靶向HER2基因的siRNA联合卡铂对肺腺癌A549细胞的抑制作用

目的 探讨靶向HER2基因的siRNA联合卡铂对肺腺癌A549细胞的抑制作用.方法 设计并合成3对靶向HER2基因的siRNA(2621组、1724组、1491组),分别转染肺腺癌A549细胞,同时设阴性对照组及空白组.应用实时荧光定量PCR法和免疫组化法检测细胞内HER2 mRNA及其蛋白的表达.应用流式细胞术检测卡铂与HER2 siRNA联合应用时肺癌A549细胞的凋亡率.结果 2621组和1724组HER2 mRNA及蛋白表达均低于1491组和阴性对照组.流式细胞术检查显示,各组间细胞凋亡率比较P＜0.01,HER2 siRNA+卡铂组细胞的凋亡率均高于对应浓度的卡铂组.结论 siRNA能抑制HER2基因在肺癌A549细胞中的表达,并与卡铂协同诱导癌细胞凋亡.     

重组腺相关病毒介导的RNA干扰抑制血管生长素表达对肺腺癌细胞成瘤能力的影响

目的 通过腺相关病毒(AAV)介导的RNA干扰(RNAi)抑制肺腺癌细胞A549血管生长素(ANG)表达,观察其对癌细胞生长和成瘤能力的影响.方法 构建H1启动子驱动的表达针对ANG的小干扰RNA(siRNA)重组腺相关病毒(AAV-shANG),转染A549细胞,同时以正常A549细胞以及转染AAV-Null的A549细胞作为对照,观察重组腺相关病毒介导的RNAi抑制ANG表达对A549细胞生长、致瘤、肿瘤细胞增殖、凋亡及肿瘤微血管密度的影响.用t检验分析各组间差别,所有数据均用x±s表示.结果 体外实验结果表明重组腺相关病毒AAV-shANG成功构建,重组腺相关病毒转染A549细胞72 h后ANG蛋白表达水平明显低于A549细胞组及AAV-Null组;转基因A549细胞细胞周期分析结果提示,正常A549细胞、AAV-Null转染细胞和AAV-shANG转染细胞的增殖指数(PI)分别为0.32±0.29、0.35±0.38和0.31±0.43,差异不明显.体内实验结果表明,AAV-shANG转染细胞组胸腺缺陷小鼠的成瘤体积、瘤质最均明显低于两对照组.各组微血管密度分别为9.4±1.5、9.8±2.1和5.7±1.9,提示AAV-shANG转染细胞组与正常A549细胞和AAV-Null转染细胞组有明显差异.各组凋亡细胞的百分率分别为(7.7±3.1)%、(8.5±5.4)%和(17.1±8.6)%.AAV-shANG转染细胞组凋亡细胞的百分率明显高于正常A549细胞组和AAV-Null转染细胞组,各组细胞增殖核抗原(PCNA)阳性表达率分别为(84.8±9.7)%、(85.8±9.8)%、(70.4±10.1)%,AAV-shANG转染细胞组PCNA表达率低于两对照组.结论 AVV-siRNA表达能显著抑制肿瘤细胞ANG表达及肿瘤细胞增殖,促进肿瘤细胞凋亡,抑制肿瘤生长.     

肺腺癌合并脑转移患者血清S100B蛋白表达水平及其介导的生物学功能初步研究

目的:探讨肺腺癌合并脑转移患者血清S100B蛋白表达水平及其介导的生物学功能。方法:采集38例未发生脑转移的肺腺癌患者(非脑转移组)和25例肺腺癌合并脑转移患者(脑转移组)血液样本,采用酶联免疫吸附试验检测血清S100B蛋白含量;将质粒载体pcDNA3.1-S100B转染至肺腺癌细胞株A549,RT-PCR检测细胞S100BmRNA表达,免疫印迹试验检测细胞S100B蛋白表达,MTT比色法检测细胞增殖能力,Transwell小室检测细胞的迁移能力。结果:脑转移组血清S100B蛋白水平(48.14±4.39)ng/L显著高于非脑转移组(15.37±1.43)ng/L(t=42.841,P=0.000)。转染S100B后A549细胞形态明显拉伸延长,并出现侵袭性伪足。阳性对照组S100BmRNA表达量为(0.743 8±0.174 1),显著高于空白对照组(0.379 5±0.070 1)和阴性对照组(0.399 1±0.083 5)(P0.05);阳性对照组S100B蛋白表达量为(1.403 7±0.209 3),显著高于空白对照组(0.791 4±0.094 3)和阴性对照组(0.809 3±0.102 7)(P0.05)。3组细胞增殖能力均随时间延长逐渐增加,其中第2、3、4、5、6、7、8天阳性对照组细胞增殖能力显著高于空白对照组和阴性对照组,各组间比较差异有统计学意义(P0.05)。转染S100B后,A549细胞迁移至细胞培养下室的数量明显增多,提示A549细胞细胞迁移能力显著升高;阳性对照组细胞迁移能力显著高于空白对照组和阴性对照组,各组间比较差异有统计学意义(P0.05)。结论:肺腺癌合并脑转移患者血清S100B蛋白显著升高,转染S100B蛋白的A549细胞增殖能力和迁移能力显著提高,S100B蛋白与肺腺癌脑转移等恶性生物学行为有关。     

siRNA抑制PTTG表达对人结肠癌LoVo细胞增殖、凋亡及细胞周期的影响

目的 探讨siRNA抑制人垂体瘤转化基因PTTG表达对人结肠癌LoVo细胞增殖、凋亡及细胞周期的影响.方法 LoVo细胞分为3组:正常细胞对照组、Lipo2000+ pGenesil-2.1 HK组(HK阴性对照组)、Lipo2000+ pGenesil-2.1-PTTG siRNA组.应用Western印迹法检测转染48 h后各组细胞PTTG蛋白表达,MTT法检测转染24、48和72 h后各组细胞增殖情况,流式细胞术检测转染48 h后各组LoVo细胞凋亡和细胞周期情况.结果 pGenesil-2.1-PTTG siRNA质粒转染LoVo细胞后PTTG蛋白表达明显低于正常和HK阴性对照组.MTT比色分析法显示,pGenesil-2.1-PTTGsiRNA质粒转染LoVo细胞后,在24、48和72 h细胞增殖能力均显著低于正常对照组和阴性对照HK组(均P＜0.05).流式细胞术检测结果显示,与对照组相比,转染pGenesil-2.1 PTTG siRNA质粒后LoVo细胞Go/G1期细胞百分率均高于正常和阴性HK对照组(均P＜0.01),而S期细胞百分率均低于正常和阴性HK对照组(均P＜0.01);Annexin V-PI双染结果显示,转染pGenesil-2.1 PTTG siRNA质粒后LoVo细胞凋亡百分率高于正常和阴性HK对照组(均P＜0.01).结论 pGenesil-2.1-PTTG siRNA质粒可明显抑制LoVo细胞PTTG蛋白表达,并进而抑制LoVo细胞增殖,促进其凋亡,使细胞阻滞于G0/G1期.     

表皮型脂肪酸结合蛋白-5基因沉默对人卵巢癌细胞A2780增殖、凋亡及侵袭力的影响

目的探讨通过siRNA干扰技术沉默表皮脂肪酸结合蛋白(FABP)-5基因表达对人卵巢癌A2780细胞增殖、凋亡及侵袭的影响。方法以人卵巢癌A2780细胞为研究对象,根据FABP-5 mRNA编码序列设计并合成干扰siRNA序列,实施瞬时转染卵巢癌A2780细胞。将人卵巢癌A2780细胞分为FABP-5 siRNA组,阴性对照组、空白对照组。用逆转录聚合酶链式反应(RTPCR)和Western印迹法分别从mRNA水平和蛋白水平检测FABP-5基因的表达。细胞计数试剂盒(CCK)-8法测定细胞体外增殖能力;流式细胞技术(FCM)检测各组细胞周期和凋亡的变化情况,划痕愈合实验、细胞侵袭实验评价沉默FABP-5基因对人卵巢癌A2780细胞迁移及侵袭能力的影响。结果 RT-PCR和Western印迹法显示,FABP-5 siRNA组较阴性对照组和空白对照组的FABP-5 mRNA和蛋白相对表达水平均显著降低。FABP-5 siRNA组细胞的生长速度明显减慢,细胞周期阻滞在G0/G1期,S期细胞数减少;与阴性对照组和空白对照组相比,FABP-5 siRNA组细胞的凋亡率明显升高(P0.01),迁移、侵袭力显著下降(P0.05)。结论特异性干扰FABP-5基因表达可抑制人卵巢癌A2780细胞的迁移和侵袭能力,并抑制肿瘤细胞增殖,因此,FABP-5的siRNA序列可能成为治疗宫颈癌的有效靶点。     

HPS-1对人肺腺癌A549细胞凋亡诱导作用的机制研究

目的 评价HPS-1对人肺腺癌A549细胞凋亡蛋白Caspase 3、8、9以及Bax、Bcl-2mRNA表达的影响,探究HPS-1抗肺肿瘤可能机制.方法 人肺腺癌A549细胞经低、中、高剂量HPS-1处理不同时间后,噻唑蓝(MTT)法检测各组细胞的增殖情况,流式细胞术(FCM)法检测各组细胞凋亡率及细胞周期比例,比色法检测各组细胞凋亡蛋白Caspase-3、8、9的表达,RT-PCR法检测各组细胞Bax、Bcl-2 mRNA的表达.结果 MTT结果显示,低、中、高剂量HPS-1对人肺腺癌A549细胞的增殖具有明显抑制作用,且具有时间、剂量依赖性;FCM法检测发现,低、中、高剂量HPS-1对人肺腺癌A549细胞的凋亡具有促进作用,且与剂量呈正相关;比色法检测各组细胞发现,HPS-1促进凋亡蛋白Caspase-3、8、9的上调,且HPS-1高剂量组凋亡蛋白上调更明显.结论 HPS-1具有抑制人肺腺癌A549细胞增殖、诱导其凋亡作用,且该作用可能与HPS-1阻滞细胞周期G1期,上调凋亡蛋白Caspase-3、8、9及Bax mRNA表达,下调Bcl-2 mRNA表达有关.     

核糖核酸干扰沉默生长抑制因子1基因表达对胃腺癌AGS细胞凋亡的影响

目的 探讨RNA干扰沉默生长抑制因子1(ING1)基因表达对胃腺癌AGS细胞凋亡的影响。方法人胃腺癌细胞株AGS经常规培养后分为空白对照组、阴性对照组[转染阴性对照小干扰RNA(siRNA)序列]、siRNA组（转染特异性ING1 siRNA序列）。应用免疫荧光、定量PCR和免疫印迹方法检测转染后不同时间的ING1基因表达沉默效果。应用流式细胞技术检测ING1基因表达沉默对AGS细胞凋亡的影响。结果ING1主要在AGS细胞胞质中表达。在荧光定量PCR技术检测中将空白对照组的ING1基因表达量设为1,则转染后24和40 h阴性对照组的ING1基因相对表达量分别为0.88±0.16和0.92±0.13,siRNA组ING1基因相对表达量分别为0.38±0.09和0.17±0.06。空白对照组和阴性对照组比较,P值分别=0.78和0.82。空白对照组和siRNA组比较,P值均=0.01。阴性对照组和siRNA组比较,P值分别=0.02和0.01。免疫印迹技术检测结果显示,转染后40 h AGS细胞中ING1蛋白表达水平明显下调。空白对照组AGS细胞凋亡率为11.06％±0.97％,阴性对照组、siRNA组转染40 h后AGS细胞凋亡率为11.82％±0.69％和 6.70％±0.41％。空白对照组与siRNA组比较P=0.024。空白对照组与阴性对照组比较P=0.76。阴性对照组与siRNA组比较P=0.019。结论ING1在人胃癌细胞凋亡过程中发挥重要作用,可能成为胃癌基因治疗的新靶点。     

siRNA干扰沉默EZH2基因对人肝癌HepG2细胞增殖的影响

目的探讨小分子RNA(siRNA)干扰沉默靶基因EZH2对人肝癌HepG2细胞增殖的影响。方法取对数生长期的HepG2细胞,分为转染组、阴性对照组及空白对照组,转染组与阴性对照组按照Lipofectamine2000使用说明分别瞬时转染EZH2 siRNA、荧光物FAM,对照组不予任何干预。分别采用MTT法检测细胞增殖活性、流式细胞仪检测细胞凋亡率及周期;qRealtime-PCR和Western blot方法检测EZH2 mRNA和蛋白表达。结果与阴性对照组相比,转染组细胞增殖明显受抑;与阴性对照组及空白对照组比较,转染组细胞凋亡率明显升高,G0/G1期细胞明显增多,S期明显细胞减少;转染组EZH2 mRNA和蛋白表达明显下调,P均<0.05。结论 EZH2 siRNA可抑制人肝癌细胞增殖活性,是一种潜在基因治疗新方法。     

下调雄激素受体表达对不同类型老年宫颈癌患者癌细胞活性的影响

目的探讨下调雄激素受体(AR)表达对不同类型老年宫颈癌患者癌细胞凋亡情况的影响及其相关机制。方法以AR为靶点构建小干扰RNA(siRNA),慢病毒为载体转染人宫颈腺癌细胞系C33a、宫颈鳞癌细胞系Caski。荧光定量PCR和Western印迹分别检测AR mRNA和蛋白的表达情况,流式细胞术检测宫颈癌细胞的凋亡情况。RT-PCR和Western印迹检测各组细胞中G蛋白耦联受体(Cpr)30 mRNA和蛋白表达情况。结果 AR干扰组人宫颈癌细胞株C33a、Caski AR mRNA及其蛋白的相对表达量较阴性对照组、空白对照组明显降低(P<0.05)。AR干扰组C33a、Caski凋亡率较阴性对照组和空白对照组明显增加(P<0.05)。AR干扰组内比较显示,C33a凋亡率明显大于Caski(P<0.05)。AR干扰组Cpr30 mRNA及其蛋白相对表达量均明显高于阴性对照组和空白对照组(P<0.05)。结论经siRNA转染下调AR表达后宫颈腺癌和宫颈鳞癌细胞凋亡率均增加,以宫颈腺癌更为明显;下调AR表达可提升Cpr30表达水平,进而激活Cpr30/Tlr3信号通路,促进宫颈癌细胞凋亡。     

特异性siRNA抑制Bcl-xl基因在T24细胞中表达的研究

目的研究RNAi（RNA interference）效应对T24细胞中Bcl-xl基因表达的抑制作用.方法设计并体外化学合成靶向Bcl-xl基因的siRNA,在倒置显微镜下观察转染前后细胞形态的改变.用RT-PCR检测转染前后Bcl-xl基因的mRNA,MTT检测细胞增殖情况,并比较各组结果.结果转染组与阴性对照组和空白对照组相比,特异性siRNA能抑制T24细胞增殖和诱导其凋亡.结论在细胞水平上,化学合成的siRNAs可以抑制Bcl-xl基因的表达,为利用RNAi抑制Bcl-xl的研究奠定基础.     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.     

A single injection of adrenergic agonists enhances pineal melatonin production in Turkish hamsters

Abstract: The purpose of this study was to determine whether the pineal gland of Turkish hamsters (Mesocricetus brandti) responds to adrenergic agonists with an increase in melatonin production, and, if it does, whether the sensitivity of the pineal gland to agonists would differ throughout the dark phase. Adult Turkish hamsters weighing 110–210 g received a subcutaneous injection of isoproterenol (ISO, 1 mg/kg B.W.) or norepinephrine (NE, 1 mg/kg B.W.) at different times of night. Animals exposed to LD 16:8 responded to ISO or NE with increased pineal melatonin content only when injected at dawn, when endogenous melatonin is at basal or near-basal levels. When the 8 hr scotophase was entirely replaced with light, the responsiveness to ISO injections at dawn disappeared. In animals exposed to light from 30 min prior to injection to the time of sacrifice, ISO injections increased pineal melatonin content (P < 0.005, three-way ANOVA), which varied, depending on the specific time of injection (effect of time of night, P < 0.05, three-way ANOVA). These results demonstrate that (1) adrenergic agonists enhance the production of pineal melatonin in Turkish hamsters, (2) this stimulatory effect takes place late, but not early in the 8 hr scotophase, and (3) the adrenergic induction of pineal melatonin production in Turkish hamsters requires priming by darkness during the appropriate circadian phase.     

Immune effector mechanisms in malaria: An update focusing on human immunity

The past decade has witnessed dramatic decreases in malaria‐associated mortality and morbidity around the world. This progress has largely been due to intensified malaria control measures, implementation of rapid diagnostics and establishing a network to anticipate and mitigate antimalarial drug resistance. However, the ultimate tool for malaria prevention is the development and implementation of an effective vaccine. To date, malaria vaccine efforts have focused on determining which of the thousands of antigens expressed by Plasmodium falciparum are instrumental targets of protective immunity. The antigenic variation and antigenic polymorphisms arising in parasite genes under immune selection present a daunting challenge for target antigen selection and prioritization, and is a given caveat when interpreting immune recall responses or results from monovalent vaccine trials. Other immune evasion strategies executed by the parasite highlight the myriad of ways in which it can become a recurrent infection. This review provides an update on immune effector mechanisms in malaria and focuses on our improved ability to interrogate the complexity of human immune system, accelerated by recent methodological advances. Appreciating how the human immune landscape influences the effectiveness and longevity of antimalarial immunity will help explain which conditions are necessary for immune effector mechanisms to prevail.     

Secondary aortoduodenal fistula

Aorto-duodenal fistulae （ADF） are the most frequent aorto-enteric fistulae （80%）, presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting. Computed tomography scan showed in the third duodenal segment the presence of inflammatory tissue with air bubbles between the duodenum and prosthesis, adherent to the duodenum. The patient was submitted to surgery, during which the prosthesis was detached from the duodenum, the intestine failed to close and a gastro-jejunal anastomosis was performed. The post-operative course was simple, secondary ADF was a complication （0.3%-2%） of aortic surgery. Mechanical erosion of the prosthetic material into the bowel was due to the lack of interposed retroperitoneal tissue or the excessive pulsation of redundantly placed grafts or septic procedures. The third or fourth duodenal segment was most frequently involved. Diagnosis of ADF was difficult. Surgical treatment is always recommended by explorative laparotomy. ADF must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained obstructive syndrome. Rarely the clinical picture of ADF is subtle presenting as an obstructive syndrome and in these cases the principal goal is to effectively relieve the mechanical bowel obstruction.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Married to M. tuberculosis: risk of infection and disease in spouses of smear-positive tuberculosis patients

Objectives To quantify the risk of infection and disease in spouses of tuberculosis patients and the extent to which intervention could reduce the risk in this highly exposed group. Methods We compared HIV prevalence, TB prevalence and incidence and tuberculin skin test (TST) results in spouses of TB patients and community controls. HIV‐positive spouses were offered isoniazid preventive therapy (IPT), and TST was repeated at 6, 12 and 24 months. Results We recruited 148 spouses of smear‐positive patients ascertained prospectively and 3% had active TB. We identified 203 spouses of previously diagnosed smear‐positive patients, 11 had already had TB, and the rate of TB was 2.4 per 100 person years(py) over 2 years (95% CI 1.15–5.09). 116 were found alive and recruited. HIV prevalence was 37% and 39% in the prospective and retrospective spouse groups and 17% in controls. TST was ≥10 mm in 80% of HIV negative and in 57% of HIV‐positive spouses ascertained retrospectively; 74% HIV negative and 62% HIV‐positive spouses ascertained prospectively, and 48% HIV negative and 26% HIV‐positive community controls. Of 54 HIV‐positive spouses, 18 completed 6‐month IPT. At 2 year follow‐up, 87% of surviving spouses had TST ≥10 mm and the rate of TB was 1.1 per 100 py (95% CI 0.34–3.29). Conclusions Spouses are a high‐risk group who should be screened for HIV and active TB. TST prevalence was already high by the time the spouses were approached but further infections were seen to occur. Uptake and adherence to IPT was disappointing, lessening the impact of short‐duration therapy.