HBV X蛋白对抑癌基因p16的表达和启动子甲基化的影响

目的探讨HBV X蛋白(HBx)对抑癌基因p16的表达、p16启动子甲基化的影响,从表观遗传学的角度探讨HBx参与HBV相关性HCC发生发展的相关机制。方法以人肝母细胞瘤细胞Hep G2、表达绿色荧光蛋白(GFP)的Hep G2/GFP、稳定表达HBx蛋白的Hep G2/GFP-HBx细胞为实验系统;采用Western Blot法检测Hep G2、Hep G2/GFP、Hep G2/GFP-HBx细胞中p16蛋白的表达水平。以DNA甲基转移酶(DNMT)抑制剂5-氮杂-2'脱氧胞苷(5-Aza-2'-DC)处理Hep G2/GFP-HBx细胞,采用甲基化特异性PCR(MSP)法检测Hep G2、Hep G2/GFP细胞及药物处理和未处理的Hep G2/GFP-HBx细胞中抑癌基因p16启动子区域的甲基化情况。计量资料多组间比较采用单因素方差分析。结果 Western Blot分析示Hep G2/GFP-HBx细胞中p16蛋白相对灰度值(23.68±3.93)显著低于Hep G2(91.23±6.87)、Hep G2/GFP(94.55±8.40)细胞,差异均有统计学意义(P值分别为0.0007、0.0014),Hep G2/GFP与Hep G2细胞中p16蛋白相对灰度值差异无统计学意义(P0.05);MSP法检测示Hep G2/GFP-HBx细胞中存在p16基因启动子区域部分Cp G位点甲基化,Hep G2、Hep G2/GFP细胞中未检出其甲基化,DNMT抑制剂5-Aza-2'-DC处理的Hep G2/GFP-HBx细胞却能恢复p16基因启动子区域的未甲基化状态。结论在肝癌细胞系中,HBx通过诱导抑癌基因p16启动子甲基化而下调其表达,DNMT抑制剂5-Aza-2'-DC能恢复p16基因启动子区域的未甲基化状态,这种可逆性修饰可为HBV相关性HCC的治疗、预防提供新思路。     

HBx基因下调p21对HepG2细胞增殖与凋亡的影响

目的:构建转基因细胞模型HepG2/HBx,观察HBx基因对HepG2细胞增殖、周期和凋亡的影响, 探讨细胞周期蛋白P21在其中的作用和意义.方法:应用脂质体转染和G418筛选构建稳定表达HBx的转基因细胞HepG2/HBx,RT-PCR和Western blot鉴定HBx mRNA与蛋白的表达.分别以四唑蓝(MTT)比色法、流式细胞术检测HepG2/HBx细胞及对照组HepG2与HepG2/pcDNA3.1细胞(转染空载体pcDNA3.1的HepG2细胞)的增殖、周期和凋亡.另半定量RT-PCR检测各组细胞中细胞周期蛋白P21与抑癌基因p53mRNA的表达.结果:HepG2/HBx细胞中有HBx mRNA和蛋白的表达.HepG2/HBx细胞生长速度加快.HepG2/HBx中G0/G1期细胞比例较对照组显著减少(43.34%±3.11%vs57.69±4.28%,P<0.01),S期细胞比例明显增加(28.69%±1.17%vs22.41%±1.99%,P<0.05),同时还发现与对照组相比其凋亡率也显著降低(1.19%±0.06%vs 5.43%±0.42%, P<0.001).细胞周期蛋白p21 mRNA在HepG2/HBx细胞中的表达较对照组细胞显著降低(0.16±0.05vs0.78±0.15,P<0.001),而p53表达则无显著变化.结论:HBx基因可下调细胞周期蛋白P21mRNA的表达,可能参与HBx基因加速HepG2细胞周期进程、促进细胞增殖以及抑制细胞凋亡的作用.     

乙型肝炎病毒HBx蛋白抑制阿霉素诱导的HepG2细胞凋亡

目的探讨乙型肝炎病毒HBx蛋白对阿霉素诱导的肝癌细胞凋亡的影响。方法将adr亚型HBx基因片段定向插入绿色荧光蛋白（GFP）真核表达载体pEGFPCl，构建重组体pGFP—HBx。将pEGFPCl、pGFPHBx转染HepG2细胞，采用G418筛选抗性克隆、荧光显微镜观察及RT—PCR检测HBx基因表达情况以建立稳定表达细胞株HepG2／GFP、HepG2／GFPHBx。用阿霉素（2．5μg／m1）分别处理HepG2、HepG2／GFP、HepG2／GFPHBx细胞，处理后不同时间在显微镜下观察细胞形态变化，并用锥虫蓝染色计数死亡细胞；流式细胞仪检测阿霉素处理36h后细胞凋亡率。结果HepG2／GFP、HepG2／GFPHBx细胞传70代后，仍表达强的GFP；RTPCR检测显示在HepG2／GFP—HBx细胞有HBx基因转录表达。锥虫蓝染色检测表明阿霉素处理的HepG2、HepG2／GFP细胞发生了明显的时间依赖性细胞死亡，而在HepG2／GFPHBx和对照组细胞未见明显细胞死亡；流式细胞仪检测显示阿霉素处理36h后，HepG2／GFP—HBx细胞凋亡率为3．94％，明显低于HepG2（59．03％）、HepG2／GFP细胞（61．38％）（P〈0．01），而与未处理对照组细胞凋亡率（2．12％，2．78％，2．55％）差异无统计学意义（P〉0．05）。结论成功建立了稳定表达GFP、GFPHBx的HepG2细胞株；HBx能够抑制阿霉素诱导的HepG2细胞凋亡。     

5-Aza-CdR体外诱导胃癌细胞系p16基因去甲基化及表达增强

目的: 观察去甲基化制剂--5-Aza-CdR对体外培养的胃癌细胞SGC7901 p16基因启动子区甲基化状态及表达的影响, 探讨胃癌细胞p16基因失活的机制及去甲基化制剂对p16基因表达的调控.方法:应用不同浓度的5-Aza-CdR(1×10-7, 5×10-7, 1×10-6, 5×10-6 mol/L)处理体外培养的胃癌细胞SGC7901后, MSP法检测用药前后细胞中p16基因的甲基化状态, RT-PCR及 Western-blot法检测用药前后细胞中p16基因mRNA及蛋白表达的变化.结果: p16基因在胃癌细胞系SGC7901中启动子区呈异常甲基化状态, 在mRNA及蛋白水平低表达. 经过1×10-7, 5×10-7, 1×10-6, 5×10-6 mol/L 5-Aza-CdR处理后, p16基因启动子区呈去甲基化状态, 各组mRNA及蛋白表达相应的比值分别与处理前的比例为2.21±0.36, 2.01±0.31;2.82±0.39, 2.22±0.33;2.98±0.42, 3.15±0.43及3.35±0.55, 3.75±0.61.结论:5-Aza-CdR能逆转胃癌细胞p16基因甲基化状态, 调控p16基因表达.     

MEK通路抑制剂对人胰腺癌细胞生长及细胞周期相关抑癌基因表达的影响

目的 观察细胞外信号调节激酶信号通路(MEK)抑制剂对人胰腺癌细胞生长及细胞周期相关的抑癌基因表达的影响。方法 培养人胰腺癌细胞系CFPAC1、PANC1和MiaPaCa2,应用50μmol/L的MEK抑制剂PD98059处理细胞24h,四甲基偶氮唑蓝(MTT)法检测细胞增殖,流式细胞仪分析细胞周期,实时定量PCR法检测p16INK4a、p21 WAF1和p27KIP1 mRNA的表达,蛋白质印迹法检测DNA甲基化酶(Dnmt)1、3a和3b表达,甲基化特异性PCR(MSP)分析p16INK4a基因启动子甲基化状况。结果 PD98059处理24h后,CFPAC1、PANC1和MiaPaCa2细胞的增殖抑制率分别为69％、78％和45％;G0/G1期细胞比例分别从(68.21±0.73)％、(56.54±0.68)％、(54.89±0.79)％增加到(80.37±0.65)％、(72.05±0.52)％、(79.21±0.93)％(P值均＜0.05);S期和G2/M期细胞比例相应减少。PD98059处理后,CFPAC1、PANC1细胞p27KIP1、p21WAF1和p16INK4a mRNA表达增加,Dnmt1和Dnmt3b蛋白表达减少;p16INK4a启动子甲基化状态被去除。而MiaPaCa2细胞仅p27KIP1 mRNA表达增加;p21WAF1、p16INK4a mRNA和Dnmt表达均无明显变化。结论 MEK通路抑制剂可能通过下调DNA甲基化酶、上调细胞周期相关抑癌基因表达而抑制胰腺癌细胞周期进展和细胞增殖。     

乙型肝炎病毒X基因下调miR-192对人肝癌细胞株HepG2凋亡的影响

目的 探讨乙型肝炎病毒X基因(HBx)通过调节人肝癌细胞株HepG2中miR-192的表达而抑制其凋亡的机制.方法 设立3个细胞组:稳定转染HBx基因的HepG2细胞(HepG2/HBx),稳定转染空载体pcDNA3.1的HepG2细胞(HepG2/pcDNA3.1)以及未作转染的HepG2细胞.用流式细胞术分析3个细胞组的凋亡率差异,用Taqman探针荧光定量PCR检测3组细胞中miR-192的表达水平.转染miR-192后,用流式细胞术检测HepG2细胞凋亡率的变化,同时用SYBR Green荧光定量PCR和Western blot检测细胞中p53、PUMA表达的变化.计量资料均数的比较用单因素方差分析.结果 HepG2/HBx细胞的凋亡率为2.37％±0.35％,较HepG2/pcDNA3.1、HepG2细胞(11.46％±0.69％、12.50％±0.66％)明显降低(F=171.722,P＜0.01).miR-192表达在HepG2/HBx细胞中为49.1％±5.9％,较HepG2/pcDNA3.1、HepG2细胞(98.0％±8.9％,100％)也明显下调(F=14.319,P＜ 0.05).转染miR-192后HepG2细胞的凋亡率(15.74％±1.17％)较转染相应阴性对照的HepG2细胞的凋亡率(10.74％±1.15％)显著升高(F=18.415,P＜0.05),同时,p53、PUMA基因在mRNA (953:1.68±0.12比0.90±0.09,F=43.115,P＜0.05 ; PUMA:1.66±0.10比0.98±0.06,F=22.541,P＜0.05)和蛋白质水平(p53:3.07比1,PUMA:2.13比1)的表达均显著上升.结论 miR-192促进HepG2细胞凋亡,HBx通过下调miR-192抑制HepG2细胞凋亡.     

乙型肝炎病毒X蛋白对HepG2细胞脂代谢相关基因表达的影响

目的 探讨乙型肝炎病毒X蛋白(HBX)对脂质代谢相关基因的影响及其在肝细胞脂肪变性发生中的作用. 方法 将质粒pIRES2-eGFP-HBX转染入HepG2细胞中,建立表达HBX的HepG2/HBx细胞模型;以转染空载体pIRES2-eGFP (HepG2/pIRES2细胞)及未转染的HepG2细胞作为对照.转染后24、48、72 h,荧光显微镜观察绿色荧光蛋白(GFP)的表达;检测细胞内甘油三酯含量;RT-PCR方法检测固醇调节元件结合蛋白1(SREBP-1)和肝X受体(LXR)αmRNA表达水平;Western blot检测HBX,LXRα及脂肪酸合成酶(FAS)蛋白表达的变化.多组间比较采用成组设计的方差分析,多组间的两两比较采用q检验;各基因表达量之间的关系采用Pearson相关分析.结果 在转染后24、48、72 h,HepG2/HBx细胞和HepG2/pIRES2细胞中有GFP的表达并随时间延长而增多、增强,仅在HepG2/HBx细胞内有HBx表达,并且随时间的延长而逐渐增加,差异有统计学意义(F= 32.21,P＜0.05),提示成功建立HepG2/HBx细胞模型;在转染后24、48、72h,HepG2/HBx细胞内LXRαmRNA相对表达量分别为0.386±0.055、0.505±0.071、0.649±0.058,SREBP-1 mRNA相对表达量分别为0.395±0.055、0.548±0.047、0.795±0.058; LXRα蛋白的相对表达量分别为0.178±0.036、0.263±0.047、0.347±0.058,FAS蛋白相对表达量分别为0.436±0.055、0.608±0.053、0.827±0.046,各相同时间点均较对照组明显增加(P＜0.05或P＜ 0.01),并均随时间的延长而逐渐增多(P＜ 0.05或P＜0.01),且与HBX表达量均呈正相关(rLXPα= 0.994,rSREBP-1= 0.984,r' LXRα=0.989,rFAS=0.991,P＜0.05).HepG2/HBX细胞内TG含量与对照组相比,差异无统计学意义(P＞ 0.05).结论 HBx-LXR α -SREBP- 1/FAS通路可能参与了调节脂质代谢相关基因的转录和表达,可能是引起肝细胞脂肪变发生的重要分子机制之一.     

乙型肝炎病毒X蛋白对HepG2细胞羧末端结合蛋白反应蛋白表达的影响

目的 研究乙型肝炎病毒X蛋白(HBx)对博莱霉素诱导HepG2细胞DNA双链断裂(DSB)损伤修复关键因子羧末端结合蛋白反应蛋白(CtIp)的影响.方法 建立稳定表达HBx的HepG2肝癌细胞株(HepG2-HBx)及空质粒对照细胞株(HepG2-vec).用博莱霉素诱导细胞DSB损伤后,用流式细胞仪检测细胞周期和细胞凋亡情况,用实时定量PCR及Western blot检测CtIP的mRNA与蛋白表达水平,并用激光共聚焦显微镜观察CtIp蛋白在细胞内的定位情况.多组数据采用单因素方差分析和SNK-q检验;两组数据间比较用t检验.结果 经检测转染HBx基因的HepG2细胞(HepG2-HBx)能稳定表达HBx.博莱霉素处理后,HepG2-HBx细胞与HepG2-vec细胞的凋亡比例分别为16.90%±0.89%和15.30%±0.86%,差异无统计学意义(q=2.074,P＞0.05),但死亡细胞比例分别为8.71%±0.74%和4.90%±0.46%,差异有统计学意义(q=7.126,P＜0.01) ;同时两种细胞株都出现了细胞周期G2/M期阻滞,差异有统计学意义(F=11.401,P＜0.05).HBx使CtIP蛋白表达水平和mRNA表达水平均下调,HepG2-HBx细胞与HepG2-vec细胞CtIp蛋白的相对表达量分别为0.66±0.04、0.73±0.05,差异有统计学意义(t=2.314,P＜0.05); CtIP mRNA相对表达量分别为1.00±0.06、1.23±0.08,差异有统计学意义(t=2.732,P＜0.05).同时观察到CtIP蛋白主要在细胞胞核内表达.结论 HBx能干扰肿瘤抑制蛋白CtIp的表达,可能影响细胞DSB损伤的修复.     

乙型肝炎病毒X蛋白上调HepG2细胞中SMYD3的表达

目的 探讨HBV是否通过调控组蛋白甲基化酶SMYD3的表达参与肝癌细胞的恶性生物学行为.方法 通过向肝癌细胞HepG2转染HBx筛选出表达HBx蛋白的细胞株HepG2-HBx.用激光共聚焦定位细胞内HBx蛋白和SMYD3蛋白的表达;实时逆转录PCR、Western blot检测转染HBx前后HepG2细胞中SMYD3 mRNA和蛋白质的表达水平;流式细胞仪检测转染HBx前后HepG2细胞增殖、凋亡的变化情况.对数据进行单因素方差分析. 结果 HBx转染后HepG2细胞中SMYD3 mRNA和蛋白质表达水平明显上调(SMYD3 mRNA:0.18±0.05与0.98±0.15,F=37.240,P<0.05;SMYD3蛋白:0.28±0.03与0.58±0.06,F=21.042,P<0.05).转染HBx后HepG2细胞凋亡率下降(7.90%±0.42%与2.23%±0.14%,P<0.01),细胞增殖能力增强(28.46%±4.33%与36.46%±0.17%,P<0.01).结论 乙型肝炎病毒X蛋白能够上调HepG2细胞中SMYD3 mRNA和蛋白质表达水平;HBx可能通过SMYD3-组蛋白甲基化途径抑制HepG2细胞凋亡、促进细胞增殖.     

微小RNA在HBx缺失突变体致肝细胞增殖中的作用及其机制

目的 研究微小RNA (miRNA)在HBx缺失突变体致人肝细胞异常增殖中的作用及其相关机制. 方法 利用miRNA芯片技术检测稳定表达HBx-d382及HBx的L02(即分别含HBx基因缺失突变体HBx-d382及野生型HBx基因)细胞系中miRNA的表达,实时荧光定量PCR对上述miRNA进行验证.选取在L02/HBx-d382和L02/HBx细胞中均表达明显下调的两个miRNA:miR-338-3P、miR-551b进行功能研究,分为实验组(转染miRNA模拟物组)、阴性对照组(NC,转染miRNA阴性对照)及脂质体组(lipo,单加转染试剂),通过脂质体转染到细胞中,四甲基偶氮唑盐法检测细胞存活率,流式细胞仪检测细胞周期,实时荧光定量PCR和Wstern blot检测细胞周期蛋白D1、细胞周期蛋白G1和E2F转录因子的改变.采用SPSS 16.0统计软件,数据均进行了正态检验并符合正态性,组间均数比较采用成组t检验. 结果 (1)与L02/pcDNA3.0细胞比较,L02/HBx-d382细胞有6个miRNA表达上调,5个miRNA表达下调; L02/HBx细胞有4个miRNA表达上调,12个miRNA表达下调.实时荧光定量PCR验证的结果与芯片相一致.(2)转染了miR-338-31p-模拟物和miR-551b-模拟物后,L02/HBx-d382及L02/HBx细胞增殖均受抑制,细胞周期均阻滞在G1期,细胞增殖能力减弱.L02/HBx-d382细胞中,细胞增殖能力:lipo组、NC组、miR-338-3p组和miR-551b组分别为90.0％±1.3％、88.0％±1.6％、56.0％±6.1％和62.0％±6.4％,miR-338-3p组与:lipo组、NC组比较,t值分别为10.402、9.133 ;miR-551b组和与lipo组、NC组比较,t值分别为8.763、7.403,P值均＜0.01.L02/HBx细胞中,细胞增殖能力:lipo组、NC组、miR-338-3p组和miR-551b组分别为91.0％±1.7％、89.0％±2.1％、60.0％±7.7％和66.0％±9.3％,miR-338-3p组与lipo组、NC组比较,t值分别为9.105、8.074;miR-551b组与lipo组、NC组比较,t值分别为7.673、7.52,P值均＜0.01.实时荧光定量PCR检测结果显示细胞周期蛋白D1、细胞周期蛋白G1和E2F转录因子的mRNA水平均无明显改变,但Western blot法发现上述基因的蛋白表达均明显下调,差异有统计学意义. 结论 ①HBx及其缺失突变体能影响L02细胞的miRNA表达谱;②在L02/HBx-d382细胞中下调更明显的miR-338-3p和miR-551b可能通过调控细胞周期蛋白D1、细胞周期蛋白G1和E2F转录因子的表达而调节了细胞的生长.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.