Clinical efficacy and molecular mechanism of Chinese medicine in the treatment of autoimmune thyroiditis

ETHNOPHARMACOLOGICAL RELEVANCE

Autoimmune Thyroiditis (AIT) is a common refractory autoimmune disease of the endocrine system that may eventually lead to complete loss of thyroid function, with subsequent severe effects on the metabolism. Because of the deficiency in current clinical management of AIT, the need for alternative therapies is highlighted. With its multi-component and multi-target characteristics, Chinese medicine has good potential as an alternative therapy for AIT.

AIM OF THE STUDY

The aim of this study was to systematically summarize the clinical efficacy and safety evaluation of TCM and its active ingredients in the treatment and regulation of AIT. Additionally, we provide an in-depth discussion of the relevant mechanisms and molecular targets to understand the protective effects of traditional Chinese medicine on AIT and explore new ideas for clinical treatment.

MATERIALS AND METHODS

The literature related to "Hashimoto", "autoimmune thyroiditis", "traditional Chinese medicine," and "Chinese herbal medicine" was systematically summarized and reviewed from Web of Science Core Collection, PubMed, CNKI, and other databases. Domestic and international literature were analyzed, compared, and reviewed.

RESULTS

An increasing number of studies have demonstrated that herbal medicines can intervene in immunomodulation, with pharmacological effects such as antibody lowering, anti-inflammatory, anti-apoptotic thyroid follicular cells, regulation of intestinal flora, and regulation of estrogen and progesterone levels. The signaling pathways and molecular targets of the immunomodulatory effects of Chinese herbal medicine for AIT may include Fas/FasL, Caspase, BCL-2, and TLRs/MyD88/NF-κB et al. CONCLUSIONS: The use of Chinese herbs in the treatment and management of AIT is clinically experienced, satisfactory, and safe. Future studies may evaluate the influence of herbal medicines on the occurrence and development of AIT by modulating the interaction between immune factors and conventional signaling pathways.

[Diagnostic value of high frequency oscillation in localization of type Ⅱ focal cortical dysplasia epilepsy]

Retrospective analysis was conducted on 9 patients with type Ⅱ focal cortical dysplasia (FCD) who underwent stereo-electroencephalography (SEEG) implantation in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University from November 2020 to February 2023. The onset area, onset time, and frequency of high-frequency oscillations (HFO) were analyzed and the correlation of HFOs with interictal, preictal, and ictal periods. SEEG recordings of 80-500 Hz HFOs were observed in both interictal and ictal periods in 9 patients, with 6 patients exhibiting fast ripples (FR) in the range of 250-500 Hz. Surgical resection of the seizure onset area and FR-generating electrodes was performed, and postoperative follow-up for over 2 years indicated Engel I in 5 cases. 6 patients showed continuous discharge during the preictal period, and the distribution index of continuous discharge was positively correlated with seizure frequency. HFOs in the range of 80-500 Hz were present in all four seizure onset patterns during the ictal period. The onset area and FR-emitting electrode were surgically removed in 6 patients with continuous discharge and overlapping HFOs during the preictal period, with 5 cases of Engel I. Type Ⅱ FCD discharges exhibited complexity, high discharge indices, and a close association with HFOs. Compared with the spike wave, the electrode range of HF is more limited, and the incidence of HF before attack is significantly increased, which is closely correlated with the onset area. The simultaneous occurrence of HFO and the spike waves has higher diagnostic value than the individual occurrence, effectively enhancing surgical efficacy.

Integrative radiomics and transcriptomics analyses reveal subtype characterization of non-small cell lung cancer

OBJECTIVES

To assess whether integrative radiomics and transcriptomics analyses could provide novel insights for radiomic features' molecular annotation and effective risk stratification in non-small cell lung cancer (NSCLC).

METHODS

A total of 627 NSCLC patients from three datasets were included. Radiomics features were extracted from segmented 3-dimensional tumour volumes and were z-score normalized for further analysis. In transcriptomics level, 186 pathways and 28 types of immune cells were assessed by using the Gene Set Variation Analysis (GSVA) algorithm. NSCLC patients were categorized into subgroups based on their radiomic features and pathways enrichment scores using consensus clustering. Subgroup-specific radiomics features were used to validate clustering performance and prognostic value. Kaplan-Meier survival analysis with the log-rank test and univariable and multivariable Cox analyses were conducted to explore survival differences among the subgroups.

RESULTS

Three radiotranscriptomics subtypes (RTSs) were identified based on the radiomics and pathways enrichment profiles. The three RTSs were characterized as having specific molecular hallmarks: RTS1 (proliferation subtype), RTS2 (metabolism subtype), and RTS3 (immune activation subtype). RTS3 showed increased infiltration of most immune cells. The RTS stratification strategy was validated in a validation cohort and showed significant prognostic value. Survival analysis demonstrated that the RTS strategy could stratify NSCLC patients according to prognosis (p = 0.009), and the RTS strategy remained an independent prognostic indicator after adjusting for other clinical parameters.

CONCLUSIONS

This radiotranscriptomics study provides a stratification strategy for NSCLC that could provide information for radiomics feature molecular annotation and prognostic prediction.

KEY POINTS

• Radiotranscriptomics subtypes (RTSs) could be used to stratify molecularly heterogeneous patients. • RTSs showed relationships between molecular phenotypes and radiomics features. • The RTS algorithm could be used to identify patients with poor prognosis.

Probiotic Fermentation of Herbal Medicine: Progress, Challenges, and Opportunities

Fermentation is a processing method used in traditional Chinese medicine (TCM). However, traditional fermentation methods suffer from poor production control. In contrast, probiotic fermented herbal medicine (PFHM) offers advantages such as the use of pure strains, a controllable process, and the ability to produce a variety of active enzymes during fermentation. As a result, PFHM has become a research hotspot. This review focuses on the progress, challenges, and opportunities in the research of PFHM. The use of probiotic enzymes during fermentation alters the active ingredients of TCM, resulting in positive pharmacological effects such as increased active ingredients, reduced toxicity, new pharmacological effects, and the reuse of herbal residues. PFHM has the potential to transfer the metabolic transformation of the effective components of TCM by intestinal flora outside the body during production and preparation, which has a broad application prospect. However, due to the complexity of the chemical composition of TCM, the mechanism of PFHM requires further investigation. Finally, we discuss the prospects of industrializing PFHM, which is essential for promoting the innovation and modernization of TCM.

Effect of ACADL on the differentiation of goat subcutaneous adipocyte

Objective

The aim of this study was to clone the mRNA sequence of the ACADL gene of goats and explore the effect of ACADL on the differentiation of subcutaneous fat cells on this basis.

Methods

We obtained the ACADL gene of goats by cloning and used -qPCR to detect the ACADL expression patterns of different goat tissues and subcutaneous fat cells at different lipid induction stages. In addition, we transfect intramuscular and subcutaneous adipocytes separately by constructing overexpressed ACADL vectors and synthesizing Si-ACADL; Finally, we observed the changes in oil red stained cell levels under the microscope, and qPCR detected changes in mRNA levels.

Results

The results showed goat ACADL gene expressed in sebum fat. During adipocyte differentiation, ACADL gradually increased from 0 to 24 h of culture, and decreased. Overexpression of ACADL promoted differentiation of subcutaneous adipocytes in goat and inhibited their differentiation after interference.

Conclusion

So, we infer ACADL may have an important role in positive regulating the differentiation process in goat subcutaneous adipocytes. This study will provide basic data for further study of the role of ACADL in goat subcutaneous adipocyte differentiation and lays the foundation for final elucidating of its molecular mechanisms in regulating subcutaneous fat deposition in goats.

Radiomic profiling of clear cell renal cell carcinoma reveals subtypes with distinct prognoses and molecular pathways

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Radiomics profile of clear cell renal cell carcinoma is heterogeneity.

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Multi-scale Radiogenomics could link molecular features and images.

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Radiomic subtypes could be used for risk stratification.

Background

To identify radiomic subtypes of clear cell renal cell carcinoma (ccRCC) patients with distinct clinical significance and molecular characteristics reflective of the heterogeneity of ccRCC.

Methods

Quantitative radiomic features of ccRCC were extracted from preoperative CT images of 160 ccRCC patients. Unsupervised consensus cluster analysis was performed to identify robust radiomic subtypes based on these features. The Kaplan–Meier method and chi-square test were used to assess the different clinicopathological characteristics and gene mutations among the radiomic subtypes. Subtype-specific marker genes were identified, and gene set enrichment analyses were performed to reveal the specific molecular characteristics of each subtype. Moreover, a gene expression-based classifier of radiomic subtypes was developed using the random forest algorithm and tested in another independent cohort (n = 101).

Results

Radiomic profiling revealed three ccRCC subtypes with distinct clinicopathological features and prognoses. VHL, MUC16, FBN2, and FLG were found to have different mutation frequencies in these radiomic subtypes. In addition, transcriptome analysis revealed that the dysregulation of cell cycle-related pathways may be responsible for the distinct clinical significance of the obtained subtypes. The prognostic value of the radiomic subtypes was further validated in another independent cohort (log-rank P = 0.015).

Conclusion

In the present multi-scale radiogenomic analysis of ccRCC, radiomics played a central role. Radiomic subtypes could help discern genomic alterations and non-invasively stratify ccRCC patients.

[Analysis of 18 cases of toxic encephalopathy caused by occupational acute 1, 2-dichloroethane poisoning]

Retrospective analysis of 18 cases of occupational acute 1, 2-dichloroethane (1, 2-DCE) poisoning. The results showed that all patients have the main manifestations such as dizziness, headache, unresponsiveness and other symptoms of nervous system damage; Brain CT showed varying degrees of diffuse white matter lesions. Brain MRI showed extensive involvement of white matter in both cerebral hemispheres. Affected white matter area presented low intensity on T1WI, hyperintensity on T2WI and T2-Flair; Lumbar puncture examination of cerebrospinal fluid (CSF) pressure (262.5±48.39) mm H(2)O; After treatment, the required time for CSF pressure to restore was (161.56±75.27) days (50-280) days. Summary, Occupational acute 1, 2-DCE poisoning caused by toxic encephalopathy can be manifested as persistent abnormalities in CSF pressure, and the CSF pressure drops slowly during treatment; Early head CT and lumbar puncture examination will be helpful for early detection of intracranial pressure in toxic encephalopathy caused by acute 1, 2-DCE poisoning. Dynamic monitoring of CSF provides guidance for acute 1, 2-DCE poisoning with a long time of treatment and various types of dehydrating agents.

Extracapsular dissection versus partial superficial parotidectomy for the treatment of benign parotid tumours

The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial superficial parotidectomy (PSP). A comprehensive literature investigation was conducted by searching electronic databases. A systematic review and meta-analysis of comparative studies were performed to assess ECD and PSP for the treatment of BPTs with fixed-effects models. The outcomes analysed were transient or permanent facial nerve injury, Frey syndrome, recurrence rate, infection, and salivary fistula/sialocele. A total of 1641 patients from seven studies (1120 ECD-treated and 521 PSP-treated patients) were included in this meta-analysis. Transient facial nerve injury (odds ratio (OR)=0.28, 95% confidence interval (CI): 0.11-0.71; p=0.008) and Frey syndrome (OR=0.12, 95% CI: 0.03-0.48; p=0.003) were less prevalent in the ECD group. The rates of permanent facial nerve injury (OR=0.77, 95% CI: 0.35-1.70; p=0.520), recurrence rate (OR=0.17, 95% CI: 0.02-1.75; p=0.14), infection (OR=0.70, 95% CI: 0.07-6.67; p=0.76), and salivary fistula/sialocele (OR=0.40, 95% CI: 0.06-2.66; p=0.350) were similar in both groups. Although there was a trend that ECD showed a reduced risk for complications, the present results are not sufficient to conclude that ECD is more beneficial than PSP.

[Analysis of the prevalence and related risk factors of prostate diseases in traffic policemen]

Objective: To investigate the prevalence and related risk factors of prostate diseases in traffic policemen. Methods: A total of 848 traffic policemen who took part in the physical examination among August and September in 2016 were selected as research subjects, and a questionnaire survey was conducted to collect their information including smoking, alcohol drinking, biological and physiological indicators, as well as prostate disease etc. The relationship between the prevalence of prostate diseases and related risk factors was analyzed by Non-conditional Logistic Regression. Results: The total prostate disease prevalence rate was 40.2% in the study subjects, and there is statistical significance (P<0.05) of differences between prostate disease group and non disease group in age, work age, smoking, drinking and field work. Single factor analysis showed that age, work age, smoking, and field work are independent risk factors of prostate disease (P<0.05) . Multivariate Logistic regression analysis showed that increasing age (OR 1.03) , smoking (OR 1.92) and field work time (OR 1.47) significantly increased the risk of prostate disease in male police after age, smoking, drinking, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipids and other indicators were adjusted. Conclusion: age, smoking and field work time are risk factors of prostate diseases in the traffic police. There is great significance in publicizing the harmful effects of smoking and reducing the duration of field work.

Prevention of type 2 diabetes with the traditional Chinese patent medicine: A systematic review and meta-analysis

AIM

Early interventions in prediabetes can prevent or delay the incidence of type 2 diabetes mellitus (T₂DM). The aim of this review was to assess the efficacy and safety of traditional Chinese patent medicine (TCPM) on the prevention of T₂DM.

METHODS

Seven electronic databases were searched to identify eligible trials published until June 1, 2016. Randomized controlled trials (RCTs) that compared TCPM plus lifestyle modification (LM) versus LM alone were included for in the. RCTs that used TCPM plus LM compared with placebo plus LM were also included. Methodological quality was assessed using the Cochrane Collaboration Risk of Bias tool. A random- or fixed-effect model was used to analyze outcomes that were expressed as risk ratios (RRs) or mean differences (MD), and the I² statistic was used to assess heterogeneity.

RESULTS

Twenty-six trials with a total of 4169 participants met the inclusion criteria. Subgroup analysis confirmed that, compared with LM alone, TCPM and LM together were significantly better at reducing diabetes (RR, 0.47; 95% CI, 0.38-0.59) and normalizing blood glucose (RR, 0.76; 95% CI, 0.69-0.85). They also caused a greater reduction in fasting plasma glucose (FBG) (MD, -0.37; 95% CI, -0.62 to -0.13), 2-h plasma glucose (2h PG) (MD, -0.91; 95% CI, -1.35 to -0.47) and body mass index (BMI) (MD, -0.45; 95% CI, -0.76 to -0.14). Compared with placebo plus LM, TCPM plus LM was superior at reducing diabetes (RR, 0.55; 95% CI, 0.45-0.68) and normalizing blood glucose (RR, 0.62; 95% CI, 0.50-0.76). The interventions were also associated with a decline in FBG levels (MD, -0.68; 95% CI, -1.25 to -0.11) and 2h PG levels (MD, -1.07; 95% CI, -1.85 to -0.29). There were no significant differences in adverse events in either group. Subgroup and sensitivity analyses found no significant difference in overall effects among all study characteristics, indicating that the overall effects were stable. Generally, the quality of evidence was low for the effect of TCPM on the incidence of diabetes and normalization of blood glucose, and was very low for the effects of TCPM on FBG, 2h PG, and BMI.

CONCLUSIONS

Based on this systematic review, TCPM may reduce the risk of progression to T₂DM and increase the possibility of regression toward normoglycemia. As a result of the methodological drawbacks of the included studies, more rigorously designed RCTs are required to more reliably assess the efficacy of TCPM and long-term follow-up is needed before TCPM can be recommended for prediabetic patients.

[Diagnostic value of combining serum soluble ST2 and interleukin-33 for heart failure patients with preserved left ventricular ejection fraction]

Objective: Diagnostic efficacy of serum markers is low for heart failure patients with preserved left ventricular ejection fraction (HF-pEF) as compared to heart failure patients with reduced left ventricular ejection fraction.We sought to explore the diagnostic value of serum levels of soluble ST2 (sST2) combined with interleukin-33 (IL-33) for the diagnosis of HF-pEF in this study. Methods: A total of 376 patients with HF-pEF (HF group), 376 matched-control patients without heart failure who shared similar clinical characteristics (non-HF group) were included in the study.Another 500 healthy individuals were recruited for assessing the normal ranges of IL-33 and sST2.Serum levels of NT-proBNP were measured by chemi-luminescence assay, while IL-33 and sST2 were measured by enzyme linked immunosorbent assay. Results: Serum levels of IL-33 and sST2 were not normally distributed in healthy population.Serum concentrations of IL-33 and sST2 were significantly higher in HF-pEF patients than in patients in non-HF group (median, IL-33: 0.437 μg/L vs. 0.127 μg/L, P<0.01; sST: 0.118 μg/L vs. 0.067 μg/L, P<0.01). The area under receiver operating characteristic curve (AUC) of sST2 for detecting HF-pEF was 0.763 (95%CI 0.729-0.795, P<0.01), with 71.01% sensitivity and 66.75% specificity, the AUC was 0.884 (95%CI 0.859-0.908, P<0.01), with 80.05% sensitivity and 81.91% specificity in patients with serum IL-33 higher than 0.117 μg/L (median level of serum IL-33 in healthy individuals, n=306). The AUC of NT-proBNP for detecting HF-pEF was 0.83, with 74.73% sensitivity and 84.57% specificity.The AUC of sST2 for detecting HF-pEF was significantly higher than NT-proBNP in population with high serum IL-33 (AUC: 0.88 vs. 0.83, P<0.01). Conclusion: Serum sST2 could serve as a satisfactory biomarker for HF-pEF diagnosis, especially for patients with high serum IL-33 concentrations.

[The application value of contrast-enhanced ultrasound in the surgery of renal masses]

Objective: To investigate the clinical value of contrast-enhanced ultrasound in the diagnosis of renal masses. Methods: A total of 50 patients with renal masses who underwent partial nephrectomy were analyzed from January 2014 to October 2016 in the Department of Urology of China-Japan Union Hospital of Jilin University.In the intraoperative contrast-enhanced ultrasound, the characteristics of ultrasound imaging were recorded including location, size, boundary, echo, real-time internal and peripheral blood and renal pelvis distance, artery, guidance on the selection of surgical methods, intraoperative real-time estimation of the extent of tumor resection. Results: In the 50 patients, there were 49 cases enhancement in the imaging of the cystic masses, 1 case had no enhancement.Contrast-enhanced ultrasound assisted clinical accurate positioning 34 masses which were in the renal contour and not convex.And 15 patients were found main arteries of renal occupied lesions.There were 38 cases whose distance from occupying to pelvis was more than 0.5 cm, and maintained the original operation scheme for partial nephrectomy.There were 12 cases whose distance from occupying to pelvis was less than 0.5 cm, and proceeded radical resection. Conclusions: Intraoperative contrast-enhanced ultrasound can provide a more accurate imaging basis for the surgeon in partial nephrectomy.It's of great significance for the correct choice of surgical procedures, and can reduce or avoid the occurrence of postoperative complications.

Effects of Tongmai oral liquid in femoral ateriovenous fistula

BACKGROUND

This study was conducted to investigate the protective effect of Tongmai oral liquid on arteriovenous fistula function and to provide an effective method to promote fistula maturation.

METHODS

Fifteen female and fifteen male SPF New Zealand rabbits were randomly allocated into 3 groups including control, Aspirin and Tongmai oral liquid groups. A side-to-side femoral arteriovenous fistula was established in each rabbit and then animals were treated with Aspirin or Tongmai oral liquid for 2 weeks. The concentrations of circulating ET-1 and NO were determined before and after operation (on preoperative day, operative day, post-D1, post-D3, post-D7 and post-D15), respectively. Blood flow of the fistula stoma and contralateral artery and vein was determined on the 15th postoperative day. Last, the fistula stoma was dissected to observe patency, thrombosis and adhesion with surrounding tissues.

RESULTS

28 rabbits survived during the surgical process and the following 15-day observational period. Tissue adhesion of arteriovenous fistula with surrounding tissues was improved and fistula thrombosis was reduced by treatment with Tongmai oral liquid. NO concentration decreased to a different extent after vascular surgery. Tongmai oral liquid failed to regulate the equilibrium between NO and ET-1, but it improved blood flow of fistula stoma, as compared to control and Aspirin groups. Blood flow of fistula stoma in the three groups was lower than that of the contralateral femoral artery.

CONCLUSIONS

Tongmai oral liquid improved the function of femoral ateriovenous fistula in the rabbit model by increasing blood flow and reducing thrombosis, probably not by regulating the dynamic equilibrium between NO and ET-1.

Selective estrogen receptor modulators promising for cardiac syndrome X

Cardiac syndrome X (CSX) is defined as a typical anginal-like chest pain with a transient ischemic electrocardiogram, but without abnormal coronary angiography. It is usually accepted that endothelial dysfunction, inflammation, oxidative stress and estrogen deficiency are the main reasons of CSX. There are some methods to treat CSX including statins, b blocker, angiotensin converting enzyme inhibitors, nitrates, estrogen, and so on. The estrogen replacement therapy (ERT), in particular, has been reported by many researchers to significantly reduce the frequency of chest pain after administration of estrogen, which has been explained as estrogen acting on its receptor to improve the endothelial function. However, it has been suggested that ERT must not be used for coronary heart disease due to its adverse effects. However, some selective estrogen receptor modulators (SERMs) can inhibit inflammatory response as well as oxidative stress, and improve the endothelial function, to reduce the occurrence of chest pain. Here, we hypothesize that SERMs may be the beneficial selection for patients with CSX.

Identification of a bovine viral diarrhea virus 2 isolated from cattle in China

The identification and characterization of bovine viral diarrhea virus 2 (BVDV-2) strain SD-06 isolated from cattle in China is reported. We performed sequence analysis of 5'-untranslated region (5'-UTR) and E2 sequences and the identity at the nucleotide and amino acid level indicated that the isolate was closely related to BVDV-2. The BVDV-2 strain New York'93 showed the highest sequence homology with the isolate SD-06. The phylogenetic analysis revealed that the isolate SD-06 belonged to BVDV-2a subtype. Furthermore, immunofluorescence assay with the monoclonal antibody specific for BVDV-2 glycoprotein E2 confirmed this identification. Thus, the strain SD-06 was the first isolate of BVDV-2 identified in China.

Twenty-year follow-up: an unusual case of nephropathy of antiphospholipid syndrome

Nephropathy of antiphospholipid antibody syndrome (NAPS) is an increasingly well-recognized aspect of antiphospholipid syndrome. The most characteristic histopathology is that of thrombotic microangiopathy, and thrombosis occurring in the renal vasculature is thought to be the initiating event. Other less common pathologies have been reported, and the mechanisms of these are unclear. Therapy has been largely empiric. We report a case of NAPS in a patient with atypical pathology, who has declined therapy with immunosuppressive agents and anticoagulants and who has maintained normal renal function in 20 years of follow-up.

Genomic sequencing and characterization of a Chinese isolate of Bovine viral diarrhea virus 2

The complete genomic sequencing and characterization of Bovine viral diarrhea virus (BVDV) isolate XJ-04 originated from cattle in China was described. The genomic RNA of the isolate was 12,284 nt long and contained short 5'- untranslated region (UTR), 3'-non-coding regions (NCR), and one open reading frame (ORF) encoding a large polyprotein of 3,895 amino acids with 20 potential N-glycosylation sites. The identity of the isolate XJ-04 with reference strains NADL (BVDV-1) and 890 (BVDV-2) in autoprotease (N(pro)) gene and structural genes (C, E(rns), E1, E2) was analyzed. The percentage of nt and aa identity in analyzed genes indicated that the isolate XJ-04 was closer to the reference strain 890 (BVDV-2) than to NADL (BVDV-1). Phylogenetic analysis revealed that the isolate belonged to BVDV-2a subtype. Furthermore, comparison analysis indicated that the isolate XJ-04 did not contain any genomic insertions that can be directly related to the cytopathic phenotype.

Cloning and identification of a novel sperm binding protein, HEL-75, with antibacterial activity and expressed in the human epididymis

BACKGROUND

The HEL-75 protein is a beta-defensin that was identified by analyzing a human epididymis cDNA library. Studying its function may not only elucidate the mechanisms of host defense, but may also provide new alternatives for novel therapeutic drugs for reproductive tract infections.

METHODS

The HEL-75 gene was amplified by PCR, and its structure and function were predicted and analyzed with bioinformatics tools. Polyclonal serum was raised against recombinant HEL (rHEL)-75 protein. The gene expression pattern was analyzed with RT-PCR and immunofluorescent staining. Finally, the antimicrobial activity and function during fertilization of HEL-75 were analyzed using a colony-forming unit assay and IVF, respectively.

RESULTS

The human HEL-75 gene is located on chromosome 20p13 and encodes a 95 amino acid protein with a predicted N-terminal signal peptide of 22 amino acids. The protein has six conserved cysteine residues, characteristic of members of the beta-defensin superfamily, as well as several potential post-translational modification sites. At the transcriptional level, HEL-75 was expressed in the epididymis and lung, but only in the epididymis at the translational level. Immunofluorescent staining showed that HEL-75 protein bound spermatozoa in the epididymis. RHEL-75 protein could kill Escherichia coli in vitro in a dose- and time-dependent fashion. However, no effect was observed on sperm motility nor fertilization when spermatozoa were blocked with anti-rHEL-75 polyclonal serum.

CONCLUSION

HEL-75 is a new beta-defensin expressed in the epididymis and on sperm; it may play an important role in host defense.

Varicosity-Schwann cell interactions mediated by ATP in the mouse vas deferens

Schwann cells, from a variety of sources, are known to possess P2Y purinergic metabotropic receptors. However, it is not known if Schwann cells associated with autonomic nerve terminals possess such receptors and if so whether these receptors are activated by the endogenous release of ATP from the nerve terminals. We show that such Schwann cells in the vas deferens give evoked calcium transients on nerve stimulation. These transients are mediated, at least in part, by the endogenous release of ATP, which acts on Schwann cell P2Y receptors to release calcium from within the cells. This work suggests the possibility that Schwann cells are active participants in the process of junctional transmission in the autonomic nervous system.

Quantal current fields around individual boutons in sympathetic ganglia

The release of a quantum of neurotransmitter from an active zone of a bouton is accompanied by the flow of extracellular current that creates a potential field about the site of transmitter action beneath the bouton. It is shown theoretically that the density of the field at the peak of the quantal current gives rise to an extracellular potential that declines to values of less than 5 microV at 1.3 microm distance in the circumferential direction around the neuron and equally rapidly in the radial direction away from the neuron. A loose-patch electrode placed over a bouton distorts the quantal field about the bouton and calculations show that under current-clamp conditions, potentials of over 40 microV can be recorded with an electrode of tip diameter 2 microm, provided the separation between the tip and the neuron's surface is about 0.1 microm. Quantal release recorded from visualized boutons on rat monopolar pelvic ganglion cells with loose-patch electrodes is in agreement with the properties of the quantal potential field given in the theoretical analysis.

Ectopic expression of the thyroperoxidase gene augments radioiodide uptake and retention mediated by the sodium iodide symporter in non-small cell lung cancer

Radioiodide is an effective therapy for thyroid cancer. This treatment modality exploits the thyroid-specific expression of the sodium iodide symporter (NIS) gene, which allows rapid internalization of iodide into thyroid cells. To test whether a similar treatment strategy could be exploited in nonthyroid malignancies, we transfected non-small cell lung cancer (NSCLC) cell lines with the NIS gene. Although the expression of NIS allowed significant radioiodide uptake in the transfected NSCLC cell lines, rapid radioiodide efflux limited tumor cell killing. Because thyroperoxidase (TPO) catalyzes iodination of proteins and subsequently causes iodide retention within thyroid cells, we hypothesized that coexpression of both NIS and TPO genes would overcome this deficiency. Our results show that transfection of NSCLC cells with both human NIS and TPO genes resulted in an increase in radioiodide uptake and retention and enhanced tumor cell apoptosis. These findings suggest that single gene therapy with only the NIS gene may have limited efficacy because of rapid efflux of radioiodide. In contrast, the combination of NIS and TPO gene transfer, with resulting TPO-mediated organification and intracellular retention of radioiodide, may lead to more effective tumor cell death. Thus, TPO could be used as a therapeutic strategy to enhance the NIS-based radioiodide concentrator gene therapy for locally advanced lung cancer.

Ectopic expression of the thyroperoxidase gene augments radioiodide uptake and retention mediated by the sodium iodide symporter in non-small cell lung cancer

Radioiodide is an effective therapy for thyroid cancer. This treatment modality exploits the thyroid-specific expression of the sodium iodide symporter (NIS) gene, which allows rapid internalization of iodide into thyroid cells. To test whether a similar treatment strategy could be exploited in nonthyroid malignancies, we transfected non-small cell lung cancer (NSCLC) cell lines with the NIS gene. Although the expression of NIS allowed significant radioiodide uptake in the transfected NSCLC cell lines, rapid radioiodide efflux limited tumor cell killing. Because thyroperoxidase (TPO) catalyzes iodination of proteins and subsequently causes iodide retention within thyroid cells, we hypothesized that coexpression of both NIS and TPO genes would overcome this deficiency. Our results show that transfection of NSCLC cells with both human NIS and TPO genes resulted in an increase in radioiodide uptake and retention and enhanced tumor cell apoptosis. These findings suggest that single gene therapy with only the NIS gene may have limited efficacy because of rapid efflux of radioiodide. In contrast, the combination of NIS and TPO gene transfer, with resulting TPO-mediated organification and intracellular retention of radioiodide, may lead to more effective tumor cell death. Thus, TPO could be used as a therapeutic strategy to enhance the NIS-based radioiodide concentrator gene therapy for locally advanced lung cancer.

Depression of transmitter release at synapses in the rat superior cervical ganglion: the role of transmitter depletion

The characteristics of depression of the excitatory postsynaptic potential (EPSP) during a short train of impulses to the rat superior cervical ganglion (SCG) have been ascertained with the object of determining the relative contributions of transmitter depletion and autoreceptors to depression. Successive EPSPs in a short train were depressed after the first (Vo) up to about the fourth impulse when a steady-state depressed EPSP level (Vss) was reached. Vss increased with the stimulation frequency between 1 and 30 Hz. Vo recovered after a short train with a time constant of about 2.8 s in the frequency range from 5 to 30 Hz. In order to determine if depression was related to changes in calcium influx with successive impulses in the train. preganglionic boutons were loaded with the calcium indicator Oregon Green 488 BAPTA-1 and line scans taken through individual boutons with a confocal laser microscope. Successive calcium transients were of about the same amplitude in boutons during short trains of impulses at 5 Hz. The contribution of autoreceptors activated by the action of endogenously derived adenosine on the extent of depression of the EPSP during short trains was ascertained by blocking these receptors with 8-phenyltheophylline (10 microM). There was no change in the extent or time course of development of depression. Similar results were obtained with the opioid receptor antagonist naloxone (10 microM) and the adrenergic receptor antagonist yohimbine (10 microM). Factors, which increased the extent of transmitter release during a train, such as increasing the external calcium concentration from 0.8 to 2.5 mM, increased depression. Factors. which decreased the extent of transmitter release such as increasing the exogenous adenosine concentration between 1 and 200 microM decreased depression. These results are interpreted in terms of a model in which vesicles are mobilised by a calcium-dependent process from a store into an available pool of docked vesicles. Depletion of the docked vesicles during exocytosis then leads to depression of transmitter release during a train of impulses.

Anti-tumor activities of chondroitinase AC and chondroitinase B: inhibition of angiogenesis, proliferation and invasion

In the current study, two specific glycosaminoglycan lyases, chondroitinase AC and chondroitinase B, were utilized to examine the roles of chondroitin sulfates and dermatan sulfate in tumor metastasis and angiogenesis. Melanoma cells (SK-MEL) or endothelial cells were treated with either medium or chondroitinase enzyme. Chondroitinase AC inhibited melanoma invasion and proliferation as well as endothelial proliferation and angiogenesis. Apoptosis of melanoma and endothelial cells, as measured by the activity of caspase-3, was also increased by chondroitinase AC, but not by chondroitinase B. Chondroitinase B inhibited endothelial and melanoma proliferation and invasion, but to a lesser extent than chondroitinase AC. Neither chondroitinase had a detectable effect on gelatinase secretion by melanoma cells. These results indicate that both chondroitin and dermatan sulfates regulate many cellular activities related to metastasis.

Quantal and non-quantal current and potential fields around individual sympathetic varicosities on release of ATP

The electrical phenomena that occur at sympathetic varicosities due to the release of ATP include spontaneous and evoked excitatory junction potentials (SEJPs and EJPs; recorded with an intracellular electrode) as well as fast and slow excitatory junctional currents (EJCs; recorded with a loose-patch electrode placed over varicosities). The electrical analysis of these transients is hampered by lack of a detailed theory describing how current and potential fields are generated upon the release of a quantum of ATP. Here, we supply such a theory and develop a computational model for the electrical properties of a smooth muscle syncytium placed within a volume conductor, using a distributed representation for the individual muscle cells. The amplitudes and temporal characteristics of both SEJPs and fast EJCs are predicted by the theory, but those of the slow EJCs are not. It is shown that these slow components cannot arise as a consequence of propagation of fast quantal components from their site of origin in the muscle syncytium to the point of recording. The possibility that slow components arise by a mechanism of transmitter secretion that is different from quantal release is examined. Experiments that involve inserting peptide fragments of soluble N-ethylmaleimide-sensitive fusion attachment protein (alpha-SNAP) into varicosities, a procedure that is known to block quantal release, left the slow component of release unaffected. This work provides an internally consistent description of quantal potential and current fields about the varicosities of sympathetic nerve terminals and provides evidence for a non-quantal form of transmitter release.

Calcium in sympathetic boutons of rat superior cervical ganglion during facilitation, augmentation and potentiation

The sympathetic preganglionic nerve terminals of the rat superior cervical ganglion were loaded with the calcium indicator oregon green 488 BAPTA-1 to measure the change in calcium concentration in the terminal boutons, (delta[Ca2+]b) following short (1 or 5 impulses) and long (200 impulses) trains at 30 Hz. The delta[Ca2+]b after a single action potential or a short train declined in two phases: a fast phase with a time constant of 530+/-30 ms and a moderate phase with a time constant of 4.0+/-0.2 s. The delta[Ca2+]b following a long train eventually declined with a time constant of 127+/-34 s (slow phase). The addition of either omega-agatoxin TK (100 nM), omega-conotoxin GVIA (100 nM) or nifedipine (20 microM) to block P-type, N-type or L-type calcium channels respectively showed that the rise in delta[Ca2+ ]b in boutons was predominantly mediated by an influx of calcium through P-type (53+/-7%) and N-type (46+/-4%) calcium channels. Experiments with caffeine, ryanodine and thapsigargin indicate that intracellular caffeine-sensitive calcium stores have a small but statistically significant effect on the fast and moderate phases. The mitochondrial uncoupler carbonyl cyanide m-chlorophenyl hydrazone (CCCP; 2 microM) significantly decreased the amplitude of the slow phase of delta[Ca2+]b relaxation, and sped its time course, suggesting that mitochondria normally dump calcium during this phase. Adenosine reduced the amplitude of delta[Ca2+]b in response to single action potentials by 30+/-6%, suggesting that adenosine-mediated autoinhibition in these boutons reduces Ca2+ influx. Spontaneous increases in delta[Ca2+]b demonstrated Ca2+ coupling between adjacent boutons. The delta[Ca2+]b kinetics are compared with F2 facilitation, augmentation and post-tetanic potentiation.

Heparinase III limits rat arterial smooth muscle cell proliferation in vitro and in vivo

Heparinase III degrades heparan sulfate proteoglycans, which are co-receptors for growth factors that stimulate arterial proliferation. We assessed the ability of locally-delivered heparinase III to limit medial vascular smooth muscle cell proliferation induced by balloon catheter injury in rat carotid arteries. Whereas vehicle-treated arteries showed 12% of smooth muscle cells proliferating after 2 days, heparinase III (0.022-5.7 mg/kg) treated arteries showed 0.8-4%. Chemically-inactivated heparinase III did not limit proliferation. In isolated rat A10 vascular smooth muscle cells, heparinase III (1 IU/ml) inhibited both PDGF-BB and bFGF mediated increases in proliferation and migration. These results suggest that heparinase III can limit proliferation by affecting heparan sulfate proteoglycan binding growth factors following arterial injury.

Vesicle-associated proteins and calcium in nerve terminals of chick ciliary ganglia during development of facilitation

1. The developmental appearance of synaptic vesicle-associated proteins and nerve terminal calcium ([Ca2+]i) sequestering processes were determined for the chick ciliary ganglia in relation to the maturation of the different phase of increased efficacy of transmitter release following nerve impulses. The maturation phases studied were from stages 34-35, at the time of synapse formation, to stage 46 at hatching. 2. Western blots and immunohistochemical localization indicated that synaptotagmin 1 and synapsin IIa were detectable at stages 34-35 and were clearly localized at the nerve terminals by stage 37. Syntaxin was clearly localized at the nerve terminals at stage 34. 3. The relative size of the postganglionic compound action potential, used to measure the transmission efficacy through the ganglion, showed that the slope of the relationship between log efficacy and log extracellular calcium concentration ([Ca2+]o) in low [Ca2+]o was about 4 by stage 46. 4. A mature facilitatory mechanism for transmission was not present at stage 34 and did not emerge until stage 38. A mature augmentation was not present at stages 34 or 38 and was not established until stages 41-42. Post-tetanic potentiation (PTP) was not present at stage 34; it was evident at stages 37-38 and only reached maturity by stages 41-42. 5. The time course of calcium changes in the nerve terminals following trains of impulses that give rise to facilitation, augmentation and PTP was determined for different stages of development using the indicator Calcium Green-1 in the nerve terminal. The mature time course of the phases of calcium decline in the nerve terminal associated with facilitation and augmentation was observed as early as stage 38, whereas that of the PTP phase did not mature until after stage 42. 6. These results are discussed in terms of the maturation of the vesicle-associated proteins and calcium influx into the terminal following trains of impulses that give rise to the different components of increased synaptic efficacy.

Multiple types of chimeric germ-line Ig heavy chain transcripts in human B cells: evidence for trans-splicing of human Ig RNA

Germ-line transcripts from Ig heavy chain loci precede the occurrence of isotype switching and are thought to play an important though still controversial role in Ig class switching. In this study, we employed a reverse transcriptase-PCR approach to detect human chimeric Ig germ-line mRNA transcripts. Multiple types of chimeric Ig germ-line transcripts (Imu-Cepsilon, Iepsilon-Cmu, Imu-Cgamma4, Igamma-Cmu, Igamma-Cepsilon, Iepsilon-Cgamma, and Igamma4-Calpha1 transcripts) were readily detected in human B cells stimulated with IL-4 alone. Sequence analysis revealed that all of these chimeric Ig germ-line transcripts represented the I exons from one Ig locus spliced to the CH exons from another locus by using consensus sequences for splicing donor and acceptor sites, indicating that they were generated through splicing machinery. In the case of stimulation of human resting B cells with IL-4 alone, the chimeric Ig germ-line transcripts are likely derived from a trans-splicing mechanism, as the extensive searching did not find evidence that Ig class-switch recombination had occurred, which alternatively could give rise to chimeric Ig mRNA by mechanisms other than trans-splicing. Similarly, an EBV-transformed gamma2 rearranged B cell line, GM1500, which produces IgG2 and contains both gamma2 productive and epsilon germ-line transcripts, also expressed chimeric germ-line RNA (Iepsilon-Cgamma2) and epsilon-productive transcripts (VDJ-Cepsilon). This line had no further sequential Sgamma2-Sepsilon rearrangements, providing evidence that the productive VDJ-Cepsilon mRNA was derived from a transcriptionally active unrearranged epsilon gene locus by trans-splicing. Taken together, these results provide possible evidence that trans-splicing of germ-line Ig RNA transcripts occurs in human B cells.

Multiple types of chimeric germ-line Ig heavy chain transcripts in human B cells: evidence for trans-splicing of human Ig RNA

Germ-line transcripts from Ig heavy chain loci precede the occurrence of isotype switching and are thought to play an important though still controversial role in Ig class switching. In this study, we employed a reverse transcriptase-PCR approach to detect human chimeric Ig germ-line mRNA transcripts. Multiple types of chimeric Ig germ-line transcripts (Imu-Cepsilon, Iepsilon-Cmu, Imu-Cgamma4, Igamma-Cmu, Igamma-Cepsilon, Iepsilon-Cgamma, and Igamma4-Calpha1 transcripts) were readily detected in human B cells stimulated with IL-4 alone. Sequence analysis revealed that all of these chimeric Ig germ-line transcripts represented the I exons from one Ig locus spliced to the CH exons from another locus by using consensus sequences for splicing donor and acceptor sites, indicating that they were generated through splicing machinery. In the case of stimulation of human resting B cells with IL-4 alone, the chimeric Ig germ-line transcripts are likely derived from a trans-splicing mechanism, as the extensive searching did not find evidence that Ig class-switch recombination had occurred, which alternatively could give rise to chimeric Ig mRNA by mechanisms other than trans-splicing. Similarly, an EBV-transformed gamma2 rearranged B cell line, GM1500, which produces IgG2 and contains both gamma2 productive and epsilon germ-line transcripts, also expressed chimeric germ-line RNA (Iepsilon-Cgamma2) and epsilon-productive transcripts (VDJ-Cepsilon). This line had no further sequential Sgamma2-Sepsilon rearrangements, providing evidence that the productive VDJ-Cepsilon mRNA was derived from a transcriptionally active unrearranged epsilon gene locus by trans-splicing. Taken together, these results provide possible evidence that trans-splicing of germ-line Ig RNA transcripts occurs in human B cells.

Quantal components of spontaneous excitatory junction potentials at visualised varicosities

The electrical signs of spontaneous transmitter release were recorded with an extracellular electrode from single visualized sympathetic varicosities on the mouse vas deferens. Ultrastructural examination of these varicosities with the electron microscope showed that they formed close-contacts with smooth muscle cells. Amplitude-frequency histograms of the spontaneous excitatory junction potentials (SEJPs) were constructed in order to determine the statistical nature of spontaneous transmitter release from a varicosity. SEJP histograms often possessed several peaks. Statistical tests showed that these were separate modes in the histograms indicating that the SEJPs were composed of subunits. The SEJP histograms were described by a mixture of distributions in which the components were identified as quanta and there was a Poisson release of quanta. The second mode in the SEJP histograms was sometimes twice that of the first mode but generally greater, suggesting a potentiation of the effects of one quantum released nearly simultaneously with another quantum. The components in the SEJP histograms were well fitted by either a Gaussian or a gamma distribution indicating that the quantum of transmitter could be described as a Gaussian or gamma variate.

Inhibition of left ventricular hypertrophy and expression of proto-oncogenes c-myc other than c-fos in myocardium by early captopril treatment in SHR rats

AIM

To explore the mechanisms by which angiotensin converting enzyme inhibitor (ACEI) prevents the development of left ventricular hypertrophy (LVH).

METHODS

Captopril (Cap 100 mg.kg(-1).d(-1)) was given orally to male spontaneously hypertensive rats from intrauterine period to 16 wk of age. Experiments were performed at 40 wk of age. SBP, left ventricular weight to body weight ratio (LVW/BW) were assessed. The levels of c-myc and c-fos mRNA in the left ventricle were measured by Northern blot.

RESULTS

Early-onset Cap therapy significantly decreased SBP. After discontinuance of treatment for 24 wk, SBP of SHRcap was still maintained at a lower level. LVW/BW in SHRcap was markedly reduced. The expression of myocardial c-myc mRNA was decreased by 72% in SHRcap compared with that in the untreated SHR, but the expression of myocardial c-fos mRNA was not different between the untreated SHR, SHRcap, and WKY rats.

CONCLUSION

Early Cap treatment may permanently prevent the development of hypertension, inhibit LVH. Furthermore, the prevention of LVH is associated with a decrease in c-myc mRNA levels, and the development and regression of left ventricular hypertrophy may be irrelevant to c-fos expression.

Nitric oxide modulation of quantal secretion in chick ciliary ganglia

1. Long-term potentiation of quantal secretion was studied at ciliary ganglion synapses of post-hatched birds following tetanic stimulation of the oculomotor nerve and the effects of nitric oxide (NO) on quantal secretion were determined. 2. Tetanic stimulation of the oculomotor nerve at 30 Hz for 20 s at room temperature increased the amplitude of the excitatory postsynaptic potential (EPSP) by about 100%; 1-2 min after the tetanus the EPSP declined exponentially with a time constant of about 10 min (long-term potentiation; LTP). LTP was due to an increase in the quantal content of the EPSP not to a change in quantal size. 3. A component of LTP was shown to be due to the release of NO in the ganglion, as blocking the synthesis of NO with L-arginine methyl ester decreased the potentiation by 70%. 4. Exogenous application of NO using sodium nitroprusside increased the amplitude of the EPSP by more than 30% due to an increase in the quantal content of the EPSP. 5. Both 8-bromo-cGMP and 8-bromo-cAMP increased the quantal content of the EPSP by more than 44% without changing the quantal size. 6. The results suggest that endogenous NO is involved in either the initiation or maintenance phase of LTP. This may occur through an increase in quantal secretion consequent on the action of an elevated cGMP increasing cAMP.

Effect of nitric oxide synthase inhibition on long-term potentiation at associational-commissural and mossy fibre synapses on CA3 pyramidal neurones

1. The sensitivity of long-term potentiation (LTP) to nitric oxide synthase (NOS) inhibition was determined for two synaptic input systems onto CA3 pyramidal neurones the LTP of which display differential sensitivity to N-methyl-D-aspartate (NMDA) receptor antagonists: the fimbrial input which activates the associational-commissural synapses on the distal apical dendrites and the mossy fibre input which synapses on the proximal apical dendrites of CA3 pyramidal neurones. 2. Following high-frequency stimulation (HFS) of the fimbrial input, average e.p.s.p. amplitude increased by 92.4 +/- 22.0% (mean +/- s.e.mean; n = 6 cells) when compared to the pre-HFS average. In the presence of 100 microM N omega-nitro-L-arginine methyl ester (L-NAME), the enhancement was reduced significantly to 32.2 +/- 11.6% (n = 5 cells; P < 0.05). In the presence of 300 microM L-NAME, the inhibition was more complete, with post-HFS e.p.s.p. amplitude increasing an average 6.2 +/- 9.3% (n = 7 cells, P < 0.05). 3. Following high frequency stimulation of the mossy fibre input, average e.p.s.p. amplitude increased by 57.9 +/- 13.0% (n = 6 cells) when compared to the pre-HFS average. The presence of 100 microM L-NAME had no significant effect on the enhancement, averaging 63.6 +/- 5.9% (n = 4 cells; P > 0.05). Similarly, increasing the concentration of L-NAME to 300 microM had no significant effect on the potentiation, with the post-HFS amplitude increasing by an average 55.6 +/- 9.5% (n = 5 cells, P > 0.05). 4. These results suggest that LTP at associational-commissural synapses (fimbrial input) is significantly depressed in the presence of the NOS inhibitor L-NAME, while mossy fibre LTP is unchanged.

Frequency of behaviour disorder and related factors in school children in Lusaka

In a cross-sectional study of behaviour disorders amongst children attending three primary schools in Lusaka 210 children, aged 8-12 years, were assessed by means of the behaviour rating questionnaire developed by Rutter for teachers. The frequency of behaviour disorder was 14.8 per cent with sex ratio 1.9:1 (boy:girl). Children's mothers were interviewed to obtain background social and demographic information about the family, and anthropometric measurements were made on the children. Behaviour disorder was largely associated with characteristics of the school, socio-economic status, mother's occupation, play facilities at home and past history of hospitalization. The relevance of the behaviour rating questionnaire for developing countries is discussed.

Clear and colorless fluid observed during percutaneous transhepatic gallbladder drainage

Twelve patients with discharge of clear colorless fluid during percutaneous transhepatic gallbladder drainage (PTGBD) were encountered during a period of 4.5 years. On the average, the fluid appeared on the 12th day after PTGBD and continued to flow until the completion of observation. The volume was usually less than 60ml per day. It flowed in an alternating pattern with normal yellow color bile each day. The fluid was observed in patients in whom satisfactory patency of the biliary system was confirmed by cholangiography and/or cholangio-fiberscopy. Biochemical examinations of the fluid revealed lower biliary lipids but a similar electrolyte composition compared to bile of normal color. It was alkaline. These observations indicate that the clear colorless fluid is different from what is known as "white bile", which is produced when there is an obstruction of the biliary tree. The fluid may be secreted from the gallbladder epithelium or the bile duct epithelium. The significance was not clarified in this study. Further investigation is necessary to elucidate the clinical implications of the clear and colorless fluid secretion.

[A recurrent gastric cancer improved by radiation therapy]

In March, 1988, a 65 year-old male underwent a total gastrectomy for a gastric cancer (Borrmann 3: a poorly differentiated adenocarcinoma; IIc: signet ring cell carcinoma). In October that year, however, an anastomotic recurrence of this tumor was found. Thus, from November, 1988 to January, 1989, to treat this recurrence, the patient received a course of radiation therapy frontally, towards the upper abdomen, with a total dose of 46.5 Gy (linac X-ray). His symptoms improved, and a CT, an upper gastrointestinal barium study, and an endoscopic examination indicated that the tumor had disappeared. No further recurrence was found until January, 1990, when the patient died of a metastasis that had spread throughout his body.

Development and localization of enkephalin and substance P in the nucleus of tractus solitarius in the medulla oblongata of human fetuses

The presence of enkephalin and substance P-positive neurons and fibers were studied by immunohistochemistry (peroxidase-antiperoxidase or avidin-biotin-peroxidase complex methods) in 26 human fetuses ranging from 11 weeks of gestation to 40 weeks of gestation. Enkephalin-positive neurons were localized in the commissural, medial and intermediate subnuclei as early as 11-12 weeks' gestation. Positive enkephalin fibers were localized around 12 weeks' gestation and in many subnuclei, notably the medial, commissural, intermediate, ventrolateral, ventral and dorsolateral subnuclei. Substance P-positive neurons were localized in the commissural and medial subnuclei around gestation age 13 weeks. Positive substance P fibers appeared even earlier, around 11 weeks of gestation in many subnuclei, notably the medial, intermediate, ventral, ventrolateral and dorsolateral subnuclei. Increase in both enkephalin- and substance P-positive fibers was evident in the later stages of development (e.g. around 26 weeks of gestation). The importance of the early appearance of enkephalin and substance P neurons and fibers of the pain pathways in the major subnuclei connecting with the cardiovascular, gastrointestinal and respiratory functions in the human has to be stressed.