The Morbidity of Multiple Sclerosis

Although the clinical course of multiple sclerosis is benignin up to one-third of patients, it is important to recognizethe high rate of morbidity in others. Most individuals passthrough a remitting phase but in a significant proportion theclinical manifestations subsequently recur, persist or slowlyprogress, and disability accumulates with time. Here we describethe frequency and spectrum of morbidity in a population basedcohort of patients with multiple sclerosis. These statisticswill guide those providing health care resources and planningservices for patients with multiple sclerosis.     

Self recognition in allogeneic radiation bone marrow chimeras. A radiation- resistant host element dictates the self specificity and immune response gene phenotype of T-helper cells

The specificity of the self-recognition repertoire in fully allogeneic (A {arrow} B), semiallogeneic (A {arrow} A x B and A x B {arrow} A), and double donor (A + B {arrow} A) radiation bone marrow chimeras was assessed by the ability of their spleen cells to generate in vitro primary plaque-forming cell (PFC) responses to trinitrophenyl- keyhole limpet hemocyanin. In contrast to spleen cells from semiallogeneic and double donor chimeras, intact spleen cells from fully allogeneic BI0 {arrow} B10.A and B10.A {arrow} B10 chimeras were not capable of generating responses to trinitrophenyl (TNP)-keyhole limpet hemocyanin. However, cultures containing a mixture of both B10 {arrow} B10.A and B10.A {arrow} B10 spleen cells did respond, demonstrating that all the cell populations required for the in vitro generation of T-dependent PFC responses were able to differentiate into functional competence in a fully allogeneic major histocompatibility complex (MHC) environment. The self recognition repertoire of T-helper cells from fully allogeneic A {arrow} B chimeras was determined to be specific for the recognition of host, not donor, MHC determinants in that they were able to collaborate with cells expressing only host MHC determinants but not with cells expressing only donor MHC determinants, even though the functional lymphocytes in these chimeras were shown to be of donor origin. Experiments utilizing double donor A + B {arrow} A chimeras further demonstrated that the ability of chimeric T cells to recognize allogeneic MHC determinants as self structures was a function of a radiation-resistant host element and not simply a consequence of the tolerization of T cell precursors to allogeneic MHC determinants, because strain A lymphocytes isolated from A + B {arrow} A chimeras were tolerant to both A and B MHC determinants but were restricted to the self recognition of syngeneic host type A MHC determinants. Finally, the Ir gene phenotype expressed by B10 {arrow} B10.A and B10.A {arrow} B10 chimeric lymphocytes was determined by their ability to function in the Ir gene controlled response to TNP-poly-L-(Tyr,Glu)-poly-D,L-Ala-poly- L-Lys [(T,G)-A--L]. The ability of lymphocytes to function in TNP-(T,G)-A--L responses was not determined by their genotype but rather paralleled the specificity of their self recognition repertoire for high responder (H-2 (b)) determinants. The possible degeneracy of the MHC-specific self recognition repertoire is discussed, and a model is proposed for Ir gene regulation in which expression of Ir gene function by lymphocytes is an antigen-nonspecific consequence of the specificity and cross-reactivity of their self recognition repertoire.     

自体移植静脉内皮细胞的缺血安全时限

目的:观察离体后不同缺血时间自体移植静脉内皮细胞的损伤程度,分析移植静脉内皮细胞缺血的安全时限。方法:实验于2005-07/2005-12在中国人民解放军胸心外科研究所完成。选择健康成年家犬29只,购自解放军第二军医大学实验动物中心。①不同缺血时间移植静脉内皮细胞损伤实验:按随机数字表法选取5只家犬,取双侧股静脉,按离体后0min,30min,60min,90min4个时间点行扫描电镜及透射电镜检查,观察内皮细胞的损伤程度,Ⅰ级正常,Ⅱ级轻度,Ⅲ级中度,Ⅳ级重度,Ⅴ级坏死,将Ⅰ,Ⅱ,Ⅲ级损伤归类为可逆性损伤;将Ⅳ,Ⅴ级损伤归类为不可逆损伤。②自体移植静脉内皮细胞缺血安全时限实验:将剩余24只家犬建立犬股静脉离体不同时间(30min,60min,90min)的自体移植模型,在术后1d,3d,7d,14d再次手术取出静脉,行扫描电镜检查,比较不同时间点移植静脉内皮覆盖率。结果:①缺血0min,30min,60min,90min组(n=60)不可逆性损伤内皮细胞数分别为12,6,28,33,缺血60min、90min组内皮细胞的损伤程度明显重于缺血0min和30min组。各组的内皮细胞覆盖率比较差异无显著性意义(P>0.05)。②24只模型犬全部存活,切口愈合佳,无红肿、溢脓或裂开。③移植术后1d,14d,缺血30min,60min及90min组内皮细胞覆盖率差异无显著性意义(P>0.05),而术后3d,7d,缺血30min组的内皮细胞覆盖率显著高于缺血60min及90min组[(62.21±3.52)%,(40.09±2.56)%,(36.17±4.55)%(P<0.01);(82.31±3.76)%,(60.22±3.23)%,(59.39±4.27)%(P<0.01)]。结论:缺血60min后静脉内皮细胞的超微结构会发生明显的不可逆性损害,移植静脉内皮细胞缺血的安全时限是60min。     

Airway obstruction at time of symptoms prompting use of reliever therapy in children with asthma

Background: In asthma treatment, doses of inhaled corticosteroids are often adapted to symptoms and need for bronchodilators. However, in cross‐sectional studies in emergency room settings, lung function and respiratory symptoms are not always concordant. Available longitudinal data are based on written peak flow diaries, which are unreliable. Using home spirometry, we studied prospectively whether mild respiratory symptoms, prompting reliever therapy are accompanied by a clinically relevant drop in lung function in children with asthma. Methods: For 8 weeks, children with asthma scored symptoms and measured peak expiratory flow (PEF) and forced expiratory volume in 1 sec (FEV₁) on a home spirometer twice daily. Additional measurements were recorded when respiratory symptoms prompted them to use bronchodilators. Results: The mean difference between symptom free days and at times of symptoms was 6.6% of personal best for PEF (95% CI: 3.2–10.0; p = 0.0004) and 6.0% of predicted for FEV₁ (95% CI: 3.0–9.0; p = 0.0004). There was complete overlap in PEF and FEV₁ distributions between symptom free days and at times of symptoms. Conclusions: Although statistically significant, the degree of airway narrowing at times of respiratory symptoms, prompting the use of reliever therapy, is highly variable between patients, limiting the usefulness of home spirometry to monitor childhood asthma.     

A novel human homologue of yeast nucleosome assembly protein, 65 kb centromeric to the p57KIP2 gene, is biallelically expressed in fetal and adult tissues

Three genes on 11p15.5 are known to undergo genomic imprinting. The gene for insulin-like growth factor II (IGF2) is normally expressed from the paternal allele, while H19 and p57KIP2, a cyclin-dependent kinase inhibitor, are expressed from the maternal allele. Five germline balanced chromosomal rearrangement breakpoints from patients with Beckwith-Wiedemann syndrome (BWS) have been mapped to 11p15.5 between p57KIP2 and IGF2, and all are derived from the maternal chromosome. By positional cloning from BWS breakpoints, we have isolated a gene 100 kb and 65 kb centromeric to the proximal end of this BWS breakpoint cluster and p57KIP2, respectively. This gene is homologous to yeast nucleosome assembly protein (NAP1) and to a human homologue of NAP1, and we designate it hNAP2 (human nucleosome assembly protein 2). hNAP2 diverges in its expression pattern from IGF2, H19, and p57KIP2, and it shows biallelic expression in all tissues tested. Thus, hNAP2 is functionally insulated from the imprinting domain of 11p15.      

Activation of the ERK/MAPK pathway: a signature genetic defect in posterior fossa pilocytic astrocytomas

We report genetic aberrations that activate the ERK/MAP kinase pathway in 100% of posterior fossa pilocytic astrocytomas, with a high frequency of gene fusions between KIAA1549 and BRAF among these tumours. These fusions were identified from analysis of focal copy number gains at 7q34, detected using Affymetrix 250K and 6.0 SNP arrays. PCR and sequencing confirmed the presence of five KIAA1549–BRAF fusion variants, along with a single fusion between SRGAP3 and RAF1. The resulting fusion genes lack the auto‐inhibitory domains of BRAF and RAF1, which are replaced in‐frame by the beginning of KIAA1549 and SRGAP3, respectively, conferring constitutive kinase activity. An activating mutation of KRAS was identified in the single pilocytic astrocytoma without a BRAF or RAF1 fusion. Further fusions and activating mutations in BRAF were identified in 28% of grade II astrocytomas, highlighting the importance of the ERK/MAP kinase pathway in the development of paediatric low‐grade gliomas. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Mutagenicity of 2-amino-3-methylimidazo[4,5-f]quinoline in human lymphoblastoid cells

2-Amino-3-methylimidazo[4,5-f]quinoline (IQ), a heterocyclic aromatic amine that has been identified in cooked meats and cigarette condensates, is mutagenic in human lymphoblastoid TK6 cells at the thymidine kinase and hypoxanthine-guanine phosphoribosyl transferase (hprt) loci. Treatment of the cells with IQ following activation with either an exogenous metabolizing mixture (S9) or following photoactivation of the azido-derivative of IQ (N3-IQ) showed that the photolytic-derivative of N3-IQ was more active. This observation is consistent with other reports that indicate that the weak mutagenicity of IQ in mammalian cells is caused by the lack of enzymes required for the ultimate activation of the compound within the cells. Two DNA adducts were found by 32P-post-labelling in the cells treated with the photoactivated N3-IQ. The major adduct was identified as N- (deoxyguanosin-8-yl)-2-amino-3-methylimidazo[4,5-f]quinoline (dG-C8-IQ) and the minor adduct as 5-(deoxyguanosin-N2-yl)-2-amino-3- methylimidazo[4,5-f]quinoline (dG-N2-IQ). The ratio of the dG-C8IQ to the dG-N2-IQ adducts was approximately 3:1 and did not significantly change in cultures treated with different concentrations of the mutagen. Approximately 50% of the adducts were removed 9 h after treatment with IQ and <10% of these adducts remained after 24 h. There was no significant preferential repair of either adduct under the experimental conditions used. The identification of 15 mutations induced at the hprt locus (of the 44 mutants analysed) showed IQ to be efficient at inducing single base deletions in a run of guanines. Six single guanine deletions were observed in the run of six guanines in exon III and one deletion of a single guanine was observed in a non- repetitive sequence in exon VI. Other mutations observed were two GC-- >TA transversions, two GC-->CG transversions, one AT-->TA transversion and one GC-->AT transition. In addition, two multiple mutations were found. The majority of the identified mutations (12/15) occurred at GC base pairs and suggests either the dG-C8-IQ or the dG-N2-IQ adduct to be the pre-mutagenic lesion.      

新型抗流感药物有望问世

H5N1流感病毒所致的禽流感在世界范围内引起了大流行,因此大家更加关注这种病毒是否会获得在人类之间传染的能力并引起禽流感大流行。目前用于治疗这种病毒感染引起的人禽流感的药物有两种,即奥司他韦(Tamiflu)和扎那米韦(Relenza),两者都是作用于病毒的神经氨酸酶。抗药性的出现需要研发新的抗流感药物。A型流感病毒的神经氨酸酶可分为遗传上不同的两种类型:一类包括N1神经氨酸酶,另一类包含N2、N9神经氨酸酶。N2、N9神经氨酸酶已经被作为当前药物设计的结构基础。用X射线衍射晶体分析法发现这两类酶结构上是不同的。前者在其活性位点…