Cytomegalovirus infection following renal transplantation in patients administered low-dose rituximab induction therapy

Anti-CD20 antibody (rituximab) is recently being used as a B cell-depleting agent in renal transplantation (RTx). However, the incidence of infectious complications associated with rituximab therapy remains uncertain. We evaluated the incidence of cytomegalovirus (CMV) infection associated with rituximab therapy in RTx. A total of 83 patients were enrolled. The immunosuppressive regimen consisted of tacrolimus or cyclosporin, mycophenolate mofetil, methylprednisolone and basiliximab. In 54 patients, only one dose of rituximab (200 or 500 mg/kg body weight) was given before RTx. A total of 25 of 43 (58.1%) recipients who were CMV seropositive prior to RTx and who received rituximab induction therapy developed CMV infection, compared to 18 of 24 (75%) CMV seropositive recipients who did not receive rituximab therapy ( P  = 0.1676). A total of 8 of 11 patients who were CMV seronegative prior to RTx and who received rituximab developed CMV infection. However, CMV seroconversion was seen in all 8 of these infected patients. Low-dose rituximab induction therapy in renal transplant recipients appears to have no influence on the incidence of CMV infection and CMV seroconversion. However, we have to consider anti-CMV prophylaxis therapy, because of high incidents of CMV infection, especially for CMV seronegative recipients who received rituximab.     

Useful detection of CD147 （EMMPRIN） for pathological diagnosis of early hepatocellular carcinoma in needle biopsy samples

AIM To make clear whether CD147 (EMMPRIN)expression in pathological tumor samples with a fineneedle aspiration biopsy is useful for pathological diagnosis of early hepatocellular carcinoma (HCC).METHODS Twenty-two patients (15 men and 7 women;median age 68 years, range 56-81 years) underwent a liver tissue biopsy in order to make a diagnosis of HCC.Paraffin-embedded liver biopsy tissue samples from 22 patients were stained with anti-CD147 antibody,murine monoclonal antibody 12C3 (MAb12C3) for immunohistochemical analysis. An immunohistochemical analysis of CD147 was performed and the degree of staining compared between tumor and non-tumor tissue. In addition, the degree of staining within tumor tissue was compared according to a number of clinicopathological variables.RESULTS The degree of staining of CD147 was significantly higher in tumor tissues than non-tumor tissues, even in tumors less than 15 mm in diameter.The expression of this protein was significantly elevated in HCC tissue specimens from patients with a low value of serum AST and γ-GTP.CONCLUSION CD147 serves potentially as a pathological target for cancer detection of early HCC.     

The hepatic sinusoidal endothelial lining and colorectal liver metastases

Colorectal cancer （CRC） is a common malignant disease and the severe nature of cases in men and women who develop colorectal cancer makes this an important socio-economic health issue. Major challenges such as understanding and modeling colorectal cancer pathways rely on our understanding of simple models such as outlined in this paper. We discuss that the development of novel standardized approaches of multidimensional （correlative） biomolecular microscopy methods facilitates the collection of （sub） cellular tissue information in the early onset of colorectal liver metastasis and that this approach will be crucial in designing new effective strategies for CRC treatment. The application of X-ray micro-computed tomography and its potential in correlative imaging of the liver vasculature will be discussed.     

A novel compound heterozygous mutation in the DAP12 gene in a patient with Nasu-Hakola disease

A 34-year-old woman showed clinical features characteristic of Nasu-Hakola disease (NHD), also designated polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLOSL). The genetic analysis of the DAP12 gene (TYROBP) identified two heterozygous mutations composed of a previously reported single base deletion of 141G (141delG) in exon 3 and a novel single base substitution of G262T in exon 4, both of which are located on separate alleles. The protein sequence motif search indicated that both mutations encode truncated nonfunctional DAP12 polypeptides. This is the first case of NHD caused by compound heterozygosity for loss-of-function mutations in DAP12.     

The mechanism of Axl-mediated Ebola virus infection

We previously reported that expression of the receptor-type tyrosine kinase Axl, which regulates cell survival and activation, enhances both pseudotype and live Ebola virus (EBOV) infection. To clarify the mechanistic basis of this enhancement, we created a series of Axl mutants and identified amino acids/domains necessary for this function, by using a pseudotype virus carrying the EBOV glycoprotein (GP). Analyses of the Axl mutants showed the importance of extracellular and intracellular regions for Axl functions, including ligand binding and signal transduction, in EBOV GP-mediated infection. These data suggest that EBOV uses the physiological functions of Axl to enter cells.     

Usefulness of low- and medium-energy collimators in 123I-MIBG myocardial scintigraphy

The heart-to-mediastinum (H/M) ratio on myocardial scintigraphy with (123)I-metaiodobenzylguanidine (MIBG) is used as a semi-quantitative index. However, the scatter from a photopeak of 529 keV on (123)I is thought to affect the H/M ratio, and collimator selection is important as well. We attempted to determine the usefulness of low- and medium-energy general purpose (LME) collimators by comparing them with low-energy high-resolution (LEHR) and medium-energy low-penetration (MELP) collimators in phantom and clinical studies. In the phantom study, we used a thoracic phantom and plastic bottles filled with (123)I-MIBG solution as upper limbs. Phantom images were acquired with LEHR, LME, and MELP collimators. Regions of interest were placed on the lung, mediastinum, heart, and liver. The average counts in the lung, coefficient of variation (CV%) in the heart, mediastinum, and liver, and H/M ratio were calculated. The H/M ratios obtained with the LEHR collimator and LME collimator were compared in a clinical study. We found that the average count in the lung measured with the LME collimator was reduced to about 30% of that obtained with the LEHR collimator in the phantom study. CV% measured with the LME collimator improved about 10% compared with that determined with the MELP collimator. The H/M ratio measured with the LME collimator was close to that measured with the MELP collimator. In the clinical study, the H/M ratios measured with the LEHR and LME collimators showed a positive relationship (y=2.1x-1.3, x; H/M with LEHR, y; H/M with LME) . LME collimators provided improved contrast and signal-to-noise ratio in evaluation of the H/M ratio on (123)I-MIBG myocardial scintigraphy.     

A comparison of the pathogenicity of avian and swine H5N1 influenza viruses in Indonesia

Highly pathogenic avian influenza H5N1 viruses are circulating in many countries. We recently discovered that these viruses have been transmitted to pigs on multiple occasions in Indonesia. To investigate whether avian H5N1 influenza viruses adapted to mammals through their introduction into pigs, we examined the growth of avian and swine isolates in cell culture and compared their pathogenicity in mice. We found that swine isolates were less virulent to mice than avian isolates, suggesting that the viruses became attenuated during their replication in pigs. Continuous surveillance of H5N1 viruses among pigs is clearly warranted.