Potential amelioration of morbidity in patients with chromosomal anomalies: relevance to Bardet‐Biedl syndrome

Genuis SJ, Lobo RA. Potential amelioration of morbidity in patients with chromosomal anomalies: relevance to Bardet‐Biedl syndrome. Given the genetic basis of their disease, children with major chromosomal abnormalities including Bardet–Biedl syndrome (BBS) are generally considered to have a guarded prognosis with persistence or progression of disease manifestations. Although various therapeutic interventions are commonly used to control signs and symptoms of illness, parents of BBS children are usually cautioned against hoping for sustained improvement. A case of a 21‐month‐old girl, diagnosed with BBS, manifesting signs of worsening visual impairment, obesity, irascible and disordered behaviour, as well as developmental delay, is presented. After initial evaluation suggested specific biochemical deficiencies, nutritional status correction was undertaken and the patient's signs and symptoms subsequently resolved over the course of several months. To the authors' knowledge, this is the first case report of sustained resolution of all disease manifestations in the face of previously deteriorating health in a young child with this major chromosomal abnormality. It appears that biochemical imbalances and insufficiencies resulting from abnormal metabolism and excretion are potentially amenable to extraordinary dietary supplementation, with partial or complete resolution of clinical abnormalities. It is recommended that all children with chromosomal abnormalities have biochemical and nutritional status evaluation with correction of disordered biochemistry as is possible.     

Radioprotection in mice following oral delivery of amifostine nanoparticles

Purpose: Amifostine (Ethyol^®) is an approved cytoprotective agent prescribed to reduce certain side-effects in the chemotherapy of ovarian or non-small cell lung cancer, or in radiation treatment of head-and-neck cancer. The usefulness of this drug is further hampered, because it is not effective when given orally. The objective of this part of the project was to evaluate the radioprotective efficacy of orally active amifostine nanoparticles.

Materials and methods: Radioprotective efficacy was evaluated by measuring the ability of the amifostine nanoparticles (equivalent to 500?mg/Kg) to inhibit whole-body gamma irradiation -induced injury in mice. All mice received acute whole-body gamma irradiation from a Cesium-137 source and the radioprotective efficacy of the formulation was determined by measuring 30-day survival at 9?Gy, bone marrow hemopoeitic progenitor cell survival at 9?Gy and 8?Gy, and intestinal crypt cell survival at 11?Gy.

Results: Thirty-day survival, hemopoietic progenitor cell survival, as well as the jejunal crypt cell survival were all significantly enhanced when the mice were treated orally with the amifostine nanoparticles 1?h prior to irradiation.

Conclusions: These results clearly and unequivocally demonstrate that the amifostine nanoparticles developed in our laboratory provides significant protection from acute whole-body gamma irradiation injury in mice.     

A20 deletion is associated with copy number gain at the TNFA/B/C locus and occurs preferentially in translocation‐negative MALT lymphoma of the ocular adnexa and salivary glands

The genetic basis of MALT lymphoma is largely unknown. Characteristic chromosomal translocations are frequently associated with gastric and pulmonary cases, but are rare at other sites. We compared the genetic profiles of 33 ocular adnexal and 25 pulmonary MALT lymphomas by 1 Mb array–comparative genomic hybridization (CGH) and revealed recurrent 6q23 losses and 6p21.2–6p22.1 gains exclusive to ocular cases. High‐resolution chromosome 6 tile‐path array–CGH identified NF‐κB inhibitor A20 as the target of 6q23.3 deletion and TNFA/B/C locus as a putative target of 6p21.2–22.1 gain. Interphase fluorescence in situ hybridization showed that A20 deletion occurred in MALT lymphoma of the ocular adnexa (8/42 = 19%), salivary gland (2/24 = 8%), thyroid (1/9 = 11%) and liver (1/2), but not in the lung (26), stomach (45) and skin (13). Homozygous deletion was observed in three cases. A20 deletion and TNFA/B/C gain were significantly associated (p < 0.001) and exclusively found in cases without characteristic translocation. In ocular cases, A20 deletion was associated with concurrent involvement of different adnexal tissues or extraocular sites at diagnosis (p = 0.007), a higher proportion of relapse (67% versus 37%) and a shorter relapse‐free survival (p = 0.033). A20 deletion and gain at TNFA/B/C locus may thus play an important role in the development of translocation‐negative MALT lymphoma. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Utility of serum ferritin as a measure of iron deficiency in normal males undergoing repetitive phlebotomy

Hematologic indices and iron balance data were obtained on 22 normal male volunteers who were subjected to a mean +/- SD phlebotomy of 164 +/- 34 ml whole blood/mo while living in a controlled environment. Over an average stay of 5 mo, volunteers did not develop anemia, but did display a reduction in iron stores that was quantitated by measurement of serum ferritin and iron balance. The percent saturation of transferrin and the usual erythrocyte parameters did not reflect changes in iron status. Loss of iron, which was calculated from quantitative phlebotomy and iron balance data, showed that a decrease of 1 ng of serum ferritin represented a loss of 4.5 +/- 5.3 mg of iron in 10 men whose initial serum ferritins were greater than 25 ng/ml, and 25.3 +/- 58.8 mg of iron in 7 men whose initial serum ferritins were less than 25 ng/ml. The period required for 3 volunteers who consumed a self-selected mixed diet at home to replace their depleted iron stores to prephlebotomy levels was about 4.5 mo. The sensitivity of serum ferritin as an index of iron stores was affirmed. In addition it was found that normal men who were consuming a mixed diet containing about 15 mg of iron daily and losing blood at a rate of 164 +/- 34 ml/mo did not increase their iron absorption sufficiently to compensate for the iron loss.