in spiny lobster fishermen. The allergic responsiveness of spiny lobster fishermen to RSC was examined. The examinations included specific IgE production, skin test responses, lymphocyte stimulation tests and specific IgG production. We found that RSC has a strong sensitizing activity in humans at a molecular weight of 10 kD or more, while it has no IgE-producing activity at a molecular weight of less than 10 kD. Neither the nonatopic controls nor the atopic non-coral-allergic controls exhibited any RAST-binding activity to any fraction. For the purification and the identification of this new allergen component, repeated gel filtration of the RSC extract was performed on a Sephacryl S-200 column, followed by gel filtration on a Superose-6 column. The purified major allergen component Den n 1, which is separated on a Mono-Q column, showed intradermal responses, lymphocyte stimulating activity and specific IgG-producing activity in RSC-induced bronchial asthma patients. The 53-kD component was electroblotted on a polyvinylidene difluoride membrane. The N-terminal amino acid sequence of this new allergen component (Den n 1) was determined as Asp-Asp-Ile-Asn-Arg-Tyr-Ala-Phe-Asp-Asn-Lys-Ile-Asn- Asp-Lys-Leu-Phe-Asp-His-Trp-Gln-Ser.

Polymerase chain reaction based assessment of leukoreduction efficacy using a cytomegalovirus DNA transfected human T-cell line

BACKGROUND AND OBJECTIVES

Detection of CMV DNA by PCR in seropositive blood donors is affected by nucleic acid extraction, amplification conditions and PCR product detection sensitivity. Clinical studies have shown that leukoreduced blood products are as effective as CMV-seronegative blood products in minimizing transfusion-associated CMV infection. We developed a PCR-based test model to assess the efficacy of leukoreduction on the removal of CMV DNA from blood donations.

MATERIALS AND METHODS

Whole blood units were spiked with a human Jurkat T-lymphocyte cell line which had been stably transfected with a CMV DNA immediate early sequence. All blood units were either CMV seronegative or shown to be CMV PCR negative. The amount of CMV DNA by PCR before, during and after filtration of blood units with third-generation leukocyte reduction filters were determined using a semi-quantitative adaptation of the Digene SHARP Signal System Assay (DSSSA).

RESULTS

Whole blood units spiked with 1-2 x 10(6) CMV transfected Jurkat cells contained no detectable CMV DNA after leukoreduction. With a higher inoculum of 2.9 x 10(8) transfected Jurkat cells per unit, CMV DNA was detected after leukoreduction; however, there was an approximate 3 log decrease in the amount of CMV DNA detected.

CONCLUSION

This CMV DNA transfected human Jurkat cell line in conjunction with semi-quantitative CMV PCR may be used to model leukoreduction efficacy and provides evidence that leukoreduction of blood products can decrease the amount of cellular CMV DNA by approximately 3 logs.

[A successfully treated case of miliary tuberculosis with adult respiratory distress syndrome and tuberculous aneurysm of abdominal aorta]

A 52-year-old woman visited a physician on Oct. 17, 1995 because of dizziness, general fatigue and a slight fever. A Chest X-ray film showed micronodulous and infiltrative shadows in the bilateral upper lung fields. Liver dysfunction was also recognized. As dyspnea and hypoxemia progressed very rapidly, the patient was intubated and kept under mechanical ventilation. A diagnosis of miliary tuberculosis with adult respiratory distress syndrome (ARDS) was made based on the detection of acid-fast bacilli from sputum obtained from the endotracheal tube. She was admitted to our hospital on Oct. 24, 1995 receiving anti-tuberculous drugs combined with high-dose methylprednisolone. As disseminated intravascular coagulation (DIC) and acute pancreatitis also developed, gabexate mesilate was added to the preceding therapy. This combination therapy was effective and the patient gradually improved. Two months after the admission, aneurysms of the abdominal aorta and left renal artery were discovered. As the size of the aneurysms had been increasing along with abdominal and low back pain, the patient was transferred to an other hospital for surgical treatment. She underwent a successful operation for pseudoaneurysms, the etiology of which was tuberculosis according to pathological findings and detection of acid-fast bacilli from the resected specimens. This is the 10th case of tuberculous aneurysm of the aorta which was successfully operated on in Japan. ARDS, DIC and aneurysm occur rarely as complications of miliary tuberculosis, but they are life-threatening, and lead to a serious prognosis if untreated. Early diagnosis of miliary tuberculosis and tuberculous aneurysm is very important for a good outcome.

[A report of outbreaks of pulmonary tuberculosis in two bars]

We experienced small outbreaks of M. tuberculosis infection in two bars. 9 patients were diagnosed as tuberculosis by identifying M. tuberculosis from their sputa. Six of them were regular customers or employees of the bar, one of them was a family members. Each outbreak within the two bars was suspected of the common source of infection, because one patient was a regular customer of the both bars. The analysis of restriction fragment length polymorphism (RFLP) was done on 5 strains of M. tuberculosis which were isolated from five of 9 patients. The result unexpectedly showed that 5 isolates were classified into 3 groups. Within each group, identical fingerprints were shown. It does mean that each outbreak in two bars was originated from independent source. There was also one relapsed case of tuberculosis. He was suspected of relapsed tuberculosis after a period of 7 years because of the similarity of drug resistance compared with his primary tuberculosis. It was cleared up that 3 different strains of M. tuberculosis were concerned with these outbreaks in the two bars. In this case, almost all patients were heavy drinkers, however, liver dysfunction and malnutrition were not recognized among them. These experiences indicate that a place like bar may be a space of infection of M. tuberculosis. We should always keep in mind a spread of tuberculosis in a place like a bar as one of problems in tuberculosis control.

[An investigation of the clinical utility of serum interleukin-5 measurements in bronchial asthma patients]

Bronchial asthma has been identified as a chronic inflammatory airway disorder associated with cell infiltration (mainly eosinophils) and airway epithelial cell detachment caused by the activation of infiltrated cells. Interleukin-5 (IL-5), a cytokine closely related to the production and activation of eosinophils, has been shown to induce the proliferation and differentiation of eosinophils, prolong their survival, and to enhance the functions of mature eosinophils. We monitored clinically the changes in serum IL-5 concentrations in patients with bronchial asthma both during and after asthma attacks. The relationship serum IL-5 concentrations and the type and severity of bronchial asthma, as well as eosinophil counts in sputum, was investigated. We also measured changes in IL-5 concentrations during steroid therapy. IL-5 concentrations were significantly decreased during asthma attacks and after their relief (p < 0.001). An analysis of blood samples taken from 55 patients suffering asthma attacks showed that serum IL-5 concentrations were significantly higher in non-atopy-type asthma than in atopy-type asthma (p < 0.05). Serum IL-5 levels are highest in severe asthma, followed by moderate asthma (p < 0.001) and mild asthma (p < 0.001). Serum IL-5 concentrations during asthma attacks and eosinophil counts in sputum were closely correlated (r = 0.85). Serum IL-5 concentrations were below the limit of determination and decrease the number of eosinophils in sputum was noted in 15 patients whose asthma was well-controlled by the long-term inhalation of beclometasone. Serum IL-5 concentrations did not decrease below the limit of determination (even during attack-free periods) in patients whose disease could not be well controlled by 6-month inhalation therapy with beclometasone. In patients with major and moderate bronchial asthma attacks, serum IL-5 concentrations decreased as symptoms improved over time following the i.v. infusion of steroids, suggesting that steroids are effective in inhibiting the production of IL-5. Measurement serum IL-5 concentrations could be clinically useful in the determination of the pathology (e.g., severity) of bronchial asthma could serve as an index for the degree of control of asthma, and may be useful in determining the disease's long-term prognosis.

Guinea pig asthma induced by red soft coral (Dendronephthya nipponica) inhalation

Spiny lobster fishermen on the Pacific coast of Miyazaki Prefecture in Japan develop bronchial asthma due to occupational sensitization to red soft coral (Dendronephthya nipponica). To assess the role of sensitization in the development of bronchial hyperresponsiveness and the relationship between bronchial responsiveness and bronchial inflammation, we established a guinea pig model of red soft coral induced asthma. Twenty-four guinea pigs were intramuscularly immunized with a priming dose of red soft coral, 5 OD280 (15 mg protein) per 0.5 ml, and 0.5 ml complete Freund's adjuvant on day 1. Booster doses were repeated on day 15. By day 43 all sensitized animals showed high hemagglutination titers against red soft coral conjugated sheep erythrocytes and high IgG1 titers by passive cutaneous anaphylaxis. On day 43, the animals were challenged by inhalation of red soft coral extracts, 20 OD280 for 30 min. The respiratory resistance was monitored by the oscillation method. The respiratory resistance increased immediately upon inhalation in all sensitized animals and returned to baseline within 4 h. The bronchial reactivity to acetylcholine, measured 6 h after red soft coral inhalation in the sensitized animals when the respiratory resistance was returned to baseline, increased significantly (p < 0.05) as compared with the values measured 24 h before inhalation. The acetylcholine response measured 30 h later did not differ from preinhalation levels. There was a significant difference in the number of eosinophils (p < 0.001) in lamina propria and epithelium and of lymphocytes (p < 0.05) in the lamina propria 6 h after inhalation in the sensitized animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Activation of Na+/H+ exchange and the expression of cellular proto-oncogenes in mitogen- and phorbol ester-treated lymphocytes

It has been suggested that an intracellular alkalinization, resulting from stimulation of Na+/H+ exchange, is a necessary step and perhaps the signal leading to cellular proliferation in cells stimulated by mitogens. This hypothesis was tested by measuring the early stages of the proliferative cascade in cells where antiport activity was precluded by omission of Na+ or by the addition of potent amiloride analogs. To circumvent possible nonspecific effects due to long incubations under these conditions, an early response to mitogens, the increased level of c-fos mRNA, was monitored. In rat thymic lymphocytes, the increase in the level of c-fos RNA induced by the combination of 12-O-tetradecanoylphorbol 13-acetate and ionomycin was unaffected by inhibition of the antiport with 5-(N-ethyl-N-propyl)amiloride. Increased c-fos RNA was also observed in the absence of Na+ and when alkalinization was prevented by means of nigericin. Similar results were obtained with phytohemagglutinin-stimulated human T lymphocytes. Moreover, although the lectin stimulated the antiport in these cells, an alkalinization was not observed, due to the concomitant occurrence of an acidifying process. It was concluded that the stimulation of the Na+/H+ antiport that accompanies the addition of mitogens is neither sufficient nor necessary for the initiation of cellular proliferation.