In vivo amyloid imaging in Alzheimer’s disease

Targeted approaches to therapy for Alzheimers disease have evolved based on detailed understanding of the genetic, molecular biologic, and neuropathologic basis of the disease. Given the potential for greater treatment efficacy in the earlier stages of the disease, the notion of early diagnosis has become more relevant. Current clinical and imaging diagnostic approaches lack reliability in the preclinical and prodromal phases of the disease. We review emerging studies on imaging of the molecular substrate of the disease, most notably the amyloid peptide, which hope to increase early diagnostic efficacy. We offer a brief overview of the demographics, diagnostic criteria, and current imaging tests, followed by a review of amyloid biology and developments in cerebral amyloid imaging yielded by recent in vitro, in vivo and human studies.     

Structural determinants for the activation mechanism of the angiotensin II type 1 receptor differ for phosphoinositide hydrolysis and mitogen-activated protein kinase pathways

While the mechanism whereby the angiotensin II type 1 receptor (AT(1) receptor) activates its classical effector phospholipase C-beta (PLC-beta) has largely been elucidated, there is little consensus on how this receptor activates a more recently identified effector, the p42/44 mitogen-activated protein kinases (p42/44(MAPK)). Using transfected COS-1 cells, we investigated the activation of this signaling pathway at the receptor level itself. Previous mutational studies that relied on phosphoinositide turnover as an index of receptor activation have indicated that key residues in the second and seventh transmembrane domains participate in AT(1) receptor activation mechanisms. Thus, we introduced a variety of mutations-AT(1)[D74N], AT(1)[Y292F], AT(1)[N295S], and AT(1)[AT(2) TM7], which is composed of a chimeric substitution of the AT(1) seventh transmembrane domain with its AT(2) counterpart. These mutations that strongly diminished the receptor's ability to activate PLC-beta had little to no effect on its ability to activate p42/44(MAPK), which not only suggests that p42/44(MAPK) does not exclusively lie downstream of the G-protein G(q)/PLC-beta pathway but also indicates that more than one activation state may exist for the AT(1) receptor. The failure of a protein kinase C inhibitor to block AT(1) receptor activation of p42/44(MAPK) further corroborated evidence that the receptor's activation of p42/44(MAPK) is largely independent of the G(q)/PLC-beta/PKC pathway. Taken together, the experimental evidence strongly suggests that the mechanism whereby the AT(1) receptor activates p42/44(MAPK) is fundamentally different from that for PLC-beta, even at the level of the receptor itself.     

Activation of c—Jun and suppression of phospho—p44／42 were involved in diphenylhydantoin—induced apoptosis of cultured rat cerebellar granule neurons

AIM:To investigate possible intracellular signal molecules involved in diphenylhydantoin (DPH)-mediated apoptosis of cerebellar granule neurons (CGN) and explore possible nolecular mechanisms of neurotoxicity of DPH.METHODS: Fluorescein diacetate (FDA) stain, hochest 33258 stain, and agar gel electrophoresis were used to test morphological and biological characters of primary CGN and cortical neurons (CN) in the presence or absence of 100μmol/L DPH; Western blot and RT-PCR were employed to further investigate apoptotic/survival signal moleculars involved in the neuronal apoptotic signal transdution. RESULTS:DPH 100μmol/L induced a typical apoptosis of CGN but had no toxicity on CN. Cerebellar granule neural apoptosis induced by 100μmol/L DPH was significantly inhibited by pre-treatment with SB203580(10μmol/L) or CEP-11004(1μmol/L) for 1h. DPH markedly upregulated the levels of phospho-c-Jun (active c-Jun), total c-Jun protein and c-jun mRNA in CGN. The levels of phospho-c-Jun dramatically elevated by DPH at 8 h were significantly inhibited by SB203580(10μmol/L) or CEP-11004 (1μmol/L). Moreover, the activities of p44/42 (ERK1/ERK2), other members of MAP kinases and generally believed to be important survival effetors in CGN, were markedly suppressed. However, the activities of both JNK and p38 were little affected in the process of apoptosis of CGN induced by 100μmol/L DPH. CONCLUSION: The selective toxicity of DPH on CGN is likely due to its ability to induce apoptosis of CGN, it is a process involved activation of c-Jun and suppression of the activity of p44/42.     

CSF-tau,CSF-Aß1-42, ApoE-genotype and clinical parameters in the diagnosis of Alzheimer’s disease: combination of CSF-tau and MMSE yields highest sensitivity and specificity

Summary. This study evaluated the sensitivity and specificity of the cerebrospinal fluid (CSF) levels of tau-protein, amyloid-ß-peptide 1-42 (Aß1-42), ApoE-genotype and the degree of cognitive decline as diagnostic markers for Alzheimers disease (AD). Data was obtained from 105 AD patients and 68 controls.Median CSF-tau levels were increased (512pg/ml vs. 145pg/ml, p<0.001) and Aß1-42-levels were decreased (238.5pg/ml vs. 310pg/ml, p<0.001) in AD patients compared to controls. A weak correlation was found between CSF-Aß1-42 and MMSE score (r=.245). Within all subjects, a correlation of CSF-Aß1-42 (r=–.337) and CSF-tau (r=.384) with age was found. The combination of CSF-tau levels and MMSE revealed the highest sensitivity (92%) and specificity (87%).In summary, CSF-tau was a useful biological marker to discriminate AD from normal aging, neurological and psychiatric disorders. CSF-Aß1-42 showed no additional benefit in discriminating patients from controls but might be useful for tracking the severity of the disease.Received January 20, 2003; accepted April 29, 2003 Published online July 30, 2003     

Financial protection of patients through compensation of providers: The impact of Health Equity Funds in Cambodia

Public providers have no financial incentive to respect their legal obligation to exempt the poor from user fees. Health Equity Funds (HEFs) aim to make exemptions effective by giving NGOs responsibility for assessing eligibility and compensating providers for lost revenue. We use the geographic spread of HEFs over time in Cambodia to identify their impact on out-of-pocket (OOP) payments. Among households with some OOP payment, HEFs reduce the amount paid by 35%, on average. The effect is larger for households that are poorer and mainly use public health care. Reimbursement of providers through a government operated scheme also reduces household OOP payments but the effect is not as well targeted on the poor. Both compensation models raise household non-medical consumption but have no impact on health-related debt. HEFs reduce the probability of primarily seeking care in the private sector.     

Skin sensitizing properties of the ethanolamines mono‐, di‐, and triethanolamine. Data analysis of a multicentre surveillance network (IVDK*) and review of the literature

Numerous publications address the skin sensitizing potential of the short chain alkanolamines triethanolamine (TEA), diethanolamine (DEA), monoethanolamine (MEA), which are not skin sensitizing according to animal studies. Regarding TEA, we analysed patch test data of 85 098 patients who had been tested with TEA 2.5% petrolatum by Information Network of Departments of Dermatology (IVDK) to identify particular exposures possibly associated with an elevated risk of sensitization. Altogether, 323 patients (0.4%) tested positive. The profile of patch test reactions indicates a slightly irritant potential rather than a true allergic response in many cases. Although used widely, no exposure associated with an increased risk of TEA sensitization was identified. Therefore, the risk of sensitization to TEA seems to be very low. MEA and DEA were patch tested in a much more aimed fashion in 9602 and 8791 patients, respectively when prevalence of contact allergy was 3.8% and 1.8%. MEA is the prominent allergen in metalworkers with exposure to water‐based metalworking fluids (wbMWFs); DEA is probably used in cutting fluids less frequently nowadays. Chronic damage to the skin barrier resulting from wbMWF, the alkalinity of ethanolamines (increasing from TEA to MEA), and other cofactors may contribute to a notable sensitization risk.     

Small GTPases in lymphocyte biology

Almost a decade ago, the small GTPase Ras was shown to be activated in response to antigen receptor triggering in T cells. Since then, Ras has been further characterized as a central molecule for the regulation of signal transduction pathways in lymphocytes. However, over the last couple of years, its exclusive role in lymphocyte biology has been challenged by the emergence of its relatives of the Rho family. Today it is well established that Rho GTPases act as unique molecular switches at several critical checkpoints in lymphocyte development and function. Additionally, a new and critical concept in GTPase signaling has taken shape over the last couple of years in that small GTPases are able to regulate quite diverse cellular processes in the immune response by linking to multiple biochemical effector pathways.     

Progressive Multifocal Leukoencephalopathy Following Combined Rituximab-Based Immune-Chemotherapy for Post-transplant Lymphoproliferative Disorder in a Renal Transplant Recipient: A Case Report

Background

Transplant recipients are at risk of developing progressive multifocal leukoencephalopathy (PML), an opportunistic infection due to reactivation of JC virus. Post-transplant lymphoproliferative disorders (PTLDs) represent a common malignancy in this population, and antiCD20-therapy has become an established component of its treatment.

碱性成纤维细胞生长因子对缺血再灌注损伤后肠道细胞信号转导途径的影响

目的：观察给予外源性碱性成纤维细胞生长因子（bFGF)后大鼠肠道细胞信号转导途径细胞外信号调节激酶（p42/p44MAPK)活性的变化,并探讨外源性bFGF对大鼠肠缺血-再灌注（I-R）损伤保护作用的分子机制。方法：以大鼠肠系膜上动脉（SMA）夹闭造成肠道缺血-再灌注模型,并将动物随机分为假手术组,生理盐水对照组,bFGF抗体预处理组及bFGF治疗组,各组分别于缺血45分钟及再灌注后2、6、24和48小时活杀动物,取血及小肠组织标本,检测血浆中二胺氧化酶（DAO）含量及组织中磷酸化p42/p44MAPK的活性。结果：缺血-再灌注损伤可激活p42/p44MAPK信号转导途径,磷酸化p42/p44MAPK在小肠的绒毛及隐窝部的上皮细胞及绒毛的基质细胞中均有表达,与生理盐水对照组及bFGF抗体预处理组相比,bFGF治疗组磷酸化p42/p44MAPK的表达被快速激活,于再灌注后2小时即达高峰,而其它2组在6小时达峰值,血浆DAO变化及HE染色显示,再灌注后6小时肠屏障功能损伤最严重,而bFGF治疗组损伤在伤后48小时较其它2组有所减轻。结论：I-R损伤可激活p42/p44MAPK信号转导途径,而外源性bFGF可使p42/p44MAPK表达的峰值提前,提示bFGF对肠道缺血-再灌注损伤后屏障功能的保护作用可能与信号转导途径p42/p44MAPK的早期激活有关。     

A vaccine against Alzheimer`s disease: anything left but faith?

Introduction: Alzheimer’s disease looms as a profound and growing threat to future human health. The disease is thought to be primarily driven by aberrant proteolysis of the amyloid precursor protein (APP) and amyloid beta (Aβ) plaque deposition.

Areas covered: We provide an overview of the molecular pathology that leads to an increase in Aβ peptide accumulation, of the mechanism of action for antibody mediated therapies and of the therapeutic vaccines that target Aβ under development. We also discuss the rationale for using vaccines in the early stages of the disease.

Expert opinion: The major components of β-amyloid plaques are Aβ_1-42 and Aβ_1-40 peptides derived from the APP. Reducing these plaques by means of passive or active vaccination against Aβ-peptides has been a long-running endeavor but with disappointing results as the impact on disease progression has been minimal. The data gathered to date could suggest that antibodies do not work, mainly because the studies have not been performed in an optimal fashion. The emerging views are that patients should be treated earlier, ideally in the prodromal or symptom free stage, antibody levels have to be high and the correct epitope must be targeted. More clinical trials to fully explore the potential of vaccines are therefore warranted.