Inhibition of Mammalian Gq Protein Function by Local Anesthetics

Background: Local anesthetics have been shown to selectively inhibit functioning of Xenopus laevis Gq proteins. It is not known whether a similar interaction exists with mammalian G proteins. The goal of this study was to determine whether mammalian Gq protein is inhibited by local anesthetics.

Methods: In Xenopus oocytes, the authors replaced endogenous Gq protein with mouse Gq (expressed in Sf9 cells using baculovirus vectors). Cells endogenously expressing lysophosphatidic acid or recombinantly expressing muscarinic m3 receptors were injected with phosphorothioate DNA antisense (or sense as control) oligonucleotides against Xenopus Gq. Forty-eight hours later, oocytes were injected with purified mouse Gq (5 x 10-8 m) or solvent as control. Two hours later, the authors injected either lidocaine, its permanently charged analog QX314 (at IC50, 50 nl), or solvent (KCl 150 mm) as control and measured Ca-activated Cl currents in response to lysophosphatidic acid or methylcholine (one tenth of EC50).

Results: Injection of anti-Gq reduced the mean response size elicited by lysophosphatidic acid to 33 +/- 7% of the corresponding control response. In contrast, responses were unchanged (131 +/- 29% of control) in cells in addition injected with mouse Gq protein. Injection of mouse Gq protein "rescued" the inhibitory effect of intracellularly injected QX314: whereas QX314 was without effect on Gq-depleted oocytes, responses to lysophosphatidic acid after QX314 injection were inhibited to 44 +/- 10% of control response in cells in addition injected with mouse Gq protein (5 x 10-8 m). Similar results were obtained for m3 signaling and intracellularly injected lidocaine.     

Dose-dependent Inhibition of Platelet Function by Acetaminophen in Healthy Volunteers

Background: Acetaminophen (paracetamol) is widely used for postoperative analgesia. Its mechanism of action is inhibition of prostaglandin synthesis in the central nervous system, and acetaminophen is traditionally not considered to influence platelet function. The authors studied the dose-dependent inhibition of platelet function by acetaminophen in healthy volunteers.

Methods: Thirteen healthy male volunteers (aged 19-26 yr) were given placebo or 15, 22.5, or 30 mg/kg acetaminophen intravenously in a double-blind, crossover study. Ten and 90 min after infusion, platelet function was assessed by photometric aggregometry and by measuring release of thromboxane B2, analgesia by cold pressor test, and plasma acetaminophen concentrations by high-performance liquid chromatography.

Results: When triggered with 500 [mu]m arachidonic acid, median platelet aggregation (area under the curve) was 25.7, 22.8, 4.1, or 3.6 x 103 area units (P < 0.001) 10 min after placebo or 15, 22.5, or 30 mg/kg acetaminophen, respectively. An increasing concentration of arachidonic acid attenuated the antiaggregatory effect. After 90 min, platelet function was recovering. Release of thromboxane B2 was also dose-dependently inhibited by acetaminophen. Although plasma concentration of acetaminophen increased linearly with the dose, no analgesic effect was detected in the cold pressor test.     

Inhibition of bone resorption by bisphosphonates: Interactions between bisphosphonates,osteoclasts, and bone

Summary Bisphosphonates are nonbiodegradable pyrophosphate analogues that are being used increasingly to inhibit bone resorption in disorders characterized by excessive bone loss. We have previously found that dichloromethylene bisphosphonate (Cl₂MBP) inhibits bone resorption through injury to the cells that resorb Cl₂MBP-contaminated surfaces. 3-amino-1-hydroxypropylidene-1,1-bisphosphonate (AHPrBP) is a more potent inhibitor of bone resorptionin vivo, and we have attempted to identify a step in the resorptive pathway that accounts for this increased potency. We found that when osteoclasts, isolated from neonatal rat long bones, were incubated on bone slices in the presence of bisphosphonates, AHPrBP was less, rather than more potent as a resorption-inhibitor than Cl₂MBP. The greater sensitivity of resorption to AHPrBPin vivo could neither be attributed to an effect of AHPrBP on the ability of osteoblastic cells to stimulate resorption in response to calcium-regulating hormonesin vitro nor to an effect on osteoclast generation: osteoclast formation was unaffected by concentrations of AHPrBP 10-fold higher than those of Cl₂MBP which inhibit bone resorption in the bone slice assay. We also found no evidence for impaired osteoclast generationin vivo in AHPrBP-treated rats. These results suggest that the comparisons of potencyin vitro do not include all the factors responsible for determining bisphosphonate potencyin vivo. Because bisphosphonates owe the specificity of their actions to their ability to bind to bone surfaces, we performed experiments using bone slices that had been immersed in bisphosphonates before use. Bone resorption was virtually abolished on bone slices preincubated in 10⁻³ M AHPrBP. Inhibition was associated with degenerative changes in osteoclasts and a more rapid decrease in the number remaining on the bone surface than occurred with Cl₂MBP. The effect was specific for osteoclasts, could be prevented if bone resorption was suppressed by calcitonin, and was not seen in osteoclasts incubated in AHPrBP on plastic coverslips. These observations suggest that AHPrBP inhibits bone resorption through injury to osteoclasts when they solubilize bisphosphonate-contaminated bone. We found that the concentration of AHPrBP used in the preincubation phase could be reduced by an order of magnitude if the volume of the AHPrBP solution was correspondingly increased. This implies that the concentration of bisphosphonate is less relevant to potency comparisons than the density of bisphosphonate on the bone surface. The latter will be strongly influencedin vivo not only by affinity for bone but by the pharmacokinetic and other properties of the compound.     

Inhibition of WISE Preserves Renal Allograft Function

Wnt-modulator in surface ectoderm (WISE) is a secreted modulator of Wnt signaling expressed in the adult kidney. Activation of Wnt signaling has been observed in renal transplants developing interstitial fibrosis and tubular atrophy; however, whether WISE contributes to chronic changes is not well understood. Here, we found moderate to high expression of WISE mRNA in a rat model of renal transplantation and in kidneys from normal rats. Treatment with a neutralizing antibody against WISE improved proteinuria and graft function, which correlated with higher levels of β-catenin protein in kidney allografts. In addition, treatment with the anti-WISE antibody reduced infiltration of CD68⁺ macrophages and CD8⁺ T cells, attenuated glomerular and interstitial injury, and decreased biomarkers of renal injury. This treatment reduced expression of genes involved in immune responses and in fibrogenic pathways. In summary, WISE contributes to renal dysfunction by promoting tubular atrophy and interstitial fibrosis.The development of interstitial fibrosis and tubular atrophy with ongoing inflammation is a major risk for progressive graft dysfunction eventually leading to the failure of the majority of renal transplants. Although multiple approaches are available for preventing or at least blunting immune responses, there is currently no effective treatment for the development and progression of interstitial fibrosis and tubular atrophy.¹ The formation of matrix proteins in parallel to a progressive loss of graft function is a hallmark of chronic allograft dysfunction (CAD). Several pathways, including those involving TGF-β and angiotensin receptor, have been found to promote fibrosis and thus significant efforts have been made to evaluate the potential utility of these two pathway inhibitors for CAD. TGF-β has been shown to play an important role in epithelial-mesenchymal transition (EMT), which may, in turn, promote deteriorating structural changes characteristic for CAD.² However, inhibiting TGF-β may, because of its immunomodulatory effects, carry the risk of augmenting inflammation.³ Angiotensin II (AngII) is a growth factor that activates the Smad pathway during EMT involving TGF-β.⁴ AngII receptor antagonists were shown to reduce BP, proteinuria, and fibrosis in some studies.^5,6 However, the application of AngII receptor antagonists is known to be associated with intimal hyperplasia and deteriorating renal function, thus making its application in CAD challenging.⁷Wnt signaling is tightly regulated during kidney development and plays an important role in the formation of various structures of the developing kidney.^8–11 In normal adult kidneys, Wnt signaling is progressively downregulated once the developmental phase is completed.¹² Activation of Wnt signaling has been reported in a variety of human disease processes, including interstitial pulmonary fibrosis,¹³ and in transplanted kidneys undergoing interstitial fibrosis and tubular atrophy.¹⁴ To understand the contribution of Wnt-modulator in surface ectoderm (WISE) on tubular atrophy and interstitial fibrosis, we generated a potent rat inhibitory antibody to rat WISE, allowing long-term treatment while minimizing immune responses toward the injected antibody. Prophylactic treatment with a rat anti-WISE antibody, referred to hereafter as anti-WISE, reduced inflammatory infiltration, improved renal function, and reduced structural graft deterioration over a 6-month observation period. Serum biomarker and changes in gene expression suggested improvements in tubular epithelial integrity as well as decreases in profibrotic and inflammatory pathways, respectively. The improvement in graft function in our studies was associated with increased β-catenin levels. Moreover, WISE protein modulated Wnt signaling in vitro in a context-dependent manner, and directly affected E-cadherin expression and α-smooth muscle actin (α-SMA) expression in renal epithelial cells and interstitial fibroblasts.     

Platelet Consumption by Arterial Prostheses: The Effects of Endothelialization and Pharmacologic Inhibition of Platelet Function

The thrombogenic mechanism of arterial grafts has been studied by determining the relative utilization of platelets, fibrinogen and plasminogen by human arterial prostheses, and by direct examination of arterial grafts in a baboon model. Forty-one survival and turnover measurements of (51)Crplatelets, (131)I-fibrinogen and (125)I-plasminogen in ten patients with aortofemoral knitted Dacron prostheses demonstrated platelet consumption after graft placement (platelet survival 4.2 days +/- 0.5 and turnover 68,000 plat/ul/day +/-10,000 compared with 8.2 days +/- 0.3 and 35,000 plat/ul/day +/- 5,000 respectively for control subjects with stable vascular disease, p < 0.01). In vitro platelet function test results were normal. Platelet consumption was interrupted by dipyridamole or a combination of dipyridamole and acetylsalicylic acid, and platelet survival normalized spontaneously during nine months postoperatively. No significantly increased consumption of fibrinogen or plasminogen was found in these patients with arterial grafts.Placement of impervious knitted Dacron velour aortic grafts in baboons reproduced platelet consumption that progressively normalized over six weeks postoperatively. Platelet survival measurements correlated directly with endothelial cell coverage of the graft luminal surface in these animals implying that endothelialization of the graft surface was also occurring postoperatively in patients.     

Cathepsin K基因抑制后对软骨细胞功能的影响研究

目的研究应用RNA干扰技术早期抑制人CathepsinK（CTSK）基因的表达对延缓软骨细胞的去分化过程及维持软骨细胞表型的影响。方法pGCsilencer TMH1／Nco／GFP／CTsKRNAi质粒体外转染人软骨细胞,并用G418筛选3周．再通过RT—PCR检测CTSK、Ⅱ型胶原和AggrecancDNA转录的表达,Western-Blot、免疫荧光检测转染后软骨细胞的CTSK、Ⅱ型胶原和Aggrecan在蛋白水平的表达。结果装入质粒载体转染第1代的软骨细胞,在体外通过细胞形态观察可发现,抑制CTSK基因后3周软骨细胞仍大多数保持多角形,而对照组则向成纤维样细胞形态变化。RT—PCR结果显示,在mRNA水平抑制了CTSK的表达,而不影响对软骨细胞Ⅱ型胶原和Aggrecan的mRNA表达。免疫荧光和Wesfem—blot的结果证实了在早期抑制了软骨细胞CTSK基因表达并维持3周左右。软骨细胞的特异性基质Ⅱ型胶原和Aggrecan在蛋白水平明显增加。结论早期抑制了软骨细胞CTSK基因的表达,可使软骨细胞去分化过程中其软骨特异性基质Ⅱ型胶原和Aggrecan增加,说明可以维持软骨细胞的表型。     

Inhibition of VEGFR-2 Reverses Type 1 Diabetes in NOD Mice by Abrogating Insulitis and Restoring Islet Function

The dysregulation of receptor tyrosine kinases (RTKs) in multiple cell types during chronic inflammation is indicative of their pathogenic role in autoimmune diseases. Among the many RTKs, vascular endothelial growth factor receptor (VEGFR) stands out for its multiple effects on immunity, vascularization, and cell migration. Herein, we examined whether VEGFR participated in the pathogenesis of type 1 diabetes (T1D) in nonobese diabetic (NOD) mice. We found that RTK inhibitors (RTKIs) and VEGF or VEGFR-2 antibodies reversed diabetes when administered at the onset of hyperglycemia. Increased VEGF expression promoted islet vascular remodeling in NOD mice, and inhibition of VEGFR activity with RTKIs abrogated the increase in islet vascularity, impairing T-cell migration into the islet and improving glucose control. Metabolic studies confirmed that RTKIs worked by preserving islet function, as treated mice had improved glucose tolerance without affecting insulin sensitivity. Finally, examination of human pancreata from patients with T1D revealed that VEGFR-2 was confined to the islet vascularity, which was increased in inflamed islets. Collectively, this work reveals a previously unappreciated role for VEGFR-2 signaling in the pathogenesis of T1D by controlling T-cell accessibility to the pancreatic islets and highlights a novel application of VEGFR-2 antagonists for the therapeutic treatment of T1D.In type 1 diabetes (T1D), genetic and environmental risk factors lead to immune dysregulation, provoking an autoimmune response directed toward insulin-producing β-cells of the islets of Langerhans. Previous investigations have estimated that β-cells or islets in nonobese diabetic (NOD) mice and humans are diminished to 10–30% of their initial mass (1,2), and the residual islets are largely dysfunctional when hyperglycemia is first detected (1,2). However, low levels of C-peptide can be detected in T1D patients as far out as 1–2 years postdiagnosis, indicating a window of opportunity for therapies that can restore or preserve islet mass and function (3).Multitarget receptor tyrosine kinase inhibitors (RTKIs), such as sunitinib, were originally designed to target malignant tumors that express dysregulated tyrosine kinases, including platelet-derived growth factor (PDGF)-R, c-FMS, or c-Kit. However, these inhibitors also target vascular endothelial growth factor (VEGF) receptors (VEGFRs), which are elevated in the parenchyma and tissue vasculature in many tumor microenvironments and during chronic inflammation. VEGF regulates vasculogenesis and angiogenesis largely through activation of VEGFR-2 (4). In addition to stimulating endothelial cell mitogenesis and cell migration, VEGF also has effects on a limited number of other cell types, including stimulation of monocyte/macrophage migration. Studies of transgenic mice lacking VEGFR-1 (5) or that express VEGFR-1 with a “dead” kinase domain (6) reveal that VEGFR-1 functions as a negative regulator of vasculogenesis and angiogenesis. Similarly, VEGFR-2 deficiency is embryonically lethal in mice but is attributed to a nonfunctional and underdeveloped vascular system (7). The phenotypes of VEGFR-1 and VEGFR-2–null mice indicate that, although VEGF-A has limited function through VEGFR-1, the vascular remodeling functions of VEGF-A are largely mediated through the activation of VEGFR-2.Tyrosine kinase inhibitors (TKIs) have shown efficacy in mouse models of muscular dystrophy (8), multiple sclerosis (9), rheumatoid arthritis (10–12), and psoriasis (13). TKI can prevent and reverse diabetes in NOD mice (14–16). Imatinib, which predominantly targets c-abl and PDGF, reversed diabetes in NOD mice (14), but other RTKIs with distinct inhibitory profiles (e.g., sunitinib) were even more effective, suggesting that the precise constellations of TK targets were critical for maximum efficacy. In this regard, the VEGF-A/VEGFR-2 pathway, a key target of sunitinib, stands out as a key kinase regulating the pathogenesis of several of these inflammatory disorders (17–19). Intriguingly, VEGF serum levels are elevated in T1D patients compared with healthy controls and positively correlate with increased HbA_1c levels (20).In this study, we determined whether VEGFR-2 might be involved in the pathogenesis of T1D and tested the therapeutic efficacy of VEGFR-2 inhibition in the NOD mouse model of T1D. We report that inhibition of VEGFR-2 by RTKIs or blocking antibodies rapidly reversed diabetes and maintains euglycemia with continued drug administration. Reversal of diabetes was attributed to an abrogation of vascular remodeling in the pancreatic islets, which impairs T-cell trafficking and the severity of insulitis, ultimately improving glucose tolerance. Histological analysis of human and mouse pancreata revealed a positive correlation between the severity of insulitis and islet vascularity, implicating inflammation as a major driving force in the vascular remodeling observed in the islets. Collectively, our findings suggest that VEGF/VEGFR-2 signaling serves a critical gatekeeper function by controlling essential remodeling of the vasculature that is necessary for T cells to gain access to tissues.     

Synthetic Mesh Improves Shoulder Function After Intraarticular Resection and Prosthetic Replacement of Proximal Humerus

BackgroundShoulder function often is limited after tumor resection and endoprosthetic replacement of the proximal humerus. This is partly attributable to the inability to reliably reattach rotator cuff tendons to the prosthesis and achieve adequate shoulder capsule repair with a metallic prosthesis. An option to attain these goals is to use synthetic mesh for the reconstruction, although the value of this method has not been well documented in the literature.Questions/purposesWe asked whether patients who had shoulder reconstruction using synthetic mesh had (1) better shoulder function; (2) improved ROM compared with shoulder reconstructions without mesh; and (3) more stable joints compared with those in patients with similar resections who had reconstructions without synthetic mesh.MethodsDuring a 5-year period, we performed 41 intraarticular resections with endoprosthetic reconstructions for malignancies in the proximal humerus meeting specified criteria to generate similarity in the study groups. Twelve patients (29%) were lost to followup before 24 months, leaving 29 patients available for review at a mean of 45 months (range, 24–70 months). This retrospective study compared 14 patients with soft tissue reconstruction that included synthetic mesh with 15 patients with soft tissue reconstruction without the use of synthetic mesh. The choice was made during consultation between the patient and surgeon, after reviewing the perceived advantages and disadvantages of each approach. A tumor band (ligament advanced reinforcement system) was used as synthetic mesh and wrapped around the prosthesis of the proximal humerus for soft tissue reconstruction in the reconstruction-with-mesh group. Study endpoints included the Musculoskeletal Tumor Society (MSTS) function scores, American Shoulder and Elbow Surgeons (ASES) score, shoulder ROM, and proximal migration of the humeral prosthesis.ResultsThe mean MSTS score for patients without synthetic mesh reconstruction was 20 ± 3 points (66%), whereas for patients with synthetic mesh reconstruction, the mean score was 24 ± 2 points (79%; p = 0.001). Patients with synthetic mesh reconstruction had a higher mean total ASES score (85 ± 1.1 points versus 72 ±1.7 points; p = 0.025), and better function for activities of daily living. They also had better ROM on mean active forward flexion (p = 0.020), abduction (p < 0.001), and external rotation (p < 0.001) than patients without synthetic mesh reconstruction. Proximal migration of the prosthesis was observed in five of 15 of patients in the group without synthetic mesh reconstruction and in none of those treated with synthetic mesh (p = 0.042).ConclusionsPatients with intraarticular resection and endoprosthetic replacement of the proximal humerus with reconstruction that included synthetic mesh had better shoulder function and ROM, and more stable joints than patients who had reconstruction without synthetic mesh. This result supports prior observations by others and it remains to be shown whether use of the ligament advanced reconstruction system is superior to other types of mesh or other types of reconstructions. Further investigation is needed but our results indicate that using mesh should be considered for patients with tumor resection and endoprosthetic replacement of the proximal humerus.

Level of Evidence

Level III, therapeutic study.     

Inhibition of corticosteroidogenesis by etomidate

The effects of the intravenous anesthetic etomidate have been investigated on ACTH-induced steroidogenesis in vitro, using purified isolated rat adrenal cells. It was found that etomidate almost completely blocked corticosterone production induced by physiological concentrations of ACTH at doses of 200 ng or greater. The mean inhibitory etomidate concentration resulting in 50% inhibition approximated 1.5 X 10(-7)M which is in the range of concentrations measured after clinical doses of etomidate.     

Inhibition of hemopoiesis by nitrous oxide

Inhibition of hemopoiesis by nitrous oxide was studied in mice and the following results were obtained. 1) During exposure to N2O, the numbers of pluripotent hemopoietic stem cells (CFU-S) and granulocyte-macrophage progenitor cells (GM-CFC) decreased significantly in the murine spleen and bone marrow, but the former more than the latter. 2) The recovery of CFU-S and GM-CFC was delayed in mice that were given low-dose irradiation followed by continuous exposure to N2O. The delay of recovery was significantly more in the spleen than in the bone marrow. 3) The levels of serum granulocyte-macrophage colony stimulating factor (CSF) in N2O exposed mice, induced by endotoxin, decreased significantly compared with those of control mice. Prolonged N2O administration to mice appears to impair the hemopoietic inductive microenvironment as well as hemopoietic stem cells and hence results in hemopoietic death and delay of hemopoietic recovery after irradiation.     

Inhibition of osteoblast apoptosis by thrombin

The multifunctional serine protease thrombin has been shown to be a specific agonist for a variety of functional responses of cells including osteoblasts. The current study was conducted to determine if thrombin was capable of inhibiting apoptosis in osteoblasts, and if so, to examine the mechanism by which this occurred. Thrombin (20-100 nM) significantly inhibited apoptosis in serum-starved cultures of the human osteoblast-like Saos-2 cell line and cultures of primary osteoblasts isolated from mouse calvariae, as well as dexamethasone-treated primary mouse osteoblasts. Inhibition of serum deprivation-induced apoptosis was shown to require thrombin's specific proteolytic activity. Primary mouse osteoblasts were found to express two functional thrombin receptors, PAR-1 and PAR-4. Thrombin inhibited serum deprivation-induced apoptosis in osteoblasts isolated from PAR-1 null mice to the same degree as in osteoblasts isolated from wild-type mice. Treatment of serum-deprived osteoblasts, isolated from either PAR-1 null or wild-type mice, with a PAR-4-activating peptide failed to significantly inhibit apoptosis compared to the relevant control. Medium conditioned by thrombin-treated osteoblasts, in which thrombin had been inactivated, was able to inhibit serum deprivation-induced osteoblast apoptosis almost as well as thrombin itself. Blocking protein synthesis, by cycloheximide pretreatment of the conditioning cells, prevented this action. The ability of known osteoblast survival factors, such as transforming growth factor beta1, fibroblast growth factor-2, insulin-like growth factor-II, and interleukin-6, to inhibit serum deprivation-induced osteoblast apoptosis was also tested. None of these factors was able to inhibit serum deprivation-induced osteoblast apoptosis to the same extent as thrombin. The results presented here demonstrate that thrombin treatment of osteoblasts inhibits apoptosis induced either by dexamethasone or by serum deprivation. Furthermore, it does so independently of the known thrombin receptors by bringing about the synthesis and/or secretion of an unknown survival factor or factors, which then act in an autocrine fashion to inhibit apoptosis.     

Inhibition of alloantigen presentation by cyclosporine

Cyclosporine (CsA) was examined for its ability to inhibit alloantigen presentation by spleen cells in a primary mixed lymphocyte reaction; by gamma interferon-induced P388.D1 macrophages to an alloreactive T cell clone; and by a B cell lymphoma, B1D.beta to an alloreactive T cell hybridoma. Alloantigen-presenting cells were treated with CsA or its inactive analogs for 2 hr, washed extensively (four times), and added to the T cells. Using this protocol, CsA maximally inhibited allorecognition by the T cells at 1000 ng/ml in all three systems. An HPLC assay for CsA cell failed to detect any significant CsA carryover into the T cell assays. Supernatant transfer experiments also failed to demonstrate CsA carryover in the more sensitive T cell hybridoma assay. These transfer experiments also failed to demonstrate the generation of inhibitory factors during the assay. Northern blot analysis and a cell-surface ELISA failed to observe any decreases in MHC class II induction in/on P388.D1 cells with CsA present during the induction. Due to the lack of detectable (less than 10 ng/ml) CsA carryover, we hypothesize that CsA has a direct effect on the formation of stimulatory MHC class II in our alloreactive systems.     

Inhibition of erythropoietin activity by cyanate

OBJECTIVE: Increased urea concentration is a measure of advanced renal failure and the adequacy of renal replacement therapy in end-stage renal disease (ESRD). Altered biologic activity due to changes in protein structure occurs when cyanate, formed spontaneously from urea, reacts with proteins. Carbamylation results in impaired erythropoietin (EPO) activity when high concentrations of cyanate react with EPO. In this study, the activity of carbamylated EPO (C-EPO), formed at a cyanate concentration which may occur in vivo, was studied in Sprague-Dawley rats. MATERIAL AND METHODS: The extent of carbamylation, causing loss of free amino groups, was monitored using trinitrobenzenesulfonic acid. Erythrocyte, hemoglobin, hematocrit and leukocyte levels were measured after either EPO, incubated EPO, C-EPO, physiologic saline or cyanate (1.5 microM; 0.2 ml) were injected subcutaneous twice weekly for 3 weeks in rats. RESULTS: In vitro carbamylation of EPO was time- and concentration-dependent. C-EPO concentration increased as the duration of exposure to cyanate increased from 6 to 72 h, or as cyanate concentration increased from 15 nM to 1.5 microM. Injections of EPO caused significant increases in vivo in all erythropoietic measures. In contrast, injections of C-EPO, physiologic saline or 1.5 microM cyanate caused no change from baseline. CONCLUSIONS: These results demonstrated diminished biologic activity in healthy rats by C-EPO formed in vitro at cyanate concentrations that may be found in vivo. C-EPO and high urea-derived cyanate levels may contribute to suboptimal erythropoietic responses to EPO therapy for chronic renal failure and ESRD, and may provide another measurement indicating inadequate dialysis.     

Inhibition of keratinocyte migration by lipopolysaccharide

A critical process in cutaneous wound healing is reepithelialization by keratinocytes that closes the breach in the epidermis. Chronic wounds fail to reepithelialize despite the presence of activated and proliferative keratinocytes around the wound perimeter. This type of wound is generally colonized to a greater or lesser extent by bacteria. This study examines the possibility that bacterial products might directly inhibit keratinocyte migration. Using conventional scratch assays, we observed a dose-dependent inhibition of keratinocyte migration by lipopolysaccharide (LPS) derived from either Pseudomonas aeruginosa or Escherichia coli . Although the P. aeruginosa preparation appeared to be slightly more inhibitory, both gave half-maximal inhibition at 0.5–0.6 ng/mL. Migration of fibroblasts was not inhibited. The result could not be attributed to a cytotoxic effect of the LPS. LPS inhibition of migration was relieved by neutralizing antibodies to toll-like receptors (TLR), 40% by anti-TLR2 and 75% by anti-TLR4. We conclude that keratinocyte migration is inhibited by bacterial products, detected through TLR4 and also through TLR2. Because chronic wounds always show some presence of bacteria, these findings provide a possible explanation for the lack of healing found in ulcers.